All About Maxicare

[sweetscience]

Share with us your maxicare experiences.. kung ano ano yung mga na-aavil niyong services, ano anong hospitals/doctors ang accredited, your rants and raves

Me, thank God di ako masyado sakitin, pero nayu-utilize ko naman ang maxicare ko, consult lang ng consult sa doctor even sa derma usually lab tests din (xray, blood test, urinalysis, etc) at APE..

Looking forward na magamit ko na ang maternity benefit ng maxicare platinum ko

[sweetscience]

By the way, dati sa megaclinic ako lagi nagpapa-consult.. pero ngayon di na sila accredited kaya clinica manila na lang ako nagpa-lab test yesterday.. sa medical city, pag weekend sobrang haba ng pila sa maxicare office para kumuha ng referral letter.. pero after that ok na

[jpeach]

Hi, sis. MaxiCare Platinum din ako c/o my husband, yun ang HMO sa office nila e. So far, we've been able to avail labs, check-ups and meds for my pregnancy. Ano pa ba ang mga maternity benefits ng MaxiCare? When I give birth, other than yung room and hospital charges, what else ang covered? How about mga PF? Sana you can share yung mga alam mo, sis. Sayang naman kasi kung hindi namin ma-maximize yung benefits.

[myleia27]

I used Maxicare maternity benefits when I gave birth last 2010. May limit lang ako on how much I can spend for the maternity pero mas malaki ang availment kapag CS. The sa final bill bahala na si Maxicare on how they divide my availament. So fa, here's what I had:

Maganda kasi sa OB nung na emergency CS ako, ang hinanap nya na Anesthesiologist at OB assist ay Maxicare accredited din. Narinig ko pa nga siya nagtatanong sa nurse to verify if Maxicare accredited yung 2. Turns out to be very helpful, kasi sa lahat ng doctors ko 3k lang ang cash out ko na prof fee na excess from Maxicare and Philhealth deductions. my OB's almost 30k, Anes is around 18k, plus yung OB assist pa.

For hospital and room charges, as far as I remember sa bill ko, they shouldered around half or more than half of the ff:

1. Operating Room Use/Charges
2. Availed in patient medicines and medical supplies
3. Follow up laboratory stuff
4. Room and Board

The rest Philhealth na ang deduction so almost nag zero ang mga charges nyan. Siguro mga almost 2k lang natira for cash out.

They didn't cover any of the expenses for my baby. After 3 months, I was able to enroll her na sa Maxicare. Actually, all of us sa family are enrolled. Really really helpful for me because I can reimburse out patient medicines, and our plan covers confinement and procedures in major hospitals such as TMC, St Lukes, etc.

[sarahsensible]

For outpatient nababagalan talaga ako sa Maxicare ( we frequent st.lukes QC kapag checkup ng kids ko ) ..taking their sweet time sa pag print ng referral at sa pag swipe... sa Medicard kasi ang bilis naman, nasanay siguro ako.

AFAIK, ang maternity coverage depende sa company yan. Usually HMO's cover pre-natal and post-natal lang talaga (lalo na raw sa mga BPO) Pero pag nagkasundo naman sa company na may maternity talaga, may certain amount depending kung Normal or CS.

Ang healthway dito sa SM The Block hindi daw tumatanggap ng maxicare? pero sa ibang healthway tumatanggap daw.

Sa in-patient, wala namang problema unless yung room na kasama sa benefits mo hindi available, you have to wait or pay for the hours lang na nagamit mo (kahit Platinum pa ata)

[hunny_ally]

Hi, sis. MaxiCare Platinum din ako c/o my husband, yun ang HMO sa office nila e. So far, we've been able to avail labs, check-ups and meds for my pregnancy. Ano pa ba ang mga maternity benefits ng MaxiCare? When I give birth, other than yung room and hospital charges, what else ang covered? How about mga PF? Sana you can share yung mga alam mo, sis. Sayang naman kasi kung hindi namin ma-maximize yung benefits.

Platinum din kami under my husband's company. Re the maternity benefit I think depende ata sa agreement between the company and maxicar and if whether you're the primary or only a a dependent. When I gave birth last 2010, as a dependent, we were able to get a maternity benefit of Php 20k. I think the amount is higher if CS. But this is for reimbursement ha. I don't know if it's because that's the SOP or it's because my OB is non-maxicare accredited. Pero sa company ng husband ko, 20k Lang talaga for NSD for dependents. Which is more than enough for us since the PFs of our doctors are waived since puro relatives. To know for sure, better ask your husband to inquire with their HR. if i remember correctly I had to submit a sonology report to maxicare through their hr on my first trimester.

[jpeach]

thanks, mga sis. ganon pala yun. iba-iba pala ang arrangement ng maxicare with different companies. sige, i will ask hubby to inquire sa office niya. i will also ask my ob to use maxicare-accredited anesthesiologist and assistant if possible. thanks for the tip!

[scents01]

^yes, iba iba talaga sis..sa maxicare ko with my previous employer, availment is 30k for NSD and 50k for CS, automatic deduction na sa bill..hindi covered ang baby pati OB's assistance if CS..tapos free pre-natal check-ups except lab fees due to pregnancy..

super gamit ko din after pregnancy, kasi ang bilis kong hingalin, mapagod etc..kaya sagot na lab tests like CBC, albumen test, urinalysis, ECG, ultrasound, pati PFs ng maxicare accredited doctos of course..

[*jyn*]

like ko ang maxicare dati... pero last week lang nabadtrip kami sa kanila kasi ang hirap kumuha ng LOA... my hubby had his ESWL for his kidney stone... nahirapan kami kumuha ng LOA kasi aside from busy ang line nila, ang dami pang hinhingi like i-fax sa kanila ang CT scan result at kelangan pa nila kausapin ang doctor... maxicare ang health card ng company nila...

sa badtrip ko, sa intellicare nalang ako humingi ng LOA... ayun, in 5 minutes may LOA nako... dependent ko kasi si hubby sa intellicare provided by my employer...

by April mag-maxicare na rin daw kami... sana maging ok... tsaka may maternity benefits na rin daw which i like, magbubuntis ulit ako next year pag nagkataon

[chefron]

yung family plan ba ng maxicare yung rate nila eh per member ba or for buong family na yun?

[jpeach]

my hubby emailed their hr and they forwarded yung parang guide dun sa benefits nila sa maxicare. natuwa ako kasi kasama yung 3d/4d ultrasound! i wasn't planning on getting that kasi feeling ko unnecessary expense pero kung libre naman, why not??

[chingky]

Hi. I'll join this thread since I'm planning to get a health plan, and I'm considering of Maxicare. After using it, like para masulit, I heard there'll be an increase in your premium for the next year, is this true? How much is the increase, if ever? Thanks!

[polar_bear]

hello..

I'm 8 months pregnant and I'm also under Maxicare Platinum c/o my husband.  The good thing about it, is covered ng maxicare pati ang delivery.  Kasi not all maxicare plans with maternity benefits eh covered ang delivery.  Depende yun tlaga sa agreement ng company at maxicare.  And not all maxicare-accredited doctors eh pumapayag ng delivery under maxicare...sa iba pwede lang maxicare kung pre-natal consultations, labs, ultrasound.. so you have to ask din your OB kung pwede ba syang magpaanak under maxicare.  Naka 3 palit ako ng OB because we didn't know na ganun pala ang rules nila. So we went to Maxicare office and inquired for their maxicare-accredited doctors na nagpeperform din ng delivery.  Sayang namin kc kung hinde mo mamaximize ang HMO diba.. 

[purplerae]

saan po ba ako makakahanap ng dermatologist na accredited ng maxicare .

[khriseeee]

My company's HMO is Maxicare Platinum and when I gave birth last February at Cardinal Santos all my hospital expenses were covered (no cash out except for the internet we got). What was covered (though claimed separately via reimburement) was my OB's PF. She was not maxicare accredited, I was able to claim 15K of her 40K PF. Baby's fees weren't covered also but claimed via reimbursement, another 15K.

What's funny is per our Maxicare schedule, I could get a room of PHP2,000/night under Maxicare and anything in excess would be charged to us. However we got a big private room at PHP 2,500/night and it was still fully covered by Maxicare.

All in all, I was very happy with the experience - I showed my card when I was admitted to the labor room and a Maxicare representative just followed up with my husband afterwards for my card. When my husband went to pay our bill all my expenses were already deducted.

I'm also claiming my baby's vaccinations from Maxicare and so far no problems at all.

[meandmyhoney]

planning to have a maxicare for my mom. since im married hindi ko siya dependent.

gusto ko sana maxicare talaga. meron kaya contact sa mga agent nila??

gusto ko coverage may inpatient/outpatient/ape.

thanks mga sis 

[sarahsensible]

sis khriseeee bongga ng company mo  ganyan din pag sa Accenture ka accordng to my sister

[hanshellite]

Hindi ako natuwa sa first use ko ng maxicare card ko. Hindi naman sa maxicare itself ang rant ko kundi sa doctor kung kanino ako nagpaconsult. It was a saturday kaya madaming tao and mahaba ang pila, more than an hour din akong nagwait sa maxicare center sa makati med to get a referral for an ENT doctor. Ayos lang naman sa akin yun kasi nga saturday. After more than an hour of patiently waiting, nabigyan na rin ako ng referral, but not to my preferred doctor kasi daw mahaba din ang pila sa doctor na yun and busy ang line nung tinatawagan ng maxicare representative. So ni-refer nya ako sa ibang doctor.

And then dun na nagstart yung inis ko sa araw na yun. Excited pa naman akong magamit yung maxicare card kasi first time ever kong magkaroon ng healthcard ( wala kasing healthcard sa previous employer ko). Pagpunta ko sa clinic ng doctor na yun, pinaregister ako and pinawait ng sandali (wala naman kasi syang ibang patients dun).. And then after a while, tinawag na rin ako ng assistant nya. During the consultation, sinabi ko na yung concerns ko. Chineck nya tongue, mouth and nose ko through a stick (parang popsicle stick).. and then after nun, nagreseta na sya ng antibiotic na hindi man lang nya inexplain kung para sa ano yun, kung kailan iinumin, benefits nun, etc ( to think ha di ko maintindihan handwriting nya, sana man lang he gives me an idea about dun sa gamot na nireseta nya). And then after nya ibigay yung small piece of paper na may reseta ng gamot, tumayo na sya agad papunta dun sa computer nya. Nagfollow up question ako. I asked if possible bang may tonsillitis ako. Aba, nagtaray ba naman ang g**o! May tinanong sya sa akin na medical term, kung may nararamdaman ba daw akong ganun. Since di ko naintindihan yung term nya, I asked kung ano yun (kasi hello? di naman ako sa medical field nanggaling noh, di ko talaga alam kung ano yung sinabi nya). Bigla ba naman tumaas ang tono at sinabing: "simple lang, do you have tonsillitis in the past or none. Answerable by yes or no. If none, you don't have to think about it. Ganun lang!"

I really don't like the manner and tone nung pagkakasabi nya. Parang padabog na ewan, then nakatalikod sya sa akin at nakaharap sa computer nya. And after that, kinausap nya na yung assistant nya (na andun lang all the time habang nagcoconsult ang lecheng doctor, kaya mejo awkward din sa akin magkwento about my concerns kasi may ibang taong nakikinig). He talked to his assistant and asked about IT concerns, di ko na matandaan ano yung tinatanong nya dahil nag-init na ang dugo ko nun, about ata sa repair ng laptop nya, basta di na related sa consultation namin. Parang ako dun, Hello? nandun pa kaya ako.. di man lang sya nagsabi na done na kami, or whatever. Parang nung tumayo sya sa chair na, yun na yun ba-bye na! Gagong doctor. May mga ganun pala talagang doctor, first time ko kasing makaencounter ng ganun eh. Lahat naman ng mga doctors na napuntahan ko before, very warm and friendly. So I was expecting na matutulungan nya din ako sa concerns ko.

Parang walang kwenta tuloy ang consultation na yun. Ang tagal kong pumila sa maxicare, tapos pagdating ko sa doctor, wala man lang akong magandang napala.. hayyy!

Now I know why there is no queue in his clinic even on saturdays!

[puglover]

We availed of the corporate plan ng maxicare. Minimum 5 members. Okay siya, walang problema pag naconfine easy procedure lang.. Kaso we didn't renew na kasi parang nadagdagan ng 30% yung price kasi mataas daw availment namin (nasurgery kasi gallstones ng mom ko)

Now my bf has maxicare sa employment nya, gawin nyang dependent si baby. Sinong pedia kaya accredited na okay? Covered ba vaccines!

[jpeach]

^ sis, patanong mo sa bf mo kung ano covered. he can ask sa hr ng company or call maxicare hotline. iba-iba kasi ang coverage, depende sa agreement ng maxicare at ng company. for us, covered ng maxicare ni hubby yung vaccines. pwede ka rin pala humingi ng list of accredited doctors sa maxicare.