Schedule of Benefits Description

A.   In-Patient Benefit

• Room & board accommodation up to the limit of your plan.

• On top of PhilHealth.

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B.   Out-Patient Benefit

• Unlimited number of medical consultations & follow-up consultations.

C.   Annual Physical Examination (APE) - For Employees
       Only

• APE can be available at any Healthway Clinics.

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D.   Emergency Care

1. Ambulance Service - Reimbursable up to maximum of Php 5,000.00.
2. In any of the accredited hospital nationwide - no-cash-out basis.
3. In a non-accredited hospital worldwide - on a reimbursement basis.

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E.   Dental Benefits (Optional)

• Can be availed at any FilDoc accredited dentists/dental clinics.

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F.   Non-Emergency Care in Non-Accredited Hospital

1. In the Philippines
   Should the plan Member opt to be confined in a non-accredited hospital, the Plan Member's eligible hospital and professional fee expenses may be reimbursed.
2. Worldwide
   Similarly, should the Plan Member be confined anywhere outside the Philippines, the Plan Member may also reimburse all eligible hospital and professional fee expenses resulting from his confinement.

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G.   Financial Assistance (Life Insurance Coverage For
       Employees)

• Life Insurance - due to natural causes
• Life Insurance - due to accident
• Loss of both hands or both feet or sight of both eyes
• Loss of one hand and one foot
• Loss of either hand or foot and sight of one eye
• Loss either hand or foot or sight of one eye

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H.   Maximum Benefit Limit

• Maximum Benefit Limit (MBL) per Illness per policy year shall apply only to Dread Diseases/Conditions and their complications.

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I.   Special Procedures and/or New Modalities of Treatment

• Coverage is limited to a maximum limit equal to 30% of the Maximum Benefit Limit

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J.   Pre-existing Illnesses

• Pre-existing conditions for account with at least 100 initial (principal) enrollees are covered immediately. The same is covered for the other new enrollees.
• Pre-existing conditions for accounts with less than 100 initial (principal) enrollees, pre-existing conditions are subject to a 12-month waiting period. After the Program is renewed for another policy year AND the plan member(s) has/have been continuously covered for twelve (12) months, pre-existing illnesses will already be covered.

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