What Is Medicare Plus? Complete Guide to Health Plans, Coverage, and Benefits

About Medicare Plus

Medicare Plus, Inc. is a trusted name in the Philippines, providing quality healthcare solutions to individuals, families, and organizations nationwide.

In 2005, the company began its operations under Prudential Life. Following steady growth and development, the company adopted the name Medicare Plus, Inc. in 2012, reaffirming its commitment to improving the country’s healthcare.

At present, Medicare Plus, Inc. has a growing network of more than 500 accredited hospitals and clinics and over 10,000 medical and dental professionals. This extensive network gives our members greater access to quality healthcare and more convenient options across the country.

Our clients come from a wide range of industries, including:

Transportation
Manufacturing
Government
Non-government organizations (NGOs)
Business process outsourcing (BPO)
Cooperatives
Workforce
Professional service

Our diverse client base reflects the flexibility and reach of our healthcare solutions.

Comprehensive Health Plans

Medicare Plus, the best HMO in the Philippines, offers Comprehensive Health Plans that cover a wide range of healthcare needs, including emergency treatments, hospitalization, check-ups, and preventive care.

1. Individual Health Plans

The Medicare Plus Individual Health Plan provides comprehensive inpatient, outpatient, and preventive benefits. It is ideal for individuals who are in good health, able to perform normal daily activities, and have a regular source of income.

Eligible members are from 15 days old to 60 years old, at the time of application. For minors, a parent or legal guardian must sign the application on their behalf.

Inpatient Benefits

Physician and surgical services
Room and board based on the selected plan
General nursing services
Use of operating, recovery, and intensive care units up to
Maximum Plan Limit
Hospital medicines
Oxygen, anesthesia, and medical supplies
Laboratory tests and other necessary diagnostic services
Blood transfusions
Standard admission kit
No admission deposit at affiliated hospitals

Outpatient Benefits

Outpatient services – Covers consultations, specialist evaluations, first aid, X-ray and laboratory exams, minor surgery, EENT care, emergency medicines, and prenatal and postnatal care.
Annual physical examination – Includes medical history review, physical examination, routine laboratory tests, ECG for members aged 35 and above, and Pap smear for female members aged 35 and above.
Preventive healthcare – Includes administration of vaccines, unlimited consultations, health and lifestyle advice, family planning guidance, wellness programs, and treatment for pain, lesions, wounds, and burns.

2. Family Health Plans

The Medicare Plus Family Health Plan is designed for families who want healthcare coverage. Principal members must be in good health, able to perform normal daily activities, and have a regular source of income. The principal member must be 18 to 60 years old at the time of application. For a married principal member, qualified dependents may include the spouse and children. Child dependents must be single, below 21 years old, and not gainfully employed.

Inpatient Benefits

Physician and surgical services
Room and board based on the selected plan
General nursing services
Use of operating, recovery, and intensive care units up to
Maximum Plan Limit
Hospital medicines
Oxygen, anesthesia, and medical supplies
Laboratory tests and other necessary diagnostic services
Blood transfusions
Standard admission kit
No admission deposit at affiliated hospitals

Outpatient Benefits

Outpatient services – Covers consultations, specialist evaluations, first aid, X-ray and laboratory exams, minor surgery, EENT care, emergency medicines, and prenatal and postnatal care.
Annual physical examination – Includes medical history review, physical examination, routine laboratory tests, ECG for members aged 35 and above, and Pap smear for female members aged 35 and above.
Preventive healthcare – Includes administration of vaccines, unlimited consultations, health and lifestyle counseling, family planning guidance, wellness programs, and treatment for pain, lesions, wounds, and burns.

3. Corporate Health Plans

With a Medicare Plus Corporate Health Plan, you can give your employees access to quality and affordable healthcare benefits that support their health, well-being, and peace of mind.

Talk to our Health Benefit Advisors (HBA) to learn about Maximum Benefit Limit, Annual Health Benefit, and Benefit Riders (e.g., Annual Physical Exam, Dental, Life Insurance if requested) based on the number of your employees.

Bottom Line

Choosing the right health plan starts with understanding your needs. Whether it’s individual coverage, protection for your family, or healthcare benefits for your employees, Medicare Plus offers a wide range of flexible healthcare plans designed to provide affordable and reliable coverage for different stages of life.

Backed by a nationwide network of accredited hospitals and clinics and medical and dental professionals, Medicare Plus helps make quality healthcare more accessible and convenient.
Get in touch with our Health Benefit Advisors to explore the different health plans and help you find the best one that suits your needs and budget.

Frequently Asked Questions

1. What comprehensive healthcare plans does Medicare Plus offer?
Medicare Plus offers Individual, Family, and Corporate Health Plans.

2. What is the difference between an Individual and Family Health Plan?
An Individual Health Plan is designed for one member, while a Family Health Plan provides coverage for an eligible principal member and qualified dependents.

3. Does Medicare Plus offer healthcare benefits for companies?
Yes. Medicare Plus Corporate Health Plans are designed for organizations that want to provide their employees with quality and affordable healthcare benefits.

4. Who can apply for a Medicare Plus Individual Health Plan?
Eligible applicants are from 15 days old to 60 years old, at the time of application. For minors, a parent or legal guardian must sign the application on their behalf.

5. Who can apply for a Medicare Plus Family Health Plan?
The Principal Member must be 18 to 60 years old at the time of application, in good health, able to perform normal daily activities, and have a regular source of income. For a married Principal Member, qualified dependents may include the spouse and children. Child dependents must be single, below 21 years old, and not gainfully employed.

Easy access health plan options for the Filipino community.

We know finding the right healthcare plan can be a complex and confusing task.
Our health plan specialists are always here to help 24/7.
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