Are Medocare Coordinators available 24x 7?

Medocare coordinators, just like other doctors, have specific clinic hours in their hospitals/clinics. Since they are not employees of Medocare, they cannot be forced to spend extra time to attend to Medocare members. As such, they will only see Medocare members for outpatient consultations during their clinic schedules. However, their secretaries are almost always present in their clinic and they can issue the appropriate referrals as instructed by the coordinator. Some
hospitals have an industrial/HMO section where you can secure specialist referral forms in the absence of the coordinator.

What do you mean by Maximum Benefit Limit (MBL)?

It is the maximum liability that Medocare shall assume per unrelated illness/injury per year on a certain member, not including Annual Physical Examination (APE). In other words, all cost of medical benefits incurred in both in-patient and out-patient availments within the contract year shall be charged against the MBL. MBL is replenished upon renewal.

How do I know if a certain diagnostic procedure requested by your accredited doctor is covered under my program?

For inquiries on benefit coverage, one can call our Call Center hotlines. Our Call Center Representatives will ask for your medical details to assess coverage of your availment based on the Healthcare Agreement between Medocare and your

How do I avail of my Annual Physical Exam benefit?

For your annual physical exam (APE) benefit, this may be coordinated by your HR Representative with our Provider-Customer Relations Department for scheduling of on-site APE whenever appropriate.  For APE availed in clinics, this should also be coordinated with our said department for scheduling prior to actual availment. This can be done via phone call or email.

What happens if we fail to file our Philhealth Benefit Claim form upon discharge?

In this case, since our program is integrated with PhilHealth, the patient will have to pay for the cost of the PhilHealth portion upon discharge.

What if I want to upgrade my room and board entitlement during elective confinement?

This is possible.  However, the patient shall have to shoulder the room and board excess fees, the incremental costs (lab fees, procedures done, etc.) and the incurred excess in professional fees due to the upgrade.