Benefits and Availments

To know more, please choose from the list below

To Watch video below for an overview of Availments Procedure
– Administration of immunization (excluding cost of vaccines)
– Family planning and counseling
– On-going records of medical history
– Medical Management of health problems, health education, counseling on diet and exercise
– Wellness programs/ lecture/seminars based on topic of choice

Annual Physical Examination (APE)
– Medical History
– Physician’s Assessment
– Chest X-ray
– Fecalysis (stool exam)
– Urinalysis (urine exam)
– Complete Blood Count
– ECG for 35 y. o. & above
– Pap smear for female 35 y. o. & above
  • – Consultations & treatments with plan coordinators
    – Referrals to accredited specialists
    – Dressings, sutures, & casts (except fiberglass supplies)
    – Treatment of minor injuries (i.e. laceration, minor burns, sprain, etc.)
    – Minor surgical procedures not requiring confinement
    – Pre/post-natal consultation with accredited OB-gynecologists
  • – Room and board based on member’s plan
    – Professional fees of the attending physicians, surgeons & anesthesiologist
    – Standard nursing services
    – Use of the operating room/recovery room, ICU/CCU
    – Oxygen and inhalation therapy
    – Blood transfusions, including human blood products except gamma globulins
    – BDressings, casts and sutures (except fiberglass supplies)
    – All drugs, medicines and injectables while confined including IV fluids, anesthesia & its administration
    – Prescribed X-rays, laboratory exams & diagnostic procedures
    – Admission kit
    • – Doctors & hospital services
      – Medications used for immediate relief of symptoms
      – Standard nursing services
      – Dressings and sutures for wound; casts (except fiberglass supplies)
      – Prescribed X-rays, laboratory exams & diagnostic procedures
      – Other medical services related to the emergency management which are deemed necessary to the treatment of the case.
      – Emergency care in areas without accredited hospitals reimbursable up to
      – Maximum Coverage Benefit (MCB) based on VC Relative Units globulins;
      1. Non-accredited hospitals
      2. Foreign territories while on official business trip
      – reimbursable up to P30,000
      – 80% of applicable hospital bills
      – 100% of PF based on ValuCare Relative Values
AVAILMENTS PROCEDURES

  • – Doctors & hospital services
    – Emergency cases at medical facilities not accredited by ValuCare may be reimbursed up to P30,000
    – Emergency cases on official business trip outside Philippine territory may be reimbursed up to P 30,000
  • – Reimbursements will be based on the schedule below:
    1. 80% on Room & Board, based on the member’s plan
    2. 80% on medicines, laboratory/diagnostic procedures
    3. 100% of the physicians fee, based on ValuCare rates
  • PERSONALIZED ACCESS TO LABORATORY SERVICES Blood tests requiring fasting done at HOME or at the OFFICE at no extra cost.

    *NOTE: PALS is initially available in Metro Manila area only.