SUMMARY OF HMO BENEFITS 2024 BDO STAFF DEPENDENTS
JANUARY 1 - DECEMBER 31, 2024
Greetings of good health!
This e- brochure was designed to make the summary of the details of the HMO benefits for 2024 easily accessible to you.
We are pleased to inform you of the enhancements for 2024 for both employees’ and dependents’ coverage under Valucare.
Your BDOEA-ALU Medical Concierge , exclusive for the BDOEA Members/ dependents, will continue to assist you on your healthcare needs. The contact numbers are herein presented for your convenience.
Stay healthy in 2024 and beyond.
Sincerely yours,
Nestor P. Perez President
Riza S. Gargallo
Executive Vice President
BDOEA-ALU
Chairperson- Welfare Committee
Dear Valued BDOEA-ALU Members,
BDOEA-ALU
HOSPITAL-BASED HMO PLAN
Access to accredited hospitals
NoaccessinallmajorhospitalsexceptforSt.Luke's,Global/QuezonCity, CardinalSantosMedicalCenter,TMCClark&TMCIloilo
Access to accredited clinics
WithaccessinTMCSatelliteClinicsExceptTMCCongressional& TrinomaBranches;NoaccessinallFortmedMedicalClinicsand HealthwayMedicalClinics
COVID-19 OUT-PATIENT CARE
Anyreasonablenumberofconsultationsduringregularclinichours
whetherFacetoFaceorin-clinicconsultationsorTeleconsult,excluding prescribedmedicines.Member'soptionifhe/sheoptstoconsultan accreditedspecialistforTELECONSULT.
MentalHealthconsultationswithaccreditedPsychiatrist(ValuCare's Teleconsult)
X-rays,Laboratoryexaminationsanddiagnosticproceduresprescribedby accreditedspecialists
Referralstoaffiliatedspecialists
Preandpost-natalconsultations(excludinglabexams)
Emergencyroomcare
ForSymptomaticPatients:
RT-PCR(SWABTEST)forsymptomaticpatientswithprescription fromanInfectiousDiseaseSpecialistandfollowingDOHcriteria
NON-COVID-19 OUT-PATIENT CARE
Anyreasonablenumberofconsultationsduringregularclinichours whetherFacetoFaceorin-clinicconsultationsorTeleconsult,excluding prescribedmedicines.Member'soptionifhe/sheoptstoconsultan accreditedspecialist.
MentalHealthconsultationswithaccreditedPsychiatrist(ValuCare's Teleconsult)
Eye,Ear,NoseandThroatCare
Treatmentforminorinjuriessuchaslacerations,mildburns,sprains& strains,fractures,etc.excludingthecostofmedicines
X-rays,Laboratoryexaminationsanddiagnosticproceduresprescribedby accreditedspecialists
Referralstoaffiliatedspecialists
Minorsurgicalproceduresnotrequiringconfinement
PreandpostnatalconsultationsshallbecovereduptoMBL(excludinglab exams)
Emergencyroomcare
PhysicalTherapy(Coveredupto15sessions/yr.)
SpeechTherapy(forstrokepatientsonly,Coveredupto15sessions/yr)
COVID-19 IN-PATIENT CARE
MAXIMUM BENEFIT LIMIT
₱ 175,000.00 MBL / Member / Illness / year
PPEKit(CovereduptoPhp3,000.00)
Useofoperatingroomandrecoveryrooms
ROOM AND BOARD
Semi Private or up to ₱1,900.00 / Day
Professionalservicesofallattendingaccreditedspecialists
Drugs,medicinesandinjectables
Bloodtransfusionsandintravenousfluids
X-rays,Laboratoryexaminationsandotherdiagnosticexaminations
Dressings,plastercasts,suturesandotheritemsdirectlyrelatedtothe medicalmanagementofthepatient
Admissionkitincludingicecap/weebag
ICUconfinement
Anesthesiaandmedications
Oxygenanditsadministration
Standardnursingservices
AllotherhospitalchargesdeemednecessarybyaccreditedPhysicianinthe treatmentofthepatient
PREVENTIVE CARE
Immunization,excludingthecostofvaccinesandrelatedmaterials
Medicalmanagementofhealthproblems
Healtheducationandcounselingondietsandexercises
Familyplanningandcounseling
Recordkeepingofmedicalhistory
AnnualPhysicalExamination(APE)
PhysicalExamination
ChestX-ray
MedicalHistory
VisualAcuity
Fecalysis
Urinalysis
CompleteBloodCount
ECGoptional:formembersaged35yearsoldabove
PapSmearoptional:forfemalesaged35yearsoldabove
EMERGENCY CARE
InAccreditedHospitals:
Accrediteddoctor'sservices
Emergencyroomfees
Medicinesadministeredduringtreatmentorfor immediaterelief
Oxygenandintravenousfluids
Dressings,castsandsutures
Laboratorytests,x-raysanddiagnosticexaminations
directlyrelatedtotheERmanagementofthepatient Nebulization(includingcostofnebules)
Ambulanceservice(hospitaltohospitalcoveredupto Php15,000.00/conduction)
InNon-AccreditedHospitals:
ReimbursementofactualhospitalbillsandProfessionalFeesbasedon HMOrates(100%HB&100%PFbasedonHMORVSuptoMBL
InForeignTerritories:
ReimbursementofactualhospitalbillsandProfessionalFeesbasedon HMOrates(100%HB&100%PFbasedonHMORVSuptoMBL)
InAreasWithoutAccreditedHospitals
ReimbursementofactualhospitalbillsandProfessionalFeesbasedon HMOrates(100%HB&100%PFbasedonHMORVSuptoMBL)
ADDITIONAL BENEFITS
PPEforIn-PatientonlyPhp3,000.00perconfinement
AmbulanceservicesPhp15,000.00perconduction
Anti-rabies/anti-venomarecoveredPhp30,000.00(ActiveandPassive) vaccine
ScoliosisiscoveredPhp60,000.00
TuberculintestiscovereduptoPhp5,000.00outrightcoverage
LaserProstatectomyiscovereduptoPhp65,000.00/member/yr
Motorbike,scooter,bicycleaccidentsunderMotorVehicularAccidentis covereduptoMBLfrom"goingtoandfromwork"to"workandnonworkrelated".
WithaccesstoTMCSatelliteclinicsexceptCongressionalandTrinom Branches
ADDITIONAL BENEFITS
Antitetanus(CovereduptoPhp20,000.00)
Congenitalillnesses(CovereduptoPhp40,000.00/member/year)
Slippeddisc,spondylosisandspinalstenosis
EpilepsyandSeizureDisorder(CovereduptoPhp50,000.00/member/year)
Endocrineabnormalities,septicemianotrelatedtomaternity,epilepsyand seizuredisorder
ChronicDermatosesandScabiesConsultations
InvoluntaryRoomUpgrading-allowedtoupgradetothenexthigher pricedroomcategoryexceptsuiteroomCoveredwithin24hours(Except SuiteRoom)
Sportsrelatedinjuries(non-companysponsored,subjecttogeneral exclusionsandlimitationsofthecontract)
Unprovoked/provokedassault
IsolationCases(ifprescribedbyanHMOaccrediteddoctoranddeemed medicallynecessary)
MultipleSclerosis
DENTAL CARE
Anynumberofconsultationswithanaccrediteddentists
Treatmentofdentalrelatedpainexcludingcostofprescribedmedicines
SimpleOralProphylaxis(2xayear)
Simpletoothextractions,exceptsurgeryforimpactions
Gumtreatmentexcludingthecostofprescribedmedicines
Recementationofjacketcrown,inlaysandonlays
Treatmentoflesions,woundsandburns
Temporaryfillings
AnnualDentalExamination
Adjustmentofdentures
Reliefand/orprescriptionforacutedentalpain
Emergencydesensitizationofhypersensitiveteeh
Orthodonticconsultation
Aestheticdentalconsultation
PermanentLightcurefilling(Four(4)surfaces/fillings/year
TemporoMandibularJointconsultation(clickingofjaws)
PRE-EXISTING CONDITIONS
DefinitionofPre-ExistingConditions
Anillnessorinjuryisconsideredtobeinexistencepriortotheeffectivedateof themembercoverage.
FOR1STDEPENDENTS:
AllExistingEnrolledDependents/AllNewlyEnrolled6monthsandabove (CovereduptoMBL)
Allnewlyenrolledbelow6months(Coveredupto50%ofMBL)
FOR2ND3RDETALDEPENDENTS:
AllExistingEnrolledDependents(CovereduptoMBL)
AllNewlyEnrolled(Coveredupto50%ofMBL)
PHILHEALTH
Employees
PhilhealthIntegrated
MEDICAL CONCIERGE VIBER NUMBERS: 0917-1243039 0917-3231363 0917-3241363 LANDLINE (02)5310-1818
powered by:
