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    Option 3 Nemesis PDF

    Uploaded by

    Jhay L Bendoy
    This document outlines the benefits and fees of Option 3 package plan with an aggregate limit of 100% and a maximum annual benefit limit of PHP 40,000. It provides 100% coverage for outpatient consultation, emergency treatment, and confinement. It also covers pre-existing illnesses after 12 months of continuous membership, annual physical examinations after 12 months, simple tooth extractions without limit, two permanent fillings per year, and financial assistance for natural death up to PHP 5,000. Accidental death is covered up to PHP 10,000 and dismemberment up to PHP 20,000. The monthly gross premiums are PHP 320 for ward or PHP 380 for semi-private room.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Option 3 Nemesis PDF

    Uploaded by

    Jhay L Bendoy
    72 views1 page
    This document outlines the benefits and fees of Option 3 package plan with an aggregate limit of 100% and a maximum annual benefit limit of PHP 40,000. It provides 100% coverage for outpatient consultation, emergency treatment, and confinement. It also covers pre-existing illnesses after 12 months of continuous membership, annual physical examinations after 12 months, simple tooth extractions without limit, two permanent fillings per year, and financial assistance for natural death up to PHP 5,000. Accidental death is covered up to PHP 10,000 and dismemberment up to PHP 20,000. The monthly gross premiums are PHP 320 for ward or PHP 380 for semi-private room.

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    Option 3 Nemesis.pdf

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    This document outlines the benefits and fees of Option 3 package plan with an aggregate limit of 100% and a maximum annual benefit limit of PHP 40,000. It provides 100% coverage for outpatient consultation, emergency treatment, and confinement. It also covers pre-existing illnesses after 12 months of continuous membership, annual physical examinations after 12 months, simple tooth extractions without limit, two permanent fillings per year, and financial assistance for natural death up to PHP 5,000. Accidental death is covered up to PHP 10,000 and dismemberment up to PHP 20,000. The monthly gross premiums are PHP 320 for ward or PHP 380 for semi-private room.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    72 views1 page

    Option 3 Nemesis PDF

    Uploaded by

    Jhay L Bendoy
    This document outlines the benefits and fees of Option 3 package plan with an aggregate limit of 100% and a maximum annual benefit limit of PHP 40,000. It provides 100% coverage for outpatient consultation, emergency treatment, and confinement. It also covers pre-existing illnesses after 12 months of continuous membership, annual physical examinations after 12 months, simple tooth extractions without limit, two permanent fillings per year, and financial assistance for natural death up to PHP 5,000. Accidental death is covered up to PHP 10,000 and dismemberment up to PHP 20,000. The monthly gross premiums are PHP 320 for ward or PHP 380 for semi-private room.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    ANNEX C

    SCHEDULE OF BENEFITS AND FEES


    Option 3
    PACKAGE PLAN AGGREGATE LIMIT 100%
    Room Accommodation Category
    Maximum Daily Room and Board Open
    Maximum Benefit Limit Php 40,000.00 / year

    I. Out-Patient Consultation / Laboratory


    II. Emergency Treatment of Illness and Injury
    100% of Total MBL
    III. Confinement
    OUTPATIENT CONSULTATION:
    1. Accredited Clinic Covered
    2. Non-accredited clinic in areas with provider network Covered (80%)
    3. Non-accredited clinic in areas with no provider network Covered (reimbursement only)
    EMERGENY TREATMENT:
    1. Accredited Hospital Covered
    2. Non - Accredited Hospital Covered (100%)
    3. Medico Legal Cases Reimbursement only
    CONFINEMENT (Hospital Bills & Professional Fees):
    1. Non – emergency in areas with no provider network Covered (100%)
    2. Non – accredited in areas with provider network Covered (80%)
    3. Emergency confinement (nationwide) Covered (100%)
    PRE-EXISTING ILLNESS:
    100 - 399 Members - Covered after twelve ( 12 ) months of continuous membership
    400 – up Members - Automatic coverage of Pre-Existing illness
    PRESCRIBED TAKE HOME MEDICINES: Not covered
    ANNUAL PHYSICAL EXAMINATION: Covered after twelve ( 12 ) months of continuous membership
    DENTAL SERVICES:
    1. Simple Tooth Extraction Unlimited
    2. Oral Prophylaxis Once a year, covered after twelve ( 12 ) months of continuous
    membership
    3. Permanent Filling 2 Permanent Filling per year
    FINANCIAL ASSISTANCE:
    1. Natural Death Php 5,000.00
    ACCIDENT INSURANCE COVERAGE (Subject to underwriting
    guidelines):
    1. Accidental Death Php 10,000.00
    2. Dismemberment due to Accident Up to Php 20,000.00 ( as per scheduled body parts)
    3. Burial Expense (accident) Php 10,000.00

    PRODUCT DESCRIPTION GROSS PREMIUM


    MODE OF PAYMENT MONTHLY
    WARD Php 320.00
    SEMI-PRIVATE Php 380.00

    Conforme: __________________________ _____________________________

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