| OUT-PATIENT BENEFITS | STANDARD | EXECUTIVE |
| 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. | |||||||||||||||||||||||
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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.