ValuCare is CBMPC’s New HMO Provider

The Countryside Builders MPC Board of Directors recently approved the appointment of Value Care Health Systems, Inc. or ValuCare as the coop’s HMO provider covering the period September 1, 2023 to August 31, 2024.

Among others, the new HMO provider covers seven (7) major hospitals, as follows:

• Asian Hospital
• Cardinal Santos Hospital
• Makati Medical Center
• Medical City – Ortigas
• St. Luke’s Medical Center – Quezon City
• St. Luke’s Medical Center – The Global City
• Davao Doctor’s Hospital

However, only those availing of the Plan Type with 100K and above Maximum Benefit Limit (MBL) are eligible for coverage at the Asian Hospital.

Following is a table of approved HMO premiums according to the age of enrollees and the type of MBL availed. The premium already includes the coop’s service fee (Amounts in Pesos):

As to the eligible enrollees of HMO, please refer to the related article on the Expansion of Eligible Enrollees to HMO published in this issue of the newsletter.

New enrollees (Principal and Dependents) however, can avail only of the MBL of P150,000.00. For dependents of members, coverage of pre- existing conditions is up to 100% per illness, per year.

The benefits under this HMO Policy are supplement to the benefits under the Philippine Health Insurance Corporation (PhilHealth). This Policy shall reimburse covered expenses up to the maximum limits, which are not payable under PhilHealth. In no instance, however, shall the total payments under both plans exceed the actual expenses incurred. Enrollee/s without PhilHealth Coverage may opt to enroll voluntarily under PhilHealth.

Effectivity of HMO coverage will be upon receipt of acknowledgment/confirmation from ValuCare of CBMPC’s enrollment. Once enrolled, ValuCare will not allow Change of Plan Type (upgrading/ downgrading) and Cancellation. NO REFUND OF PREMIUM resulting from withdrawal of enrollees.

ANY AVAILMENT MADE IN EXCESS OF ALLOCATED MBL SHOULD BE SETTLED DIRECTLY BY THE ENROLLEE TO THE DOCTOR/HOSPITAL/CLINIC CONCERNED.

ValuCare is a Managed Care Company established by a group of medical practitioners providing HMO coverage since 1997. In 2021, it became ISO – Certified for Quality Management and Information Security Management by QAS International Ltd. It has various satellite offices, member’s hub and roving liaison officers nationwide. Some of its corporate accounts consist of SM Group of Companies, Lucio Tan Group of Companies, Robinsons Corporation Group of Companies, various Banking and Financing Firms, Educational Institutions and Shipping Companies. Its latest client is Bangko Sentral ng Pilipinas. It has more than 300,000 enrollees and more than 1,000 corporate accounts.

Added Benefit

Added benefit is the Viber Community created by ValuCare for all members so they can directly access their Customer Care Services for the issuance of Letter of Authority (LOA) and other concerns thus, avoid queueing in hospital clinics.

Those interested are advised to get in touch with Ms. Maritess “Thex” Gabriel of the coop thru email at: cbmpc2003@yahoo.com.ph or thexmari920@ yahoo.com; or at telephone numbers 8522-0538 or 8354-5926.