BENEFIT COVERAGE
Coverable Cases
Mind Care PLUS covers online consultations for the following conditions that do not require urgent care, physical examination, or visualization by a psychiatrist:
- Mental and behavioral disorders due to psychoactive substance use (e.g., alcohol, opioids)
- Schizophrenia, schizotypal, and delusional disorders
- Mood (affective) disorders (e.g., bipolar disorder, depression)
- Neurotic, stress-related, and somatoform disorders (e.g., phobias, PTSD, pain disorders)
- Behavioral syndromes associated with physiological disturbances and physical factors (e.g., eating disorders, sleep disorders, sexual disorders, postpartum depression)
- Disorders of adult personality and behavior (e.g., gender identity disorder, kleptomania)
Limitations
The following psychiatric services, programs, and facilities are not covered:
- Medical certificates for medico-legal purposes
- Psychological tests and interpretation
- Medicines
- Short-term and long-term hospitalization, including partial hospital care in mental health facilities
- Acute withdrawal symptoms
Services related to the following conditions are also excluded:
- Mental disorders caused by cerebral dysfunctions (e.g., dementia)
- Mental retardation caused by incomplete development of the mind
- Disorders of psychological development (e.g., dyslexia, autism)
- Behavioral and emotional disorders usually occurring during childhood and adolescence (e.g., ADHD)
- Dependency recovery services and substance abuse/chemical dependency programs
- Medical treatment of self-inflicted illnesses or injuries
- Religious, marital, relationship, vocational, employment, learning disability, or sex therapy counseling services
- Programs whose primary focus is educational rather than therapeutic
- Any psychiatric condition or treatment not specifically listed as covered
MindCheck: Mental Health Assessment / Screening
Includes two (2) Mental Health Assessment / Screening sessions using:
- Perceived Stress Scale
- Depression and Anxiety Scale
Chat Support with Mental Health Associates
Covers five (5) online chat support sessions with Mental Health Associates.
Mental Health Hotline
Covers three (3) online call support sessions with Mental Health Associates.
AVAILMENT PROCEDURE
Request for an Appointment Procedure
- Visit www.philcare.com.ph and click the Member Gateway tab.
- Click the “DigiMed PLUS or Mind Care PLUS Consult? Click Here” link and enter the reference number indicated in the email notification.
- Input the patient's basic information and submit.
- Accomplish and sign the Consent Form.
- Answer the Self-Reporting Questionnaire and the PHQ-9 Questionnaire, then submit.
- Wait for a call from the Medical Team to schedule an appointment.
- An email notification will be sent to confirm the appointment details with the Psychiatrist.
Video Teleconsultation Procedure (Day of Consultation)
- Log in at least ten (10) minutes before your scheduled appointment.
- Log in through the PhilCare website or click the link provided in the email or SMS notification.
- Click the “DigiMed PLUS or Mind Care PLUS Consult? Click Here” link.
- Click the Upcoming Appointment link found on the lower portion of the screen.
- Proceed with the online consultation at the scheduled appointment time.
- Click the Join Call button on the homepage.
- Ensure that your camera and microphone are turned on before joining.
- Engage in the medical video teleconsultation with your Psychiatrist.
MindCheck: Mental Health Assessment / Screening
- Log in to PhilCare Gateway .
- Enter the Reference Number provided in the Certificate of Coverage (COC).
- Choose MindCheck from the menu options.
- Complete the registration details and agree to the Terms and Conditions.
- Answer and submit the survey.
- Results will be emailed to the nominated email address provided during registration.
Chat with Mindscapes
- Log in to PhilCare Gateway .
- Enter the Reference Number provided in the Certificate of Coverage (COC).
- Choose Chat with Mindscapes from the menu options.
- Wait for the next available Mental Health Associate to connect and assist you.
Mental Health Hotline
- Log in to PhilCare Gateway .
- Enter the Reference Number provided in the Certificate of Coverage (COC).
- Choose MS Helpline from the menu options.
- Enter your preferred mobile contact information for the session.
- Wait for the next available Mental Health Associate to connect and attend to you through the callback feature.
IMPORTANT NOTES
📝 Refund Policy: You may cancel within 15 days of receiving your Certificate of Coverage if unused. Email: prepaidcs@philcare.com.ph
📩 You will receive a soft copy of the full policy contract within 24 hours from release of your Certificate of Coverage. You may also request it via: order@philcare.com.ph
💡 If you do not agree with the Terms and have not registered your product, you may request a refund subject to PhilCare’s Return, Refund & Cancellation Policy.
✅ You confirm that all personal and health information provided is true and correct. Misrepresentation may result in cancellation of membership or denial of coverage.
Coverage Activation Timelines- Emergency Plans – activates within 7 calendar days
- VidaCare – activates within 7 calendar days
- Consultation Plans – activates within 3 days
- DigiMed and MindCare – activate within 24 hours
- Dengue RX and Dengue Assist – activate within 30 days
Coverage begins automatically on the activation date. Conditions or incidents occurring before activation are not covered.
💵 Some plans may include a co-pay amount that must be settled before coverage applies.
🚫 Coverage is subject to general exclusions. Please review the full list of non-coverable conditions.
🔒 PhilCare values your data privacy. All medical information is used solely for healthcare purposes and treated confidentially.
GENERAL EXCLUSIONS AND LIMITATIONS
General Exclusions
No Healthcare Benefits shall be paid for the following services, procedures, or conditions unless otherwise specified in the Agreement:
- Behavioral, developmental, psychiatric, or psychosomatic disorders.
- Sexually transmitted diseases such as herpes, gonorrhea, syphilis, and vulvar warts.
- Injuries from riots, strikes, and civil disturbances.
- Diseases declared epidemic or pandemic by health authorities.
- Cosmetic and beautification procedures unless reconstructive due to accidental injury.
- Weight reduction programs and obesity-related procedures.
- Dental procedures except those needed after accidental injury.
- Pregnancy-related conditions and complications.
- Circumcision, sterilization, artificial insemination, infertility treatment, and sex transformation.
- Experimental medical treatments and alternative therapies.
- Routine physical examinations for employment, school, licensing, or permits.
- Screening procedures.
- Self-inflicted injuries, tattoos, piercings, attempted suicide, and related complications.
- Injuries related to negligence, illegal drugs, alcohol, crimes, or dangerous activities.
- Alcoholism and drug addiction-related illnesses.
- Professional sports and hazardous activities.
- Military service and war-related injuries.
- Chronic dermatoses.
- Non-emergency services from non-affiliated providers.
- Additional hospital charges beyond covered limits.
- Custodial, domiciliary, convalescent, and intermediate care.
- Medical certificates.
- Professional fees of medico-legal officers.
- Organ donation and transplant donor-related expenses.
- Benefits already covered by PhilHealth or government healthcare programs.
- Charges exceeding MBL and inner limits.
- Durable medical equipment and oxygen outside covered confinement.
- Corrective appliances and prosthesis such as stents, braces, eyeglasses, hearing aids, and pacemakers.
- Hepatitis B, C, and D.
- Allergens for hypersensitivity testing.
- Blood screening and blood typing for donors.
- Executive checkups and diagnostic confinement.
- Assault-related injuries caused by the member.
- Professional fee excess charges.
- Take-home medicines, vitamins, supplements, and non-therapeutic drugs.
- Outpatient medicines except emergency treatment and IV chemotherapy.
- Vaccines, whether elective or emergency-administered.
- Error of refraction conditions such as myopia and astigmatism.
- Outpatient pain management except emergencies.
- Complications from non-covered procedures.
- Conditions covered by law or government programs.
General Limitations
- PhilCare is not liable for delays caused by disasters, epidemics, war, riots, labor disputes, or unavailable facilities/personnel.
- Members shoulder costs if the working diagnosis is initially non-covered until final diagnosis confirms eligibility.
- Hospital services are subject to hospital rules and room availability.
- Total covered costs cannot exceed the benefit limit during the one-year term.
