Accredited medical network
Go to the accredited medical network for no-cash-out access.
HMO Features
Standard Features & Benefits
Experience all the essential benefits you'd expect from a top-tier health plan — plus competitive advantages through our Etiqa insurance partnership.
Features & Benefits: Just Like Any Health Plan
4 black & white features every health plan should offer
24/7 nationwide coverage
Get 24/7 coverage nationwide with emergency coverage worldwide.
Inpatient, outpatient & emergency
Get inpatient, outpatient, and emergency medical benefits.
Room & board and MBL limits
Get room & board and maximum benefit limits per illness per year.
More Than Your Usual Health Plan
Competitive advantages for growing teams
Big 9 hospitals & Healthway clinics
Go to the Big 9 hospitals and Healthway clinics for no-cash-out.
Outside-network reimbursement
Go outside the network for non-emergency reimbursement.
Benefits on top of PhilHealth
Get benefits on top of PhilHealth (MBL+P/H, not MBL−P/H).
Digital healthcare access
Get digital access to healthcare from online and mobile platforms — Members Portal, Smile App, and Doctor Anywhere.
Doctor Anywhere
Consult with Doctors Anytime, Anywhere
Experience the convenience of online medical consultations fully covered by Etiqa through the Doctor Anywhere app.
General Practitioner
Connect with accredited general practitioners anytime—on-demand or by appointment.
Specialist Doctors
Book your appointments with a wide range of medical specialists across various fields.
Mental Health Experts
Access discounted online sessions with licensed mental health professionals for counseling support.
Inpatient & Outpatient Claims
Simplified Reimbursement Process
We aim to make your reimbursement experience as straightforward as possible. Follow our guidelines to submit your claims efficiently.
Inpatient (IP)
Process
- Member goes to choice of accredited or non-accredited hospital as Private Patient for reimbursement, and does not show card.
- Member is diagnosed and treated.
- Member files PhilHealth, settles the (whole) bill.
- Member is discharged.
- Member downloads and files IP Claim form + support documents with Etiqa Claims.
- Member waits 15 days for Etiqa to reimburse claim as-charged, and deposit directly to bank account.
Requirements
- Completed/signed IP claim form
- Hospital Statement of Account (photocopy ok)
- BIR-approved invoices for professional fees | hospital bills
- Meds bought outside from non-availability must have the corresponding Rx
- All documents must be original copies (except Statements of Account)
- Erasures should be countersigned by the authorized signatory
- *The above list of requirements is not final: Etiqa reserves the right to request additional docs on a case-to-case basis.
- *If any claim exceeds P10,000, original receipts will be required.
- *Submit claim form and all supporting documents through the claims portal linked below.
Outpatient (OP)
Process
- Member goes to choice of accredited or non-accredited hospital or clinic as Private Patient for reimbursement, and does not show card.
- Member is diagnosed and treated.
- Member settles the (whole) bill.
- Member is discharged.
- Member downloads and files OP Claim form + support documents with Etiqa Claims.
- Member waits 15 days for Etiqa to reimburse claim as-charged, and deposit directly to bank account.
Requirements
- Completed/signed OP claim form
- Medical certificate in-lieu of doctor’s diagnosis
- BIR-approved invoices for professional fees | hospital bills
- For lab expenses, lab request signed by the doctor (photocopy ok)
- All documents must be original copies (except lab requests)
- Erasures should be countersigned by the authorized signatory
- *The above list of requirements is not final: Etiqa reserves the right to request additional docs on a case-to-case basis.
- *If any claim exceeds P10,000, original receipts will be required.
- *Submit claim form and all supporting documents through the claims portal linked below.
Ready to explore Mediwealth plans?
Schedule a free consultation and get a tailored quote for your team.