[Blueboard] Medical Insurance Update

personnel at admu.edu.ph personnel at admu.edu.ph
Mon Oct 8 12:09:24 PHT 2007

5 October 2007

TO    :   University Community
          (HMO Members)

FROM  :   Ms. Imelda G. Nibungco
          Personnel Director

          Expanded Benefits

Please be informed of the following changes in the benefits provided under
our health insurance plan.

        1.  Out-Patient Tests
              Confirmatory tests such as MRI, CT scan, Thallium tests and
              the like, done on an Out-patient basis will be treated as
              In-patient claims. There will be a cumulative cap of
              Php 20,000.00 per year per member for these procedures.

        2.  Emergency Cases
              Emergency treatment due to vehicular accidents or
              accidental body injury related cases will be charged to
              In-patient benefits.  Prerequisite procedures or
              documentation required for emergency cases, like LOA's,
              police reports and medical certification of attending
              physician should be submitted within 2 days
              after the availment.  These requirements will
              substantiate the claim for emergency treatment.

        3.  Specialist Fees
              Each member shall be entitled to a Specialist's fee
              benefit of Php 1,200.00/per day per Specialist,
              regardless of the number of specialists and days the
              patient is confined. This is subject to an aggregate
              maximum of Php 12,000.00 per confinement.

        4.  Prenatal and Postnatal consultation Outside the Network
              Prenatal and postnatal consultations availed outside the
              network facility can be reimbursed, subject to the
              limits of the Plan.

We are continuously monitoring the use of our health insurance plan.
Should you have any problems/concerns regarding the use or availment of
our health care benefit, do let us know.  A Health Care Feedback Form
located at the subsection of the Personnel Office website may be accessed
for your convenience or click on the URL below:


Personnel Director

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