INHEALTH BIZ | InsureAssist.ph
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INHEALTH BIZ
COMPREHENSIVE HEALTH CARE PLAN FOR STARUPS AND SMEs

People - your most critical asset.

Pre-packaged comprehensive solutions designed for SMEs.

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DETAILS OF INLIFE HEALTH CARE'S
INHEALTH BIZ

Big benefits for your small business
InHealth Biz is a comprehensive yet affordable health program made specifically for micro and small enterprises with 5 to 99 employees.

Flexible options with competitive premium rates
Have the freedom to choose quality health benefits that best fit your business. InHealth Biz gives you the option to tailor your health plan, from choosing your benefit limit, to picking your hospital provider access.

Option 1
Access to all IHC-accredited facilities nationwide, except Healthway and Fortmed

Option 2

All to all IHC-accredited facilities, except Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC and BGC) and The Medical City, Fortmed and Healthway Clinics

Option 3
All IHC-accredited facilities in the Visayas and Mindanao area, except Healthway Clinics

Option 4
All IHC-accredited facilities in Luzon outside NCR, except Healthway Clinics

Out-Patient Benefits

This includes annual physical examination, preventive health care such as Immunization Administration and Health Education Counseling on diet or exercise, and other out-patient services like Medical Consultation and First Aid Treatment.

In-Patient Benefits

This includes services of all accredited Physicians including surgical services, room and board, general nursing service, and other services or supplies deemed medically necessary.

Emergency Care Benefits
Such as ambulance services, emergency care-related procedures in accredited and non-accredited hospitals, and room upgrade.

Summary of Plan Benefits for InHealth Biz

Membership Guidelines

Age Eligibility

  • 18 to 65 years old, as of last birthday

  • for 66 – 70 y.o.  principal members, x2.5 the standard rates

  • for 71 – 75 y.o. principal members, x3.5 the standard rates
     

Philhealth Amount (Non-Philhealth)

Additional P3,500 per non-Philhealth enrollees, inclusive of VAT

Effective date proviso

  • Not waived.

  • Under the Effective Date Provision, if the enrolled person, on account of injury or illness, is not actively working in full time employment on the date his coverage would otherwise have become effective as provided above, the coverage shall not become effective until the date such person returns to full time active work.

  • If the enrolled dependent, on account of injury or illness, is confined in a hospital on the date his coverage would otherwise have become effective as provided above, the coverage shall not become effective until the date such dependent is discharged from the hospital.

Timeline for Deliverables (Cards, SOA & Health Care Agreement or HCA)

IHC to provide the deliverables within 10 to 15 working days from inception date; provided all documents are submitted & complete

Payment Arrangement

15 working days from SOA receipt

Submission of Signed HCA by the client

Should be submitted back to IHC within ten (10) working days from receipt of final version of the HCA.

Digital-Enabled Customer Experience

HR Portal for authorized representative. Please provide name and email address of the appointed representative. All enrolled members may download and use IHC Mobile App once activated.

Utilization Report

  • The provided utilization format will be in compliance to data privacy act.

  • Option for expanded utilization information may only be provided, once client company signs the contract or signs the waiver to

OUTPATIENT BENEFITS

ANNUAL PHYSICAL EXAMINATION
BASIC 5 ONLY
Taking of Medical History/ Physical Examination
Covered
Chest X-ray
Covered
Routine Urinalysis
Covered
Routine Fecalysis
Covered
Complete Blood Count (CBC)
Covered
PREVENTIVE HEALTH CARE
-
Health Education Counselling on Diet or exercise
Covered
Periodic Monitoring of Health Problems
Covered
Family Planning Counselling
Covered
Passive and active vaccines for treatment of tetanus and animal bites-except human immunoglobulin (ER and Non-ER provided 1st treatment/dose is availed in IHC network)
Covered for the 1st dose up to P20,000
Initial treatment of Animal bites
Covered up to P5,000 per year, except cost of vaccines
Covid-19 Vaccines
Not Covered
OUT-PATIENT CARE
-
Consultations during regular clinic hours, except prescribed medicines
Covered
Eye, ear, nose and throat (EENT) treatment prescribed by an affiliated physician/specialist
Covered
Treatment for minor injuries such as lacerations, mild burns, sprains and the like
Covered
Dressings, conventional casts (plaster of Paris) and Sutures.
Covered
X-Ray, laboratory examinations, routine, and diagnostic procedures prescribed by an affiliated physician/specialist, provided however that the cost of diagnostic procedures covered shall be limited to a specific amount.
Covered
Eye laser therapy for retinal tear, retinal hole, retinal detachment and glaucoma prescribed by an affiliated physician/specialist, excluding eye correction such as Lasik, PRK and the like
Subject to PEC limit
Blood products transfusions and intravenous fluids, including blood screening and cross matching.
Covered (blood screening of donor’s blood is excluded)
TELEMEDICINE CONSULTATIONS
Covered
4K TV
Gourmet Breakfast
Spa Package
Private Pool

Laboratory, X-ray and other diagnostic examinations prescribed by physician on duty are covered up to applicable MBL

ROUTINE PROCEDURES
-
Urinalysis
Covered
Fecalysis
Covered
Complete Blood Count
Covered
Chest X-ray
Covered
Blood Chemistries
Covered
DIAGNOSTIC PROCEDURES
-
Computed Tomography Scans (CT Scan)
Covered, if medically necessary
Bone Density Test (Dex Scan / Bone Mineral Density Studies) without nuclear or radio isotope
Covered, if medically necessary
Audiograms and Tympanograms
Covered, if medically necessary
Arterial Blood Gas
Covered, if medically necessary
Anti-Nuclear Antibody, C-Reactive Protein, Lupus Cell Exam
Covered, if medically necessary
Adrenocortical Function
Covered, if medically necessary
24-hour Holter Monitoring/ Ambulatory Cardiac Monitoring
Covered, if medically necessary
Throat Swab
Covered, if medically necessary
Positron Emission Tomography (PET scan)
Covered, if medically necessary
Esophageal Manometry
Covered, if medically necessary
24 Hour EEG Monitoring
Covered, if medically necessary
Diagnostic Radiographs:
-
a. Biliary tract: Cholecystogram and Cholangiogram
Covered, if medically necessary
b. Chest, ribs, sternum and clavicle
Covered, if medically necessary
c. Digestive: Plain film of the abdomen, Barium Enema, Upper GI Series, Lower GI Series, Small Bowel series
Covered, if medically necessary
d. Face (including sinuses), Head and Neck
Covered, if medically necessary
e. Urinary: KUB, Pyelograms and Cystograms
Covered, if medically necessary
f. X-ray of the extremities and pelvis
Covered, if medically necessary
g. X-ray of the spine (cervial, thoracic, lumbo-scaral)
Covered, if medically necessary
Diagnostic Ultrasounds
-
a. 2D-Echo with Doppler
b. Abdomen
Covered, if medically necessary
c. Duplex Scan
Covered, if medically necessary
d. Digestive and Urinary Systems
Covered, if medically necessary
e. Ultrasoundof the Lungs and Chest inclduing the Thryroid
Covered, if medically necessary
f. 4D Ultrasound except for maternity-related cases
Covered, if medically necessary
Electroencephalogram
Covered, if medically necessary
Electromyelography and Nerve Conduction Studies
Covered, if medically necessary
Endoscopic Procedures (including video gastroscopy & colonoscopy)
Covered, if medically necessary
Impedance Plethysmography
Covered, if medically necessary
Lead Electrocardiogram
Covered, if medically necessary
Mammography and Sonomammogram
Covered, if medically necessary
Myelogram
Covered, if medically necessary
Pap`s Smear
Covered, if medically necessary
Perfusion Scan
Covered, if medically necessary
Plasma/Urinary Cortisol, Plasma Aldosterone
Covered, if medically necessary
Pulmonary Function Tests / Lung Function Studies
Covered, if medically necessary
Radionuclide Ventriculography
Covered, if medically necessary
Surface Electromyography (SEMG)
Covered, if medically necessary
TMST-Treadmill Stress Test (except Nuclear TMST)
Covered, if medically necessary
Genetic/Immunologic Studies
Covered, if medically necessary
Stress Testing (all types except Cardiac and Treadmill Stress Tests)
Covered, if medically necessary
Electrophoresis
Covered, if medically necessary
Inhalation therapy
Covered, if medically necessary
Laryngeal Stroboscopy
Covered, if medically necessary
Arthroscopic diagnostic procedures
Covered, if medically necessary
M-Mode Echocardiography
Covered, if medically necessary
Brain Stem Auditory Evoked Response
Covered, if medically necessary
HEPATITIS PROFILE – e.g. HBeAg, HBS Ag, Anti HBc (lgM), Anti-HAV (lgM)
Covered, if medically necessary
ANA Profile e.g. Anti-Nuclear-Antibody, Anti Native- DNA, Anti-SM, Anti-SSA, Beta HCG, ANA
Covered, if medically necessary
Thyroid Profile e.g. T3, T4, TSH, FTA-ABS
Covered, if medically necessary
TORCH Profile e.g. Anti-Toxoplasma Gondii (lgM), Anti-Rubella, Anti-Cytomegalo – Virus (Total lg)
Covered, if medically necessary
SLE test, FAT Widal Test, ASO Titer, Serum lg-Ci,
Covered, if medically necessary
Alpha-Feto Protein, ESR
Covered, if medically necessary
Urine/Blood culture and sensitivity test
Covered, if medically necessary
24-hour protein determination
Covered, if medically necessary
Troponin
Covered, if medically necessary
Glycosylated Hemoglobin
Covered, if medically necessary
Prostate Specific Antigen (PSA)
Covered, if medically necessary
APAS Testing (AntiPhospholipid Antibody Syndrome)
Covered, if medically necessary
Microscopic Examination
Covered, if medically necessary
Allergy Testing / Desentization (cost of allergens NOT covered)
Covered, except cost of allergens

INPATIENT BENEFITS (scroll on the right side to see all services)

IN-PATIENT SERVICES
-
Room and Board according to the Member’s Room & Board Accommodation under which the Member is enrolled
Covered
Use of operating room, Intensive Care Unit (ICU), isolation room (if prescribed by attending Physician) and recovery room
Covered
Professional fees in accordance with IHC Schedule of Rates
a. Attending Physicians
b. Surgeons
Covered
c. Anesthesiologists
d. Cardio-pulmonary clearance before surgery and cardiac monitoring during surgery.
Standard Nursing Services
Covered
Medicines for in-patient use
Covered
Blood products transfusions and intravenous fluids, including blood screening and cross matching.
Covered
Laboratory examinations, disgnostic tests and therapeutic procedures incidental to confinement
Covered
Dressings, conventional casts and sutures
Covered
Anesthesia and its administration
Covered
Oxygen and its administration
Covered
Standard Admission kit
Covered
All other items directly related in the medical managemnet of the patient, as deemed medically necessary by the attending affiliated physician
Covered
Assistance in administrative requirements through a Medical Liaison Officer
Covered

EMERGENCY CARE BENEFITS (scroll on the right side to see all services)

EMERGENCY CARE in Affiliated Hospitals
-
a. Doctor’s services
b. Emergency Room Fees
c. Medicines used for immediate relief during treatment
d. Oxygen, Intravenous fluids and blood products.
Covered up to MBL
e. Dressings, conventional casts (plaster of Paris) and sutures.
f. Laboratory and diagnostic examinations and other medical services related to the emergency treatment of the patient
g. Room Upgrade (Emergency Case) – Except Suite Room Accommodation
Member shall shoulder excess charges and incremental cost
In Non-affiliated Hospitals
REIMBURSEABLE up to 100% of hospital & professional fees based on IHC rates up to P30,000 per case per member
Outside the Philippines
REIMBURSEABLE up to 100% of hospital & professional fees based on IHC rates up to P30,000 per case per member
Areas w/o affiliated Hospital
REIMBURSEABLE up to 100% of hospital & professional fees based on IHC rates up to 50% of the MBL
Ambulance Service (affiliated to affiliated)
Covered subject to 50% of MBL
Ambulance Service (Affiliated/Non-Affiliated to Affiliated); if in Provincial areas – Hospital to Hospital
Reimburseable up to P2,500 per conduction

PROVIDER ACCESS (scroll on the right side to see all services)

PROVIDER ACCESS
-
Option 1
Access to all IHC-accredited facilities nationwide, except Healthway and Fortmed and American Eye,
Option 2
Access to all IHC-accredited facilities, except Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC and BGC) and The Medical City, Fortmed, Healthway Clinics and American Eye.
Option 3
All IHC-accredited facilities in the Visayas and Mindanao area, except Healthway Clinics and American Eye
Option 4
All IHC-accredited facilities in Luzon outside NCR, except Healthway Clinics and American Eye

OTHER BENEFITS AND SPECIAL SERVICES

Covid-19 Cases are covered up to applicable limits per year

  • Ward Plan             –  Up to P50,000 per year

  • Semi-private Plan   – Up to P75,000 per year or MBL, which ever is less

  • Private Plans         – Up to P100,000 per year or MBL, whichever is less

Covid-19 Testing

Covered up to P2,500 if SYMPTOMATIC; otherwise not covered

Motor Vehicular Accidents

If in an IHC accredited provider: up to P10,000 per incident but not to exceed 50% of MBL. If in non-IHC accredited

Unprovoked Assault, including domestic violence, whether initiated by the Member or by a known or unknown third party

If in an IHC accredited provider: up to P10,000 per incident but not to exceed 50% of MBL. If in non-IHC accredited

DENTAL CARE (optional) - scroll on the right to see all services

PREVENTIVE SERVICES
-
Unlimited Consultations
Covered
Oral Hygiene Instruction
Covered
Oral Prophylaxis (mild to moderate)
Covered (Once per year)
Annual Dental Examination
Covered
RESTORATIONS
Unlimited Temporary fillings
Covered
Permanent Fillings
Three (3) surfaces Amalgam OR Two (2) surfaces Light cure
Unlimited recementation of jacket crown inlays and onlays
Covered
Unlimited Simple Tooth extraction except surgery for impaction
Covered
DENTURES & ORTHODONTICS
Adjustment of Dentures – limited to adjustment of clasp
Covered
Orthodontic Consultation
Covered
Aesthetic Dental Consultation
Covered
Dental education and counselling
Covered
TREATMENTS
Treatment for lesions, wounds and burns
Treatment of Dental related pain excluding cost of prescribed medicines
Covered
Relief and/or prescription for acute dental pain
Covered
Emergency desensitization of hypersensitive teeth
Covered
Gum Treatment(except gum surgery)excluding cost of prescribed medicines. This shall include the management of other dental problems excluding surgeries.
Covered

GROUP LIFE WITH ACCIDENTAL DEATH & DISABLEMENT (AD&D) BENEFITS   (Optional) Life - 10,000

AD&D Coverage
-
a. life
100% of amount of insurance
b. entire sight of both eyes
100% of amount of insurance
c. both hands or both feet
100% of amount of insurance
d. one hand and one foot
100% of amount of insurance
e. either hand or foot and sight of one eye
100% of amount of insurance
f. Arm at or above elbow
70% of amount of insurance
g. Leg at or above knee
60% of amount of insurance
h. One hand at or above wrist
50% of amount of insurance
i. One foot at or above the ankle
50% of amount of insurance
j. Hearing of both ears
50% of amount of insurance
k. Sight of one eye
50% of amount of insurance
l. Four fingers and thumb of one hand
50% of amount of insurance

Eligible Members

  • 18 to 65 years old, as of last birthday

  • Overage principal members may be accepted subject to substandard rating of x2.5 (for ages 66 – 70) and x3.5 (for ages 71 – 75).

PRE-EXISTING CONDITIONS

  • FOR PRINCIPAL MEMBERS: Pre-existing conditions are covered up to MBL

  • FOR DEPENDENTS: Pre-existing conditions are covered once 75% minimum participation is met; otherwise subject to the following:

  • If 50% <= P < 75%; subject to 1 year contestability

  • If 25% <= P < 50%; subject to 1 year contestability (with adjusted rate)

BOOK AN APPOINTMENT FOR A DISCUSSION ON HOW TO PROVIDE A COMPREHENSIVE HEALTH CARE PLAN FOR YOUR SME/SMALL BUSINESS/STARTUP'S EMPLOYEES OR TEAM MEMBERS

Please click on the button below if you wish to book an appointment schedule to have an online discussion about getting a comprehensive health care plan for your SME or small business or startup's employess or team members.

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