HMO companies have their respective network of hospitals and doctors. It is best to stick with a partner hospital for optimum insurance benefits. But if it’s not possible, know what to do and expect after getting medical service.
Many health card companies will reimburse what you have spent on a non-accredited hospital. Bear in mind that there is no guarantee that the full amount will be paid back to you.
Maxicare
- Fill out the Maxicare reimbursement form
- Attach medical certificate or signed form by the doctor
- Submit the form and necessary documents to the Claims office (charge slip or BIR registered receipts)
Medicard
- Fill out the claim form
- Submit to reimbursementreceiving@medicardphils.com
Philcare
- Fill out the form from Philcare
- Philcare Claim Form
- Submit at the branch of account
Valucare
- Fill out the Valucare reimbursement form
- Submit the completed form at the Valucare head office
- File a claim within 30 days for Metro Manila and 60 days for provincial
It is understandable that emergencies may not always permit the use of an accredited hospital’s facility. For example, remote locations may have limited hospitals within your health card’s network. In this situation, the HMO will reimburse whatever you spend on hospital care.
Once you have filed for reimbursement, you may wait until further notice for its approval. It may take up to 14 business days or more before you can get an update. In some cases, it may take only a few days depending on company policy.
Will I Receive Cash?
Is reimbursement paid on a cash basis? It all depends on the policy of the HMO. Some may provide a check equivalent to your expenses while others may be in the form of crediting. Ask your provider what to expect when they reimburse.
Going to affiliate hospitals of HMO ensures that your medical expenses are covered. If you are near one, it is best that you proceed with the treatment and use your account.
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