The ER Care Series do not cover pre-existing conditions and/or chronic conditions. Many persons with pre-existing and/or chronic conditions control and manage their illnesses while leading active lifestyles. If they will benefit from coverage that provides emergency medical care arising from accidents, viral and bacterial illnesses and the specific conditions mentioned above, they may consider availing of this product for themselves for those contingencies.
Consultations with neurologist, neurosurgeons, specialists of sleep medicine, and developmental and behavioral pediatricians.
The Out-patient Consultation Voucher shall cover consultations made only in a doctor’s office and if not listed below as exclusion:
- Consultations in emergency room facilities.
- Consultations with non-accredited Physician and/or in a non-accredited hospital.
- Conditions secondary to all pregnancy and fertility-related illnesses / treatments.Sexually transmitted infections such as but not limited to syphilis, gonorrhea, chlamydia, human papillomavirus infection and HIV/AIDS.
- Consultations for complications resulting from sterilization of either sex or reversal of such, artificial insemination, sex transformations, and circumcision.
- All in-clinic procedures. The following are examples but not limited to:
1. Ophthalmology procedures like visual acuity, refraction, slit lamp exam, fundoscopy, tonometry, etc.
2. Ears, nose, throat (ENT) procedures like ear irrigation/cleaning, ear/nasal suctioning, rhinoscopy, laryngoscopy, etc.
3. Surgical procedures like incision and drainage, wound cleaning, debridement, suture removal, etc.
4. Injection administration
5. Pap smear.
- Dermatological consultations and procedures for purpose of beautification. Examples are but not limited to acne, warts, hyperpigmentation and milia.
- Consultations with neurologists.
- Psychiatric disorders, psychosomatic illnesses, hyperventilation syndrome, stress related conditions, adjustment disorders, childhood and developmental disorders, alcoholism and its complications or conditions related to substance or drug abuse, addiction and intoxication.
- Hypersensitivity and allergy tests.Cardio-pulmonary (CP) clearance required prior to surgery or medical procedures.
- Physical examination required for obtaining employment, medical certification, insurance or government license, including cardio-pulmonary (CP) clearance required prior to surgery or other medical procedures.
- Injuries or illnesses due to military, paramilitary, police service, high risk activities, or suffered under conditions of war.
- Injuries or illnesses which are self-inflicted, caused by attempt at suicide or incurred as a result of or while participating in a crime or acts involving the violation of law, administrative order or ordinances.
- Diseases declared by the Department of Health as “epidemic”.
- Outpatient medicines.Medico-legal consultations.
- Physical therapy