Special Modalities of Treatment

Standard limit (for Inpatient/Hospitalization & Emergency Cases only; Subject to evaluation of coverage from PhilCare Call Center)

 

SPECIAL MODALITIES OF TREATMENT

COVERAGE

 

1

Laparoscopic Cholecystectomy

Covered up to ₱35,000 limited to once per contract

2

Lithotripsy

Covered up to ₱30,000 limited to once per contract

3

Magnetic Resonance Imaging (MRI)

Covered subject to ₱5,000

4

Use of Nuclear / Radioactive Isotopes

Covered subject to ₱5,000

5

Hysterescopic Myoma Resection

Covered subject to ₱20,000

6

Laparoscopic Adrenalectomy (Unilateral)

Covered up to ₱75,000 or subject to ABL; whichever is lower

7

Laparoscopic Adrenalectomy (Bilateral)

Covered up to ₱85,000 or subject to ABL; whichever is lower

8

Transurethral Microwave Therapy of Prostate

Covered up to ₱30,000 limited to once per contract

9

Hysteroscopic Guided D&C/Biopsy

Covered subject to ₱10,000

10

Percutaneous Ultrasonic Nephrolithotomy

Covered up to ₱40,000 limited to once per contract

11

Ureterolithotripsy

Covered up to ₱35,000 limited to once per contract

12

Stereotactic Brain Biopsy

subject to ABL

13

Cryosurgery

Covered up to ₱1,000 / area, subject to ABL limited to once per contract year

14

Sleep Study/Polysomnograms (Sleep Recording)

Covered subject to ₱5,000

15

Continuous Positive Airway Pressure (CPAP) titration for sleep

Covered subject to ₱5,000

16

Neuroscan

Covered subject to ₱5,000

17

Pelvic Laparoscopy

Covered subject to ₱25,000

18

All special Modalities of Treatment and/or diagnostic procedures for which there are no comparable conventional or traditional equivalent or counterparts

Covered up to ₱5,000 / procedure / member / year

19

Sclerotherapy for varicose veins as prescribed by an affiliated Physician, to be availed through Affiliated vascular surgeons

Covered up to ₱5,000 / member / year

Notes:

  1. Aggregate limit
  2. If requested by Dermatologist, not covered(considered cosmetic cases)