Frequently asked questions

The PhilCare unli-CONSULT plan allows you to avail of unlimited out-patient consultation services for 12 months from its nationwide network of medical specialists and dentists.

No, the consultation plan is only for an out-patient consultation. You can seek out-patient consultation from PhilCare-accredited physicians you can find here: PhilCare Consultation Cards.

The consultation plan is not transferable once successfully registered. The name entered during registration will be the recognized PhilCare member.

Registration can be done via online Click here to Register. Coverage is effective four (4) calendar days from registration date. By registering, you agree to the terms and conditions of PhilCare.

The count of one (1) year starts once the plan is activated. Plan is activated four (4) days from registration date.

You will receive an email confirmation informing you if registration is successful or not, and if there’s a data concern.

After four (4) calendar days from successful registration, you may avail of consultation services.

Set an appointment with the doctor. You must bring:

• Letter of Authorization (LOA)
• Personalized member card
• Valid ID

Consultation must be done within 3 calendar days from LOA issuance.

1. Go to philcare.com.ph/consultationcards
2. Input your certificate number, birthdate, and birthplace
3. Select doctor and area
4. Download the LOA and member card

No. You must present the LOA to the doctor for consultation approval and billing.

Yes, one LOA is needed per consultation. Each will have a unique approval code.

No limit on number of consultations per day. Just generate separate LOAs.

LOAs are self-generated online unless the system is down.

Hotline: +63 (02) 462-1800 or 1-800-1888-3210 (PLDT)

Yes, except for ENT, maternity-related, psychiatric, and behavioral conditions whether congenital or acquired.

Download and present the consultation card and a valid ID to the dental clinic. Appointment is recommended.

No, the consultation plan covers only the consultation fee.

No. PhilCare pays the full consultation fee. You should not pay anything extra.

Download PhilCare’s mobile app HeyPhil in Google Play to search for accredited clinics and hospitals. You may also click the following link to view your list of accredited clinics and hospitals: List of Accredited Clinics or Hospitals

Non-covered diseases under your plan are based on your health plan.

For individual members, please pay ₱40.00 and the corresponding delivery charge based on your location (Metro Manila – ₱65.00, Luzon – ₱75.00, Visayas – ₱95.00, Mindanao – ₱110.00) in any of our payment centers and submit an affidavit of loss and a copy of the deposit slip through fax to (02) 8027311 local 19235 or email marcela.villados@philcare.com.ph. Indicate “Lost ID card replacement” as subject.

For corporate accounts, coordinate with your HR and submit an updated Membership Update Form and Affidavit of Loss. Expect card delivery within 10 working days.

Your PhilCare certificate number is printed in front of your health plan with “Cert# 0000000000”. You may also call (02) 462-1800 or 1-800-1888-3230 (PLDT) to verify.

Online appointments are not yet available. You may call or visit PhilCare clinics to make an appointment for consultation or availment. PhilCare Owned Clinic Network - schedule and contact information.

You may call (02) 462-1800 or 1-800-1888-3230 for PLDT. We’ll provide an estimate based on utilization but it may not be 100% accurate if some availments are pending encoding.

You may access the forms through the following link.

Yes, you may still apply under Individual Plans. For quotation, call (02) 802-7333 local 19216/19224 or email customercare@philcare.com.ph.

Yes, PhilCare offers clinic bundle plans and ER prepaid plan products that are giftable for your loved ones.

Pre-existing conditions is covered. The only exceptions are maternity-related cases and cases related to all forms of behavioural disorders, developmental or psychiatric disorders and psychosomatic illnesses whether acquired or congenital.

The following are the diseases and conditions in which the emergency and hospitalization health plans cannot be used. No health care benefits shall be paid for the following services, procedures or conditions. This is not a complete list of non-covered illnesses and diseases. PhilCare reserves the right to the final interpretation of all definition, provisions and articles relating to the health plans.

A. List of diseases not covered but not limited to:

Anal fistulae / Asthma / Auto immune conditions / Cardiovascular diseases / Calculi of the urinary system / Cataracts / Sinus conditions requiring surgery / Cerebrovascular diseases / Cholecystitis/cholelithiasis / Chronic skin conditions / Cirrhosis of the liver / Collagen disease / Degenerative conditions / Diabetes mellitus / Diseased tonsils requiring surgery / Endometriosis / Epilepsy / Gastric or duodenal ulcer / Hallux valgus / Hemorrhoids / Hernia / HIV/AIDS / Hypertension / Neurologic conditions / Obesity, dyslipidemia and other metabolic conditions / Pathological abnormalities of nasal septum and turbinates / Thyroid conditions / Tuberculosis / Tumors, whether benign or malignant of all organs and organ systems, including malignancies of the blood or bone marrow / Non-emergency case during point of availment / Pre-existing and congenital conditions

Pre-existing and congenital conditions – An illness or condition shall be considered pre-existing if, prior to the effective date of health coverage the pathogenesis of such illness or condition has started, whether or not the member is aware of such illness or condition.

B. General exclusions applicable to health care coverage:

• Care by Non-Affiliated Physician in either Affiliated or Non-Affiliated Hospitals
• Care by an Affiliated Physician in Non-Affiliated Hospital
• Additional hospital charges and professional fees resulting from taking a room category higher than that specified in the member’s benefit schedule
• Additional personal comfort items (e.g., telephone and television, additional food trays, admission kit and such other items of the same nature)
• Procurement or use of corrective appliances, prosthesis, artificial aids and durable equipment such as but not limited to the following: stents, prolene mesh, pins, screws, plates, wires, VP shunt, clips, hearing aids, intraocular lens, eyeglasses, contact lenses, balloons, valves; braces, crutches, pace maker
• All pregnancy-related conditions and complications relating to mother and unborn child, requiring medical and surgical care, regardless of time/date of occurrence
• All sexually transmitted diseases
• Blood screening, blood typing, cross-matching for potential donors in relation to blood donation and transfusion
• All forms of behavioral disorders whether congenital or acquired; developmental or psychiatric disorder; psychosomatic illness
• Any injury, illness or condition which the member may suffer after he has taken intoxicating drugs or alcoholic beverage
• Medical or surgical procedures that are experimental or not generally accepted as standard medical treatment
• Allergens used for hypersensitivity testing
• Treatment of injuries/illnesses from hazardous sports (e.g. bungee jumping, scuba diving, etc.)
• Treatment of injuries/illnesses due to war or military service
• Treatment where care is provided by government program
• Injuries from member’s own misconduct or crime
• Assault injuries by the Member (e.g. domestic violence)
• Vaccines (even during emergency)
• In-patient pain management requiring specialized team/equipment
• Disease declared epidemic by DOH
• Charges after hospital discharge time
• Screening procedures/services
• Cosmetic surgery except for functional restoration due to disease/accident

The exceptions of this health plan coverage are medical conditions which require in-person medical check-up. These include but are not limited to:

• Emergency-related cases – Heart attack, Stroke, Trauma injuries, Hypertensive emergency, Severe abdominal pain, Difficulty of breathing, Severe burn, Animal bite
• Maternity related cases – Labor, Pre-eclampsia, Threatened abortion/bleeding, Fetal distress/problems
• Dental consultations
• Mental health related conditions
• Medical conditions related to all forms of behavioral disorders
• Developmental or psychiatric disorder and psychosomatic illness
• Post-operation follow-up and complications
• “Fit to work” assessments, disease clearance, COVID-19 clearance, etc.

Consultation for Pre-existing conditions is covered. Exceptions include cases related to behavioral disorders, developmental or psychiatric disorder and psychosomatic illness whether acquired or congenital.

The following are the diseases and conditions in which the emergency and OP laboratory and diagnostics procedures cannot be used. No health care benefits shall be paid for the following services, procedures or conditions. This is not a complete list of non-covered illnesses and diseases.

A. List of diseases not covered but not limited to:

Anal fistulae / Asthma / Auto immune conditions / Cardiovascular diseases / Calculi of the urinary system / Cataracts / Sinus conditions requiring surgery / Cerebrovascular diseases / Cholecystitis/cholelithiasis / Chronic skin conditions / Cirrhosis of the liver / Collagen disease / Degenerative conditions / Diabetes mellitus / Diseased tonsils requiring surgery / Endometriosis / Epilepsy / Gastric or duodenal ulcer / Hallux valgus / Hemorrhoids / Hernia / HIV/AIDS / Hypertension / Neurologic conditions / Obesity, dyslipidemia and other metabolic conditions / Pathological abnormalities of nasal septum and turbinates / Thyroid conditions / Tuberculosis / Tumors, whether benign or malignant

B. General exclusions

Same as the general exclusions listed above.