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Select Access Optional Benefits

OUT-PATIENT BENEFITSSTANDARDEXECUTIVE
Blue Cross pays 80% of eligible claimed amount for reasonable, normal and customary fees. Reimbursement only.
Consultation in Doctor's Office
maximum of 12 visits per year, limit of one per day
P 300 (per visit)P 600 (per visit)
Specialist Consultation
upon written referral from doctor, maximum of 8 visits per year, limit of one per day
P 450 (per visit)P 900 (per visit)
Physiotherapist or Chiropractor
maximum of 10 treatments per year, limit of one per day
P 300 (per visit)P 600 (per visit)
Medicines and Drugs prescribed by a Doctor
for a covered condition or disability and procured from a recognized pharmacy
P 7,500
(limit per year)
P 15,000
(limit per year)
Diagnostic, X-rays and Laboratory Tests
necessary for the treatment of a covered disability
P 6,000
(per year)
P 12,000
(per year)


DENTAL PLAN
Blue Cross pays 80% of eligible claimed amount for reasonable, normal and customary fees. Reimbursement only.
BENEFITSLIMIT

Over-all Limit per year (excluding dentures)

P 9,000

X-rays (required prior to performance of dental service to a limit of)

200

Amalgam Fillings (per surface)
i) Pre-Molar
ii) Molar
iii) Cusp Restoration
iv) Amalgam Cores
v) Amalgam Pins


300
350
600
500
100

Anterior Filling (per surface)
i) Composite
ii) Acid Etch


500
500
BENEFITSLIMIT

Root Canal Fillings (per tooth)

P 1,500

Extractions
i) Simple
ii) Surgical: Impacted Wisdom Teeth
iii) Apicoectomy

300

1,500
1,500

Dentures (as a result of accident only)
i) Full Set
ii) Both Sets


4,000
7,000

Routine Oral Examination
Not to exceed 2 per year

200

Scale & Polish
Not to exceed 2 per year

400


ANNUAL PHYSICAL EXAMINATION

Includes:

  • Taking of medical history
  • Comprehensive physical examination
  • Complete blood count
  • Chest x-ray
  • Stool analysis
  • Urinalysis
  • Pap smear for female clients 35 years old and above
  • Electrocardiogram (ECG) for clients 40 years old and above

Notes:

1. Issue age is up to 65 years old.
2. For Group Accounts with at least 4 employees, or Families with at least 4 members (all members should enroll).
3. Premium quotations are available upon request from our Account Executives.