🎯 Gov’t Employees: Gamitin ang ₱7,000 Medical Allowance nang Tama!
Alam mo bang pwede mong gamitin ang ₱7,000 annual medical allowance (EO 64 s.2024) para sa HMO-type benefits?
Introducing 👉 Kaiser National HealthCare Shield — ang pinaka-responsive na HMO plan for government groups
🛡️ KAISER NATIONAL HEALTHCARE SHIELD
Now available for all government personnel! 💼🏥
✅ Open to ALL employees of NGAs, SUCs, and GOCCs — regular, casual, contractual, full-time or part-time!
✅ No minimum number of members needed (as long as the whole agency enrolls)
✅ Must have an authorized signatory
✅ Subject to underwriting approval
✅ Aligned with DBM Budget Circular #2024-6 (Effective December 12, 2024)
✅ No cash-out during hospitalization
✅ Up to ₱75,000 coverage per illness per year
✅ With financial assistance in case of accident or death
🛡️ Kaiser International HealthGroup – “Your First Name in Healthcare.”
📌 Available through government coops, unions, and associations.
📌 Secure your health today. Ask us how your agency can enroll!
📲 Message us now para sa FREE proposal and presentation!
WHO ARE ELIGIBLE?
- Government personnel in the National Government Agencies (NGAs), including SUCs, and GOCCs regardless of appointment status whether regular, casual, or contractual; appointive or elective, and on full-time or part-time basis.
- Must have an authorized or designated signatory of a government agency.
- No minimum number of members required provided the entire agency/department will enroll.
- All government institutions must enroll to avoid anti-selection.
- All government members will be subject to Underwriting Guidelines
- and approval.
Our Five-Point HealthCard Program
Package of Annual Physical Examination (APE) at Kaiser Designated Clinics. (For Principals only)
- a. Complete Blood Count
- b. Urinalysis (Urine examination)
- c. Fecalysis (Stool examination)
- d. Chest X-Ray
- e. Electrocardiogram (adults age 40 and above, or if prescribed)
- f. Pap Smear (Women age 40 and above, or if prescribed)
No deposit upon admission (for surgical cases, please contact Kaiser)
| Room and Board | According to plan package |
|---|---|
| Operating room and Recovery room | Maximum Benefit Limit |
| Administered medicines | Maximum Benefit Limit |
| X-ray and laboratory examinations | Maximum Benefit Limit |
| Salists like anaesthesiologists, internists, surgeons, etc. | BASED ON KAISER ACCREDITED UNITS |
| Services and medications for general/spinal anaesthesia or other forms of anaesthesia necessary for a surgical procedure | Maximum Benefit Limit |
| Intravenous fluids and transfusion of fresh whole blood | Maximum Benefit Limit |
| ICU confinements | Maximum Benefit Limit |
Maximum Benefit Limit (MBL) – the maximum amount payable per illness per member per year; inclusive of consultations, diagnostic procedures, and hospitalization
In the event that the assured member suffers illness or injury not requiring confinement in a hospital, Kaiser shall provide:
- Referral to specialists
- Regular consultations and treatment (except prescribed medicines)
- Laboratory and X-Ray examinations
- Treatment of minor injuries and surgery not requiring confinement
- Eye, ear, nose and throat treatment
- Once a month pre and natal consultationt
During an emergency case, a member who is in a critical condition caused by an illness or injury, the following benefits are:
- a. Physician ’s services
- b. Medicines utilized during treatment or for immediate relief
- c. Casts, dressings and sutures
- d. Oxygen and intravenous fluids
- e. X-ray, laboratory and other diagnostic examinations directly related to the emergency management of the patient
The Member shall be entitled to dental services administered by an accredited service provider. The dental benefits shall cover the following services:
- a. Consultation and Dental Examinations
- b. Dental Nutrition and Dietary Counselling
- c. Dental Health Education
- d. Restorative and Prosthodontic planning
- e. Simple tooth extractions
- f. Temporary filling-unlimited (as needed)
- g. Annual prophylaxis (mild cases only)
- h. Simple tooth Adjustment of Dentures
- i. Recementation of loose crowns, in-lays and on-lays
- j. Permanent filling up to 2 surfaces only
KAISER INTERNATIONAL HEALTHGROUP INC. agrees to give/provide, in the event of death or injuries through natural causes or accidental means, the heirs and/or assigns of any member who is enrolled in this health care program. Provided that the death or injury results from:
| COVERAGE | CATEGORY |
|---|---|
| 10,000.00 | Natural Death |
| 20,000.00 | Accidental Death |
| 10,000.00 | Loss of Both Hands |
| 10,000.00 | Loss of Both Feet |
| 10,000.00 | Loss of Both Sight |
| 10,000.00 | Loss of One Hand and One Foot |
| 10,000.00 | Loss of One Hand and One Sight |
| 10,000.00 | Loss of One Foot and One Sight |
| 5,000.00 | Loss of One Hand or One Foot |
| 5,000.00 | Loss of Sight of One Eye |
Should an accredited physician / specialist prescribe or require any of the following and / or procedures, these limits will apply; per procedure per member per year.
| Dialysis | Maximum Benefit Limit |
| Chemotherapy | Maximum Benefit Limit |
| Radiotherapy | Maximum Benefit Limit |
| Laparoscopic Surgery (including Hospital bill and professional fee) | 50,000/member/year |
| Lithotripsy | 50,000/member/year |
| Angiography (e.g.coronary,cerebral,retinal, pulmonary, GI, etc) | P5,000.00 |
| Myelogram | P5,000.00 |
| Electromyography, Nerve Conduction Velocity Studies | P5,000.00 |
| Pulmonary Perfusion Scan | P5,000.00 |
| Tests involving use of Nuclear Technologies (e.g. Radionuclide Ventriculography/ Thallium stress testing/ Radionuclide/ Thyroid scan, etc.), Nuclear technologies such as Pyrophosphate, Scintigraphy, Positron Emission Tomography, Radio Isotope Scanning, etc.) | P5,000.00 |
| 24-Hour Holter Monitoring, 2-D Echo and Doppler | P5,000.00 |
| Treadmill Stress Test | P5,000.00 |
| Bone densitometry scan (Dexascan) | P5,000.00 |
| Orthopedic Arthroscopy | P5,000.00 |
| Endoscopy including one of video | P5,000.00 |
| Adrecortical Function (e.g. Primary Aldosteronism, Cushings Disease) | P5,000.00 |
| Plasma/Urinary Cortisol, Plasma Aldosterone, etc. | P5,000.00 |
| Mammography(breast cancer) and Sonomammogram | P5,000.00 |
| Laboratory/ancillary services for conditions whose pathogenesis or subsequent clinical improvement not yet fully established in Medical Science | P5,000.00 |
| Anti-nuclear antibody (ANA), C-Reactive protein (Rheumatic and its complications), Lupus cell exam | P5,000.00 |
| New modalities and/or diagnostic and treatment procedures for conditions with established etiologies and its use is only as alternative to the conventional methods | P5,000.00 |
| Radioactive Iodine Therapy | P5,000.00 |
| Genetic/Immunologic studies | P5,000.00 |
| Active immunization for dog bites, venom, anti- tetanus | P10,000.00 |
| Congenital Illness | P10,000.00 |
| Physical Therapy | Lip to 10 sessions |
II. TERMS
PRE-EXISTING CONDITION
All pre-existing conditions shall be deemed covered by KAISER.
PHILHEALTH
This is a PhilHealth integrated Health Plan. All members are required to have PhilHealth Coverage. Those without PhilHealth membership or those who do not claim PhilHealth benefits when hospitalized (in-patient/out-patient) shall pay the PhilHealth benefit portion.
ELIGIBILITY
The PRINCIPAL is at least 18 years old up to age 65.
EFFECTIVITY DATE: Effective date for GROUP/CORPORATE ACCOUNT, unless specifically provided within the corporate healthcare agreement, is based on the following:
| DATE OF RECEIPT OF APPLICATION/ | ENROLLMENT EFFECTIVITY DATE |
|---|---|
| 11 TO 25 OF THE MONTH | 1st OF THE FOLLOWING MONTH |
| 26 TO 10 OF THE MONTH | 16th OF THE FOLLOWING MONTH |
III: RATES
MAJOR HOSPITALS
- MMC Makati Medical Center
- CSMC Cardinal Santos Medical Center
- SLMC Saint Luke Medical Center
- AHMC Asian Hospital Medical Center
- TMC The Medical City
- Cebu Doctors Hospital
- Chong Hua Hospital
- UC Medical Hospital
KAISER HEALTHCARD CORPORATE RATES
| Plan includes Major Hospitals | Annual | Benefit Limit |
|---|---|---|
| SEMI PRIVATE up to HEALTH 800 | Php 7,000 | Php 75,000 |