INHEALTH BIZ

Comprehensive Health

for SMEs

Health is the way forward for your business.

Everyone counts (on you)

Because you prioritize them, your staff look to you as  more than just an employer but as a leader.

Effective health benefits for every employee

With Insular Health Care’s commitment to quality health care, this comprehensive yet affordable health care maintenance program is made specifically for small and medium entrepreneurs.

Out-Patient Benefits

This includes annual physical examination, preventive health care such as Immunization Administration and Health Education Counseling on diet or exercise, and other out-patient services like Medical Consultation and First Aid Treatment.

In-Patient Benefits

This includes services of all accredited Physicians including surgical services, room and board, general nursing service, and other services or supplies deemed medically necessary.

Emergency Care Benefits

Such as ambulance services, emergency care-related procedures in accredited and non-accredited hospitals, and room upgrade.

Summary of Plan Benefits for InHealth Biz

Membership Fees
Plan I (Any accredited Hospital including top 9 major Hospitals)
  • Asian Hospital Medical Center (AHMC) 
  • Makati Medical Center (MMC) 
  • Cardinal Santos Medical Center (CSMC) 
  • St. Luke’s Medical Center – Quezon City (SLMC-QC) 
  • The Medical City (TMC) 
  • St. Luke’s Medical Center – Global (SLMC-GC) 
  • Cebu Doctor’s Hospital (CDH),
  • Chong Hua Hospital (CHH) 
  • Davao Doctor’s Hospital (DDH)
Accommodation Benefit Limit* VAT-INCLUSIVE MEMBERSHIP FEES
Annual Semi-Annual Quarterly
PRINCIPAL
Private 150,000 17,950 9,514 4,847
Semi-Private 80,000 14,485 7,677 3,911
Ward 70,000 11,995 6,357 3,239
DEPENDENT
Private 150,000 24,480 12,974 6,610
Semi-Private 80,000 19,530 10,351 5,273
Ward 70,000 16,175 8,573 4,367

*Note: Maximum Benefit Limit (MBL) per illness per injury per year

Plan II (Any accredited Hospital excluding top 9 major Hospitals)
  • Asian Hospital Medical Center (AHMC)
  • Makati Medical Center (MMC)
  • Cardinal Santos Medical Center (CSMC)
  • St. Luke’s Medical Center – Quezon City (SLMC-QC)
  • The Medical City (TMC)
  • St. Luke’s Medical Center – Global (SLMC-GC)
  • Cebu Doctor’s Hospital (CDH),
  • Chong Hua Hospital (CHH)
  • Davao Doctor’s Hospital (DDH)
Accommodation Benefit Limit* VAT-INCLUSIVE MEMBERSHIP FEES
Annual Semi-Annual Quarterly
PRINCIPAL
Semi-Private 150,000 14,325 7,592 3,868
Private 80,000 11,575 6,135 3,125
Ward 70,000 9,585 5,080 2,588
DEPENDENT
Semi-Private 150,000 19,515 10,343 5,269
Private 80,000 15,600 8,268 4,212
Ward 70,000 12,905 6,840 3,484

*Note: Maximum Benefit Limit (MBL) per illness per injury per year

 

OTHER FEES (*** One-Time Fee)

  1. Open Door Dental 370.00 per member per year***
  2. Life (Group Term) / AD&D
    • OPTION I: P 20,000 105.00 per principal per year***
    • OPTION II: P 50,000 262.50 per principal per year***

ADDITIONAL BENEFITS

  1. Open Door Dental Benefits
    • Fees for Dental benefit should be on a one-time basis only.
  2. P 20,000 or P 50,000 Life (Group Term) Insurance with AD&D for employees only.
    • Fees for Life (Group Term) Insurance with AD&D should be on a one-time basis only.

NOTES

  1. Guaranteed room upgrade for the first 24 hours.
  2. Standard program provisions for In Health Biz effective 1 February 2017 shall apply.
  3. Above rates are inclusive of 12% VAT.
  4. Type of payment for Principals is Non-contributory (subject to 100% enrollment by all eligible employees).
  5. Eligibility Requirement for Principal: 
    • All regular employees of THE COMPANY at least 18 years to less than 65 years old.
  6. Benefits include coverage for Basic Annual Physical Examination (APE).
  7. Plan and benefits should be uniform or according to Rank/Position/Classification. Dependent’s plan shall in no way be superior over their respective principal.
  8. Applicable for accounts with less than 10% field based, non-office based employees only.
  9. Coverage may only be activated 5 working days from date of payment.
  10. Program shall be subject to the following provisions:
    • Extra-ordinary inflation
    • Imposition of new government tax
    • Extra-ordinary increase of hospital costs (more than 30%
  11. Waiver of application form subject to submission of electronic data (E-data)
  12. Non-Philhealth integrated benefits for non-philhealth members only. (Members should be declared prior to start of coverage).
  13. Without access to Healthway Medical Clinics, Inc. and American Eye Center.
  14. Insular Health Care, Inc. exclusions shall apply.
  15. Applicable for group of 20 – 99 enrollees.
Outpatient Benefits
1. Annual Physical Examination

  • Taking of Medical History
  • Physical Examination
  • Chest X-Ray
  • Routine Urinalysis
  • Routine Fecalysis
  • Complete Blood Count (CBC)
  • Electrocardiogram (ECG) for members 35 years old and above, or if indicated
  • Pap Smear for female members 35 years old and above, or if indicated

2. Preventive Health Care

  • Immunization Administration (Only the 1st dose of Anti-Rabies/Anti-Venom/Anti-Tetanus Vaccines are covered – does not include the cost of vaccine and determination of susceptibility)
  • Health Education Counseling on diet or exercise
  • Periodic Monitoring of Health Problems
  • Family Planning Counseling
  • Health education and wellness program (up to 4x a year)
  • Medical information dissemination through clinics, newsletters, seminars, etc.

3. Outpatient Services

  • Medical Consultation during regular clinic hours including specialist evaluation
  • First Aid Treatment of minor injury or illness
  • Minor surgery not requiring confinement
  • Necessary X-rays, laboratory examinations, routine diagnostic and therapeutic procedures
  • Eye, Ear, Nose and Throat (EENT) care
  • Pre and Post Natal Consultations (covered up to MBL)
  • Transfusion of blood and other blood elements (except blood donor screening)
  • Cauterization of Warts except Genital Warts and Condyloma Acuminata (up to 1,000 per member, per year)
  • Speech Therapy (covered up to MBL)
  • Physical Therapy (covered up to MBL)
  • Sclerotherapy – must be medically necessary and recommended by an affiliated vascular surgeon and not for aesthetic purpose (covered up to MBL)
Inpatient Benefits
  1. Services of a Physician including surgical services
  2. Room and Board using a “step-ladder” system (lowest to highest); Room amenities (vary according to actual hospital set-up)
  3. General Nursing service
  4. Use of Operating Room and Recovery Room
  5. Anesthesia and its administration
  6. Drugs and Medications during confinement
  7. Confinement in Intensive Care Unit
  8. Other Services/Supplies deemed medically necessary such as but not limited to:
    • Oxygen and its administration
    • Dressing, Sutures, Cast (Plaster of Paris or fiberglass cast ) and other medical supplies
    • Laboratory Tests and other necessary diagnostic service
    • Transfusion of blood and other blood elements except donor-screening services
  9. Assistance in administrative requirements through a Liaison Officer
  10. Admission Kit
Emergency Care Benefits
  1. Ambulance Services (Hospital to Hospital Transfer Only)
    • Accredited to Accredited Hospital Transfer (covered up to Php 3, 500)
    • Non-Accredited to Accredited Hospital Transfer (covered up to Php 3, 500)
  2. In Accredited Hospitals, coverage is as follows:
    • Professional Fees of Attending Physicians
    • Emergency Room Fees
    • Medicines, blood transfusions, intravenous fluids, oxygen, dressings, sutures and casts
    • X-ray, laboratory and other diagnostic examinations
    • Treatment of laceration, pains and other minor injuries
    • Dressing, sutures and cast (Plaster of Paris or fiberglass cast)
    • First dose of anti-rabies, anti-venom and anti-tetanus vaccines.
  3. In Non-Accredited Hospitals /Areas with no Accredited Clinic or Hospitals / Areas outside the Philippines
    • Reimbursable up to 80% of the Total Hospital Bills including professional fees on RVS or Php 15,000 (Php 10,000 or HB and Php 5,000 for PF), whichever is less
  4. Room Upgrade (In case of unavailability)
    • Covered for the first 24 hours for genuine emergency cases only – except Suite Accommodation
Other Benefits / Special Services
  1. Motor Vehicular Accidents
  2. Coverage for newer modalities (up to Php 5,000 per member, per year)
  3. Unprovoked Assault (Up to MBL)
  4. Work-related Illnesses or Injuries – ECC Cases (Up to MBL)
  5. Congenital Conditions (Up to Php 25,000 per member, per year)
Complex Diagnostic Procedures
 

The following are covered up to MBL, except for some procedures, as indicated:

  1. Lithotripsy
  2. Laparoscopic Cholecystectomy (LapChole), Adrenalectomy, Hernioplasty / Herniorrhaphy / Herniotomy, Oophorectomy/ Oophorocystectomy and alll other laparoscopic procedures for diagnostic purposes
  3. All other laparoscopic procedures for therapeutic purposes (up to Php 20,000 per year)
  4. Cryosurgery
  5. Angiogram and/or Angioplasty/Coronary Artery Bypass Graft
  6. Chemotherapy/ Radiotherapy
  7. Dialysis
  8. Computed Tomography Scans (CT Scan)
  9. Magnetic Resonance Imaging (MRI) & Magnetic Resonance Angiogram (MRA)
  10. Functional Endoscopic Sinus Surgery (FESS)
  11. Nuclear medicine procedures
    • Thyroid Scan
    • Thallium Scintigraphy / Thallium Stress Test
    • Sestamibi Stress Test / Hexamibi
    • Radioactive Isotope Scan
    • HIDA Scan
    • Radionuclide Renography
    • Body Metastatic Survey
    • Bone Scan / Imaging / Densitometry
    • Dacryoscintigraphy
    • Gastric Scintigraphy
    • Glomerular Filtration Rate
    • Liver or Spleen Imaging
    • Tetro Rest and Stress
    • Thyroid Imaging / Scintigraphy
  12. Other nuclear medicine procedures (up to Php 5,000 per session)
  13. Laser eye procedures such as Laser Iridotomy /Iridectomy,Yag Laser, and Argon Laser (up to Php 5,000)
  14. All other Laser Eye Procedures except Photorefractive Keratectomy – one session per eye per year (up to Php 5,000)
  15. All other Laser procedures (up to Php 5,000)
  16. Mammography and Sonomammogram
  17. Transurethral Microwave Therapy of Prostate (up to Php 30,000 per session)
  18. Gamma Knife Surgery
  19. Heart Surgery
  20. Arthroscopic Procedures
  21. Hysteroscopic Procedures (Myomectomy, D&C and Polypectomy)
  22. Ultrasound (except Maternity Cases)
  23. Benign Prostatic Hyperplasia
  24. 2D Echo with Doppler
  25. 24 Hour Holter Monitoring
  26. Herniorraphy
  27. Electromyography
  28. Treadmill Stress Test
  29. Myelogram
  30. Video Gastroscopy
  31. Endoscopic Procedures for diagnostic purposes
  32. Endoscopic Procedures for therapeutic purposes (up to Php 5,000 per session)
  33. PET Scan (up to Php 5,000 per session) 
  34. Percutaneous Ultrasonic Nephrolithotomy – one session per contract per year (up to Php 40,000)
  35. Perfusion Scan
  36. Stereotactic Brain Biopsy (up to Php 20,000)
Pre-Existing Conditions (PECs)
Pre-existing conditions without exclusions are covered up to the Benefit Limit of the Program for Principals and Dependents subject to 100% enrollment of eligible principal members.

  1. Dreaded Illnesses
  2. Non-Dread Illnesses
Optional Benefits
Dental Care Benefits

Provided by the Filipino Doctors Preventive Healthcare Management, Inc.

  1. Preventive Services
    • Unlimited Consultations
    • Oral Hygiene Instruction
    • Oral Prophylaxis – mild to moderate (once a year)
    • Annual Dental Examination
  2. Restorations
    • Unlimited Temporary Fillings
    • Light Cure Filling – 2 Surfaces
    • Unlimited recementation of jacket crown inlays and onlays
    • Unlimited Simple Tooth extraction except surgery for impaction
  3. Dentures and Orthodontics
    • Adjustment of Dentures – limited to adjustment of clasp
    • Orthodontic Consultation
    • Aesthetic Dental Consultation
    • Dental education and counselling
  4. Treatments
    • Treatment for lesions, wounds and burns
    • Treatment of Dental related pain excluding cost of prescribed medicines
    • Relief and/or prescription for acute dental pain
    • Emergency desensitization of hypersensitive teeth
    • Gum Treatment(except gum surgery)excluding cost of prescribed medicines. This shall include the management of other dental problems excluding surgeries
Group Term Life Insurance With Insular Life

A financial assistance shall be given to the principal member’s beneficiary / ies in case of natural death..

Accidental Death and Disability

If the insured individual suffers, directly and independently of all other causes, any accidental bodily injury / loss within one hundred eighty days (180) days after due date of the accident causing the injury / loss, the Company shall pay the indemnities set in the Schedule of Indemnities.

LOSS Indemnity
Life The Sum Insured
Both Hands The Sum Insured
Both Feet The Sum Insured
Sight of Both Eyes The Sum Insured
One Hand and One Foot The Sum Insured
Sight of One Eye and One Hand; or Sight of One Eye and One Foot The Sum Insured
One Hand or One Foot or Sight of One Eye 1/2 of the Sum Insured

 

Program Features
Network of Accredited Providers
1. Hospital and Clinics 1,019
2. Doctors 32,000
3. Dentists 2,071
4. Primary Care Centers 1
Customer Care
1. 24/7 Hotline Yes
Membership Guidelines
  1. Membership Eligibility
    • Principals – All regular employees age 18 to less than 65 years old
    • Dependents
  2. Philhealth Provision – Integrated
Other Inclusive Benefits
Coverage is as follows:

1. Gullaine-Barre Syndrome Up to MBL/PEC Limit
2. Scoliosis, Spinal Stenosis and Kyphosis Up to Php 25,000
3. All other physical deformities Consultations only
4. Chronic Dermatoses Up to MBL/PEC Limit
5. Chronic Glomerulonephritis and Pyelonephritis Up to MBL/PEC Limit
6. Poliomyelitis Up to MBL/PEC Limit
7. Slipped Disc Up to MBL/PEC Limit
8. Neurologic Diseases and Spinal Stenosis Up to MBL/PEC Limit
9. Diabetes and its Complications Up to MBL/PEC Limit
10. Malignant Tumor Up to MBL/PEC Limit
11. Sleep Study directly related to an organic illness Up to PHP 5,000
12. Vitiligo and Psoriasis Consultations only
13. Pain Management Up to P 3,000 per year
14. Post-operative Analgesia Up to P 3,000 per operation
15. Insular Health Care Mobile App (IMA) Covered
16. VIP Program Covered
17. FREE Clinic Vouchers Covered (1 Clinic Voucher for every 25 members)
18. Access to Lifestyle Partners (Discount) Covered
19. Waiver of Application Form Covered (if applicable)
20. Experience Discount Benefit Covered (if applicable)
21. HMO Card Released within 7 Working Days

Summary of Plan Benefits for InHealth Biz

Membership Fees
Plan I (Any accredited Hospital including top 9 major Hospitals)
  • Asian Hospital Medical Center (AHMC) 
  • Makati Medical Center (MMC) 
  • Cardinal Santos Medical Center (CSMC) 
  • St. Luke’s Medical Center – Quezon City (SLMC-QC) 
  • The Medical City (TMC) 
  • St. Luke’s Medical Center – Global (SLMC-GC) 
  • Cebu Doctor’s Hospital (CDH),
  • Chong Hua Hospital (CHH) 
  • Davao Doctor’s Hospital (DDH)
BENEFIT LIMIT
Principal
Private 80,000
Semi-Private 70,000
Ward 150,000
Dependent
Private 80,000
Semi-Private 70,000
Ward 150,000
VAT-INCLUSIVE MEMBERSHIP FEES
ANNUAL
Principal
Private 17,950
Semi-Private 14,485
Ward 11,995
Dependent
Private 24,480
Semi-Private 19,530
Ward 16,175
SEMI-ANNUAL
Principal
Private 9,514
Semi-Private 7,677
Ward 6,357
Dependent
Private 12,974
Semi-Private 10,351
Ward 8,573
QUARTERLY
Principal
Private 4,847
Semi-Private 3,911
Ward 3,239
Dependent
Private 6,610
Semi-Private 5,273
Ward 4,367

*Note: Maximum Benefit Limit (MBL) per illness per injury per year

 

Plan II (Any accredited Hospital excluding top 9 major Hospitals)
  • Asian Hospital Medical Center (AHMC)
  • Makati Medical Center (MMC)
  • Cardinal Santos Medical Center (CSMC)
  • St. Luke’s Medical Center – Quezon City (SLMC-QC)
  • The Medical City (TMC)
  • St. Luke’s Medical Center – Global (SLMC-GC)
  • Cebu Doctor’s Hospital (CDH),
  • Chong Hua Hospital (CHH)
  • Davao Doctor’s Hospital (DDH)
BENEFIT LIMIT
Principal
Private 150,000
Semi-Private 80,000
Ward 70,000
Dependent
Private 150,000
Semi-Private 80,000
Ward 70,000

VAT-INCLUSIVE MEMBERSHIP FEES
ANNUAL 
Principal
Private 14,325
Semi-Private 11,575
Ward 9,585
Dependent
Private 19,515
Semi-Private 15,600
Ward 12,905
SEMI-ANNUAL
Principal
Private 7,592
Semi-Private 6,135
Ward 5,080
Dependent
Private 10,343
Semi-Private 8,268
Ward 6,840
QUARTERLY
Principal
Private 3,868
Semi-Private 3,125
Ward 2,588
Dependent
Private 5,269
Semi-Private 4,212
Ward 3,484

*Note: Maximum Benefit Limit (MBL) per illness per injury per year

 

OTHER FEES (*** One-Time Fee)

  1. Open Door Dental 370.00 per member per year***
  2. Life (Group Term) / AD&D
    • OPTION I: P 20,000 105.00 per principal per year***
    • OPTION II: P 50,000 262.50 per principal per year***

ADDITIONAL BENEFITS

  1. Open Door Dental Benefits
    • Fees for Dental benefit should be on a one-time basis only.
  2. P 20,000 or P 50,000 Life (Group Term) Insurance with AD&D for employees only.
    • Fees for Life (Group Term) Insurance with AD&D should be on a one-time basis only.

NOTES

  1. Guaranteed room upgrade for the first 24 hours.
  2. Standard program provisions for In Health Biz effective 1 February 2017 shall apply.
  3. Above rates are inclusive of 12% VAT.
  4. Type of payment for Principals is Non-contributory (subject to 100% enrollment by all eligible employees).
  5. Eligibility Requirement for Principal: 
    • All regular employees of THE COMPANY at least 18 years to less than 65 years old.
  6. Benefits include coverage for Basic Annual Physical Examination (APE).
  7. Plan and benefits should be uniform or according to Rank/Position/Classification. Dependent’s plan shall in no way be superior over their respective principal.
  8. Applicable for accounts with less than 10% field based, non-office based employees only.
  9. Coverage may only be activated 5 working days from date of payment.
  10. Program shall be subject to the following provisions:
    • Extra-ordinary inflation
    • Imposition of new government tax
    • Extra-ordinary increase of hospital costs (more than 30%
  11. Waiver of application form subject to submission of electronic data (E-data)
  12. Non-Philhealth integrated benefits for non-philhealth members only. (Members should be declared prior to start of coverage).
  13. Without access to Healthway Medical Clinics, Inc. and American Eye Center.
  14. Insular Health Care, Inc. exclusions shall apply.
  15. Applicable for group of 20 – 99 enrollees.
Outpatient Benefits
1. Annual Physical Examination

  • Taking of Medical History
  • Physical Examination
  • Chest X-Ray
  • Routine Urinalysis
  • Routine Fecalysis
  • Complete Blood Count (CBC)
  • Electrocardiogram (ECG) for members 35 years old and above, or if indicated
  • Pap Smear for female members 35 years old and above, or if indicated

2. Preventive Health Care

  • Immunization Administration (Only the 1st dose of Anti-Rabies/Anti-Venom/Anti-Tetanus Vaccines are covered – does not include the cost of vaccine and determination of susceptibility)
  • Health Education Counseling on diet or exercise
  • Periodic Monitoring of Health Problems
  • Family Planning Counseling
  • Health education and wellness program (up to 4x a year)
  • Medical information dissemination through clinics, newsletters, seminars, etc.

3. Outpatient Services

  • Medical Consultation during regular clinic hours including specialist evaluation
  • First Aid Treatment of minor injury or illness
  • Minor surgery not requiring confinement
  • Necessary X-rays, laboratory examinations, routine diagnostic and therapeutic procedures
  • Eye, Ear, Nose and Throat (EENT) care
  • Pre and Post Natal Consultations (covered up to MBL)
  • Transfusion of blood and other blood elements (except blood donor screening)
  • Cauterization of Warts except Genital Warts and Condyloma Acuminata (up to 1,000 per member, per year)
  • Speech Therapy (covered up to MBL)
  • Physical Therapy (covered up to MBL)
  • Sclerotherapy – must be medically necessary and recommended by an affiliated vascular surgeon and not for aesthetic purpose (covered up to MBL)
Inpatient Benefits
  1. Services of a Physician including surgical services
  2. Room and Board using a “step-ladder” system (lowest to highest); Room amenities (vary according to actual hospital set-up)
  3. General Nursing service
  4. Use of Operating Room and Recovery Room
  5. Anesthesia and its administration
  6. Drugs and Medications during confinement
  7. Confinement in Intensive Care Unit
  8. Other Services/Supplies deemed medically necessary such as but not limited to:
    • Oxygen and its administration
    • Dressing, Sutures, Cast (Plaster of Paris or fiberglass cast ) and other medical supplies
    • Laboratory Tests and other necessary diagnostic service
    • Transfusion of blood and other blood elements except donor-screening services
  9. Assistance in administrative requirements through a Liaison Officer
  10. Admission Kit
Emergency Care Benefits
  1. Ambulance Services (Hospital to Hospital Transfer Only)
    • Accredited to Accredited Hospital Transfer (covered up to Php 3, 500)
    • Non-Accredited to Accredited Hospital Transfer (covered up to Php 3, 500)
  2. In Accredited Hospitals, coverage is as follows:
    • Professional Fees of Attending Physicians
    • Emergency Room Fees
    • Medicines, blood transfusions, intravenous fluids, oxygen, dressings, sutures and casts
    • X-ray, laboratory and other diagnostic examinations
    • Treatment of laceration, pains and other minor injuries
    • Dressing, sutures and cast (Plaster of Paris or fiberglass cast)
    • First dose of anti-rabies, anti-venom and anti-tetanus vaccines.
  3. In Non-Accredited Hospitals /Areas with no Accredited Clinic or Hospitals / Areas outside the Philippines
    • Reimbursable up to 80% of the Total Hospital Bills including professional fees on RVS or Php 15,000 (Php 10,000 or HB and Php 5,000 for PF), whichever is less
  4. Room Upgrade (In case of unavailability)
    • Covered for the first 24 hours for genuine emergency cases only – except Suite Accommodation
Other Benefits / Special Services
  1. Motor Vehicular Accidents
  2. Coverage for newer modalities (up to Php 5,000 per member, per year)
  3. Unprovoked Assault (Up to MBL)
  4. Work-related Illnesses or Injuries – ECC Cases (Up to MBL)
  5. Congenital Conditions (Up to Php 25,000 per member, per year)
Complex Diagnostic Procedures
 

The following are covered up to MBL, except for some procedures, as indicated:

  1. Lithotripsy
  2. Laparoscopic Cholecystectomy (LapChole), Adrenalectomy, Hernioplasty / Herniorrhaphy / Herniotomy, Oophorectomy/ Oophorocystectomy and alll other laparoscopic procedures for diagnostic purposes
  3. All other laparoscopic procedures for therapeutic purposes (up to Php 20,000 per year)
  4. Cryosurgery
  5. Angiogram and/or Angioplasty/Coronary Artery Bypass Graft
  6. Chemotherapy/ Radiotherapy
  7. Dialysis
  8. Computed Tomography Scans (CT Scan)
  9. Magnetic Resonance Imaging (MRI) & Magnetic Resonance Angiogram (MRA)
  10. Functional Endoscopic Sinus Surgery (FESS)
  11. Nuclear medicine procedures
    • Thyroid Scan
    • Thallium Scintigraphy / Thallium Stress Test
    • Sestamibi Stress Test / Hexamibi
    • Radioactive Isotope Scan
    • HIDA Scan
    • Radionuclide Renography
    • Body Metastatic Survey
    • Bone Scan / Imaging / Densitometry
    • Dacryoscintigraphy
    • Gastric Scintigraphy
    • Glomerular Filtration Rate
    • Liver or Spleen Imaging
    • Tetro Rest and Stress
    • Thyroid Imaging / Scintigraphy
  12. Other nuclear medicine procedures (up to Php 5,000 per session)
  13. Laser eye procedures such as Laser Iridotomy /Iridectomy,Yag Laser, and Argon Laser (up to Php 5,000)
  14. All other Laser Eye Procedures except Photorefractive Keratectomy – one session per eye per year (up to Php 5,000)
  15. All other Laser procedures (up to Php 5,000)
  16. Mammography and Sonomammogram
  17. Transurethral Microwave Therapy of Prostate (up to Php 30,000 per session)
  18. Gamma Knife Surgery
  19. Heart Surgery
  20. Arthroscopic Procedures
  21. Hysteroscopic Procedures (Myomectomy, D&C and Polypectomy)
  22. Ultrasound (except Maternity Cases)
  23. Benign Prostatic Hyperplasia
  24. 2D Echo with Doppler
  25. 24 Hour Holter Monitoring
  26. Herniorraphy
  27. Electromyography
  28. Treadmill Stress Test
  29. Myelogram
  30. Video Gastroscopy
  31. Endoscopic Procedures for diagnostic purposes
  32. Endoscopic Procedures for therapeutic purposes (up to Php 5,000 per session)
  33. PET Scan (up to Php 5,000 per session) 
  34. Percutaneous Ultrasonic Nephrolithotomy – one session per contract per year (up to Php 40,000)
  35. Perfusion Scan
  36. Stereotactic Brain Biopsy (up to Php 20,000)
Pre-Existing Conditions (PECs)
Pre-existing conditions without exclusions are covered up to the Benefit Limit of the Program for Principals and Dependents subject to 100% enrollment of eligible principal members.

  1. Dreaded Illnesses
  2. Non-Dread Illnesses
Optional Benefits
Dental Care Benefits

Provided by the Filipino Doctors Preventive Healthcare Management, Inc.

  1. Preventive Services
    • Unlimited Consultations
    • Oral Hygiene Instruction
    • Oral Prophylaxis – mild to moderate (once a year)
    • Annual Dental Examination
  2. Restorations
    • Unlimited Temporary Fillings
    • Light Cure Filling – 2 Surfaces
    • Unlimited recementation of jacket crown inlays and onlays
    • Unlimited Simple Tooth extraction except surgery for impaction
  3. Dentures and Orthodontics
    • Adjustment of Dentures – limited to adjustment of clasp
    • Orthodontic Consultation
    • Aesthetic Dental Consultation
    • Dental education and counselling
  4. Treatments
    • Treatment for lesions, wounds and burns
    • Treatment of Dental related pain excluding cost of prescribed medicines
    • Relief and/or prescription for acute dental pain
    • Emergency desensitization of hypersensitive teeth
    • Gum Treatment(except gum surgery)excluding cost of prescribed medicines. This shall include the management of other dental problems excluding surgeries
Group Term Life Insurance With Insular Life

A financial assistance shall be given to the principal member’s beneficiary / ies in case of natural death..

Accidental Death and Disability

If the insured individual suffers, directly and independently of all other causes, any accidental bodily injury / loss within one hundred eighty days (180) days after due date of the accident causing the injury / loss, the Company shall pay the indemnities set in the Schedule of Indemnities.

LOSS Indemnity
Life The Sum Insured
Both Hands The Sum Insured
Both Feet The Sum Insured
Sight of Both Eyes The Sum Insured
One Hand and One Foot The Sum Insured
Sight of One Eye and One Hand; or Sight of One Eye and One Foot The Sum Insured
One Hand or One Foot or Sight of One Eye 1/2 of the Sum Insured

 

Program Features
Network of Accredited Providers
1. Hospital and Clinics 1,019
2. Doctors 32,000
3. Dentists 2,071
4. Primary Care Centers 1
Customer Care
1. 24/7 Hotline Yes
Membership Guidelines
  1. Membership Eligibility
    • Principals – All regular employees age 18 to less than 65 years old
    • Dependents
  2. Philhealth Provision – Integrated
Other Inclusive Benefits
Coverage is as follows:

1. Gullaine-Barre Syndrome Up to MBL/PEC Limit
2. Scoliosis, Spinal Stenosis and Kyphosis Up to Php 25,000
3. All other physical deformities Consultations only
4. Chronic Dermatoses Up to MBL/PEC Limit
5. Chronic Glomerulonephritis and Pyelonephritis Up to MBL/PEC Limit
6. Poliomyelitis Up to MBL/PEC Limit
7. Slipped Disc Up to MBL/PEC Limit
8. Neurologic Diseases and Spinal Stenosis Up to MBL/PEC Limit
9. Diabetes and its Complications Up to MBL/PEC Limit
10. Malignant Tumor Up to MBL/PEC Limit
11. Sleep Study directly related to an organic illness Up to PHP 5,000
12. Vitiligo and Psoriasis Consultations only
13. Pain Management Up to P 3,000 per year
14. Post-operative Analgesia Up to P 3,000 per operation
15. Insular Health Care Mobile App (IMA) Covered
16. VIP Program Covered
17. FREE Clinic Vouchers Covered (1 Clinic Voucher for every 25 members)
18. Access to Lifestyle Partners (Discount) Covered
19. Waiver of Application Form Covered (if applicable)
20. Experience Discount Benefit Covered (if applicable)
21. HMO Card Released within 7 Working Days

Own a Business? Lead Your People to Health.

Because human capital is the most crucial asset of all.

Insular Head Office

2/F Insular Health Care Building, 167 Dela Rosa corner Legazpi Street, Legazpi Village, Makati City 1229, Metro Manila, Philippines

Contact Numbers:

(632) 893-5952

(632) 813-0131 to 0136

24/7 support through Insular Health Care’s Call Center (Toll Free Number 1-800-10-8177857)

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