What are ER Shield, ER Vantage Plus, and Health Vantage Programs?

ER Shield and ER Vantage Plus are one-time use emergency health plans while Health Vantage is a multiple-frequency of availment emergency.

  • ER Shield: up to Php 50,000 for Php 800 premium.
  • ER Vantage Plus: hospital and out-patient emergency care (40, 60, 80 variants).
  • Health Vantage: outpatient and inpatient emergency care (40, 60, 80 variants).
What are the coverable cases for ER Shield, ER Vantage Plus, and Health Vantage?

Covered conditions include:

  • Accidents (excluding stroke), appendicitis, bronchitis, gastritis, dengue, sprains, fractures, viral infections, UTI, pneumonia, typhoid, and more.

Excludes injuries due to misconduct, war, and hazardous activities.

Are all expenses incurred in the hospital covered?

ER Shield covers up to Php 50,000 for:

  • ER care
  • Medically necessary diagnostics & treatment
  • Special modalities like MRI (Php 5,000 limit)

ER Vantage Plus/Health Vantage also cover board and room confinement under limits.

What if the total aggregate limit will not be consumed totally can I again use the plan in the future?

ER Shield and ER Vantage Plus are one-time use only. Health Vantage can be used multiple times within the year until the limit is reached.

Do I need to have a PhilHealth for ER Shield, ER Vantage Plus, and Health Vantage programs?

PhilHealth is required for ER Vantage Plus and Health Vantage when hospitalized. Not required for ER Shield.

Who are qualified to have an ER Shield, ER Vantage Plus and Health Vantage programs?

Anyone aged:

  • 6 months to 64 years (ER Shield and Vantage Plus)
  • 6 months to 60 years (Health Vantage)
Once I register an ER Shield or ER Vantage Plus, can I already use it?

No, there is a 7-day waiting period from registration before activation.

When can I start using my Health Vantage plan?

Seven (7) days after full payment and submission of application form.

Can I register/apply an ER Shield, ER Vantage Plus, or Health Vantage plan for another person?

Yes, as long as you know their complete personal details for registration.

How long will the ER Shield, ER Vantage Plus, and Health Vantage be effective?

You may use the plan within one year from the start of plan effectivity.

Are ER Shield and ER Vantage Plus transferable?

As long as not yet registered, the ER Shield and ER Vantage Plus are transferable. That is why one can purchase the plans for gifts or corporate giveaways.

Can I use the ER Shield, ER Vantage Plus and Health Vantage in hospitals not included in the plan provider list?

No, services can only be availed in the designated hospitals. We have already made arrangements with the hospitals regarding the procedures for accepting the plans and provision of services.

There are more than 550 hospitals nationwide where you may avail the services for ER Shield, ER Vantage Plus, and Health Vantage.

What are the non-coverable conditions for ER Shield, ER Vantage Plus, and Health Vantage?

No coverage for: non-emergency, pre-existing, congenital, maternity-related, and conditions under PhilCare's general exclusion list.

  • Massive Bleeding
  • Acute Appendicitis
  • Fractures from accidents
  • Convulsions
  • Dehydration (e.g., diarrhea, fever)
  • Syncope
What are the non-covered illnesses and diseases?

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.

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 (during the actual time of pregnancy or thereafter)
  • 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 as evidenced by clinical history or alcoholic breath as determined by the examining physician and/or conditions or illnesses resulting from alcoholism and drug addiction
  • Medical or surgical procedures that are experimental in nature and those that are not generally accepted as standard medical treatment by the medical profession, that may include but is not limited to Chiropractic Services, Acupuncture, and Reflexology
  • Allergens used for hypersensitivity testing regardless if administered as an outpatient or in patient procedure
  • Treatment of injuries or illnesses resulting from the voluntary participation of a member in any hazardous sport or activity that may include but is not limited to: bungee jumping, scuba diving, hang-gliding, mountain climbing, parachuting, surfing, rock climbing, airsoft, paintballing, boxing, wrestling, martial arts (such as taekwondo, judo, karate, etc.), gymnastics, motor sports (drag racing, jet skiing), wakeboarding, water skiing and all such other voluntary activities which pose a grave danger to life and limb
  • Treatment of injuries or illnesses due to military service or suffered under conditions of war
  • Treatment of injuries or illnesses wherein the care or reimbursement of services is provided by law or a government program, up to the stipulated limits
  • Treatment of any injury which is proven to be attributable to the member’s own misconduct such as negligence, intemperate use of drugs or alcoholic liquor, direct or indirect participation in the commission of a crime, whether consummated or not, violation of a law or ordinance, unnecessary exposure to imminent danger or hazard to health, including fireworks related injuries, infections or complications as a result of tattoos and piercing of the ear or any body part, whether self-inflicted or done by a third party, or attempted suicide or self-destruction, whether sane or insane
  • All cases of assault perpetrated by the Member including domestic violence which result in harm or injury to the Member perpetrator
  • Vaccines, whether elective or administered during an emergency treatment are not covered
  • In-patient pain management necessitating specialized pain management team and/or the use of specialized equipments
  • All diseases declared as epidemic by the Department of Health (DOH) and any other recognized health agencies
  • All hospital charges and professional fees incurred after the day and time the discharge from hospital has been duly authorized
  • All procedures and/or services considered screening
  • Pre-existing and congenital anomalies and conditions, and their complications
  • Cosmetic procedure and surgery and oral surgery solely for the purpose of beautification except reconstructive surgery to treat functional defects due to disease or accidental injury