ALLCARE for Individuals Terms & Conditions
Benefits Details
HMO Benefits
- ₱50,000 to ₱250,000 per illness HMO coverage or Maximum Benefit Limit
Access to over 1,600 hospitals and clinics nationwide, including all Healthway clinics, and nine (9) major hospitals:
- Asian Hospital & Medical Center
- Cardinal Santos Medical Center
- Makati Medical Center
- St. Luke’s Medical Center - Global City
- St. Luke’s Medical Center - Quezon City
- The Medical City
- Chong Hua Hospital
- Cebu Doctors’ University Hospital
- Davao Doctors Hospital
- Can be used for emergency care, outpatient consultations, non-confinement; medical procedures; Inpatient (confinement in a small private room or equivalent)
- All pre-existing conditions are covered up to ₱30,000 for the first year and up-to-MBL upon renewal
- Congenital disease/deformities are covered up to ₱30,000
- Special Modalities covered up to MBL
- HIV-related cases coverage up to 30% of MBL as long as medically necessary
Life Insurance
The plan member is provided with a life insurance coverage to serve as financial assistance for his designated beneficiaries as a result of his death:
Death due to natural causes : ₱50,000.00
Death due to accident : ₱100,000.00
Physical Exam
Free one (1) Basic 7 Annual Physical Exam including:
- Complete Blood Count
- Urinalysis
- Fecalysis
- Xray
- Physical Examination
- Pap smear (for female enrollees 35 years old and above); and
- ECG (for enrollees 35 years old and above) to be conducted at/provided by a specific accredited APE provider.
- Discounted Health Packages at Shinagawa Diagnostic & Preventive Care on:
- Japanese Standard Health Checkup
- Blood Exam
- Diagnostic Imaging Exam
- Endoscopy Procedure
Teleconsultation
24/7 video consultations with summarized medical information and prescription
Dental Care
- Oral examinations/diagnosis as needed
- Annual Prophylaxis every six (6) months (twice per policy year)
- Gum problem consultation and treatment
- Simple tooth extraction when indicated (excluding impaction)
- Temporary fillings when indicated
- Recementation of loose jacket crowns
- Adjustment/repair of dentures
- Oral hygiene instruction
- Dental health education and consultation
- Orthodontic treatment consultation
- Discounted rates of up to 20% for other services not covered by the dental plan (e.g. dentures, crowns, bleaching, orthodontic treatment, x-rays and dental surgery)
- Two (2) teeth light cure fillings
- Dental benefits can only be available on a no-cash-out basis (reimbursement not allowed) at any accredited dental clinics/dentists nationwide only.
Emergency Care
Ambulance Service Coverage
A one-time reimbursable ambulance service of up to ₱5,000 covers transport from the emergency site to the nearest facility. Transfers to another hospital afterward are not reimbursable.
In Accredited Hospitals
Doctor services, X-Rays, laboratory and diagnostic examinations, and other medical services related to the emergency treatment of the member are covered subject to MBL
In Non-Accredited Hospitals and outside the Philippines
Reimbursable up to 100% of the amount the HMO partner provider would have paid in an accredited facility.
Room Upgrade
If a small private room is unavailable during an emergency, a room upgrade is covered for up to 24 hours, excluding suites.
Optical Perks
- 7-Step Comprehensive Eye Exam
- Buy 1, Get 1 Promo
- 15% discount on all regular items, pre-packed Tony Morgan London computer glasses, and Shamir and Tokai Lenses
- 10% discount on all Bausch and Lomb Contact Lenses
- Unli-free custom fitting and frame adjustments, and ultrasonic eyewear cleaning
- Replacement of screws and nose pads for frames
- Eye care health talks/webinar
- Up to 65% off on select Lasik services
- Up to 60% on select implantable contact lenses
- Free comprehensive eye screening
- Free comprehensive eye screening
- Free comprehensive eye exam
- 10% discount on select products in selected Sarabia Optical branches
- 5% discount on any brand of contact lenses of your choice
Mental Health Benefits
- Free comprehensive mental health survey
- Mental health consultation coverage up to ₱20,000 with a limit of 10 sessions at a maximum of ₱2,000 per session.
Limitations
The benefits package excludes coverage of the following:
- Care by non-accredited Physician and/or in a non-preferred/non-accredited hospital or clinic, except in emergencies wherein the Emergency Provision of the Agreement shall apply.
- All Pregnancy-related conditions requiring medical/surgical care and screening tests related thereto.
- All dental related services not expressly stipulated in the Dental Rider Endorsement.
- Sterilization of either sex or reversal of such, artificial insemination, sex transformations, or diagnosis and treatment of infertility, and circumcision (except treatment of urological conditions).
- Rest cures, custodial, domiciliary, or convalescent care.
- Cosmetic surgery, dental/oral surgery, and dermatological procedures for the purpose of beautification except reconstructive surgery to treat a dysfunctional defect due to a disease or accident.
- Psychiatric disorders, psychosomatic illnesses, hyperventilation syndrome, stress related conditions, adjustment disorders, alcoholism and its complications or conditions related to substance or drug abuse, addiction and intoxication.
- Sexually transmitted diseases/ infections.
- Medical and/or surgical procedures which are not generally accepted as standard medical treatment by the medical profession like acupuncture.
- Procurement or use of corrective appliances, artificial aids and durable equipment, and orthopedic prosthesis and implants.
- Surcharges resulting from additional personal (luxuries/accommodation) request or service including special nursing services.
- Physical examination required for obtaining employment, certification for whatever legal purpose it may serve, insurance, or a governmental license.
- Injuries or illness due to military, paramilitary, police service, high risk activities, or those suffered under conditions of war.
- Reimbursement of procedures obtained through government programs.
- Injuries or illnesses which are self-inflicted, caused by attempt at suicide or incurred as a result of or while participating in a crime or any acts in violation of law, administrative order or ordinance.
- Outpatient/take home medicines.
- Valvular Heart Disease and/or Rheumatic Heart Disease.
- Medico-legal consultations and confinements.
- All hospital expenses and professional fees incurred by a Member when discharged against medical advice and those subsequent expenses incurred by the said Member for the same condition and its complication after such discharge during the contract period.
- Organ or blood donor screening and other screening procedures that are purely diagnostic or for screening purposes including among others. Purified Protein Derivative (PPD), and procedures conducted prior to hormonal replacement therapy.
- Organ Donor Services “for organ transplants and/or open-heart surgery and all services related thereto”.
- All hospital charges and professional fees after the day and time hospital discharge have been duly authorized.
- Professional fees of assistant surgeons.
- Conditions excluded by medical underwriting.
- Concealment cases.
- Use of emergency room facilities on non- emergency cases or by reason of conditions/ injuries not falling under the term “Emergency” as defined under this Agreement.
- Diseases declared by the Department of Health as epidemic.
- Miscellaneous Fees not related in the diagnosis and treatment of a member's condition such as, but not limited to, “nursing fee”, waste/biologic hazard disposal fee, management fee, local taxes, and other analogous fees.
Terms of Engagement
Eligibility
- SoloCare enrollees must be sign up online for the enlistment on their Membership Enrollment Form (MEF) and appropriate membership fees.
- Eligible members shall be between 1 day old to 65 years of age upon enrollment.
- Minor members (1 day old to 17 years old) can enjoy HMO-related benefits only (HMO, Annual Physical Exam, Life Insurance, Emergency Ambulance Service, Teleconsultation, and Dental Benefits) at regular rates.
Requirements for Enrollment
- Government-issued IDs
- Birth Certificate (for minor plan members)
Address Information and Card Delivery
- The member is responsible for providing accurate and complete address information in the SoloCare Enrollment Form and in ensuring their availability during delivery. ALLCARE will send email notifications with tracking details.
- ALLCARE's logistics partner will make two delivery attempts within 60 days from the date of activation.
- Charges for reshipping will apply if the card is returned due to the following reasons: incorrect/outdated address information, incomplete address (e.g., missing house number), failure to pick up from the assigned LBC branch, and/or if delivery status is marked as "House Closed", "Consignee Unknown", or "Moved Out".
Membership
- Membership activation will commence 7-10 working days after date of confirmation of complete requirements and verification of payment.
- All members must claim their benefits through the ALLCARE MyBenefits Dashboard or ALLCARE MyBenefits app.
- Unclaimed benefits and perks are not refundable or transferable.
In case of membership forfeiture, a calculated refund shall be made to the member, if and only if, the following conditions are all applicable:
- the member has chosen to pay the membership fees via One-Time Annual Payment;
- the member was activated no more than 6 months on the date of request for membership termination;
- the said member has NO UTILIZATION both on Health, Dental, Life Insurance and other benefits outlined in this page;
- The member must provide basic information for members’ registration to be submitted by ALLCARE to partner providers.
- The member shall accept the standard terms and conditions of each membership found on the ALLCARE website.
- All members get access to the ALLCARE MyBenefits Dashboard where disbursement of benefits is automated like Requesting for LOA/LOG, requesting for a dental check-up, annual physical, etc. or in the absence of the member’s card, he/she can use the portal to get their membership number for emergencies.
General Utilization Procedure
Every member shall follow each benefits’ utilization procedure as described in their MyBenefits Dashboard
MyBenefits Dashboard
All members of ALLCARE may view and avail all of their benefits through the MyBenefits Dashboard. The MyBenefits Dashboard is accessible on web and on mobile.
Other Online Channels
All members can reach the ALLCARE Benefits team via email at support@allcare.io or via ALLCARE official Facebook and Messenger account.
Emergency Cases
For emergency needs, the member is advised to directly go to the nearest accredited medical facility for immediate medical attention.
Account Suspension and Deletion due to Non-Payment
If the member under Semi-Annual, Quarterly, or Monthly modes of payment fails to pay the membership within the prescribed period prior to respective service cycles, ALLCARE reserves the right to suspend and delete your account until payment has been made and confirmed.
Service Cycle
The service cycle for the provided services shall commence on the date of activation and recur depending on the member's chosen mode of payment thereafter.
Notification Email
An email notification will be sent to the provided email address: 30 days prior to the commencement of the next billing cycle. This email will serve as a reminder to settle outstanding payments.
Payment Due Date
Clients are required to make payment within 15 days of receiving the notification email to avoid any service disruptions.
Suspension Warning
In the event of non-payment 7 days before the service cycle, a suspension warning will be issued via email, notifying the client that their account is at risk of suspension.
Account Suspension
Failure to make payment within the specified 15-day period may result in the temporary suspension of services. The client will be notified of the suspension and given a grace period of 7 days to settle outstanding dues.
Account Deletion Endorsement
If payment is not received within the 7-day grace period after suspension, the account will be endorsed for deletion. The client will receive a final notification stating that their account is slated for deletion unless payment is made within the specified timeframe.
Reactivation of Services
Once payment is received and processed, suspended services will be promptly reactivated. However, if an account has been endorsed for deletion, reactivation may be subject to additional terms and fees.
Payment Methods
Payments shall be made through the designated payment methods as specified in the initial agreement.
Contact Information
It is the responsibility of the Member to ensure that their contact information, including email address, is accurate and up-to-date. Failure to receive notifications due to outdated contact information does not exempt the client from adhering to the specified payment terms.
By utilizing the services provided by ALLCARE, the client agrees to abide by these payment terms and conditions. ALLCARE reserves the right to amend these terms with prior notice. Members will be informed of any changes to the terms and conditions through the email address associated with their account.
Privacy Statement
SECTION 1 - OVERVIEW
The ALLCARE Privacy Statement (“Privacy Statement”) explains the personal data which ALLCARE Technologies Philippines Inc. (“ALLCARE”) collects from the user (“data subject”) through the utilization of ALLCARE’s system, why ALLCARE collects such data, how ALLCARE uses the data and the privacy setting options that ALLCARE may offer the data subject upon the use of ALLCARE’s services.
The data subject is advised to read carefully ALLCARE’s entire Privacy Statement before using and/or utilizing the services of ALLCARE specifically its: website, e mail notifications, Short Message Service (“SMS”) notifications, call logs, mobile applications, social media accounts, and all of its other online services. This will help the data subject to understand what ALLCARE does with the data that it has obtained, derived, or inferred. ALLCARE’s processing of personal data includes the following:
- Collection
- Use/Sharing
- Storage
- Disposal
By accepting the services, the data subject confirms that he or she is of legal age and that he or she accepts and consents to be bound by the provisions of this Privacy Statement as well as the processing of his or her personal data, which may include personal information and/or sensitive information as set out in this Privacy Statement and/or otherwise provided by the data subject or possessed by ALLCARE for one or more of the purposes as described herein.
SECTION 2 - USER INFORMATION WITH ALLCARE
ALLCARE collects personal data, as defined under the Data Privacy Act of 2012 and its implementing rules and regulations, to operate effectively and provide the data subject the best experience of ALLCARE’s services. The data subject voluntarily provides pertinent data directly upon creation of an account or upon registration in ALLCARE’s system. ALLCARE is able to collect information from the data subject through other means whenever such data subject utilizes the services of ALLCARE. ALLCARE collects user data for the following purposes:
- Operational processes
- Product sourcing
- Service Request
- Customer inquiry handling
- Prospecting
- Client prospecting
- Forecasting
- Marketing
- Reporting
When the data subject makes use of ALLCARE’s service or browses ALLCARE’s store, ALLCARE automatically collects and stores certain information in the ALLCARE server logs. These information include, among others:
- Personal information (name, address, birthday and contact information)
- Benefits information (benefits available and HMO information)
- Medical / Patient information (necessary for HMO processing)
- Work / Professional information
- Service preferences
- Internet protocol address
- Cookies that may uniquely identify the browser and operating system of the user
ALLCARE uses cookies and other similar technologies to collect and store information when its service is used. The use of these cookies is limited only to storing data on the specific session of the data subject.
To protect the personal information of the data subject, ALLCARE takes reasonable and appropriate organizational, physical, and technical measures intended to protect the data against any accidental or unlawful destruction, alteration, disclosure, as well as protection against human dangers such as unlawful access, fraudulent misuse, unlawful destruction, alteration and contamination.
In case of questions or requests on the submitted information, please contact the Data Protection Officer (“DPO”), Jose Paulo Dela Fuente of ALLCARE at the details provided below:
- Name: Joy Mica C. Hernandez
- Email: joy@allcare.io
- Mailing Address: #74 Mangan-Vaca purok 1, Subic, Zambales 2209
ALLCARE uses the personal information that it collects from the data subject to provide, maintain, protect, improve, and develop ALLCARE’sservices. ALLCARE also usessuch information to be able to offer the data subject a more personalized content (i.e. searching). Further, ALLCARE may use the data provided by the data subject to create a profile in its system which will allow ALLCARE to identify the data subject whenever ALLCARE’s services are used. ALLCARE may also use the email address that is provided to it to inform the data subject of its services such as product offers, changes, or improvements in the system.
In particular, ALLCARE uses the personal data it collects from the data subject for the following purposes:
- Operational processes
- Benefits sourcing
- Marketing
- Database uploading
- Database back-ups
- Reporting
- Program reviews
- Feasibility studies
ALLCARE will keep the personal data of the data subject confidential. However, it may be necessary for ALLCARE to transfer and disclose personal information for the purpose of service deliveries and other related operations, service delivery improvement, and similar purposes to the following categories of parties:
- Companies and/or organizations that act as ALLCARE’s agents, contractors and/or service providers;
- ALLCARE’s channel partners and affiliates for purposes that are related to the purpose for collecting and using the data subject’s personal information;
- Other parties in respect of whom the data subject has previously given his/her express consent;
- ALLCARE’s auditors, consultants, accountants, lawyers or other financial or professional advisers; and/or
- Companies and/or organizations that assist ALLCARE in processing and/or otherwise fulfilling transactions and providing the data subject with products and/or services that he/she has requested or subscribed for;
ALLCARE will only disclose personal information with the abovementioned entities for the purpose/s indicated only with the consent of the data subject or if required by an applicable law, judicial or other governmental action. The data subject is deemed to have given such consent once he or she provides personal information details in ALLCARE’s system.*
*Please see detailed discussion on consent under Section 4.
ALLCARE data is stored in medium to highly secured places, depending on the sensitivity of the information. ALLCARE uses the following as data storage mediums:
- Amazon web services cloud
- Google G-Suite
- Local file storage
- Local computers
- Trello
- Excel sheets
- Data drive
- Filing cabinets
- Internal ALLCARE administration system
- FreshDesk ticketing system
- MySMS
- X-Lite softphone
- HubSpot
ALLCARE keeps the personal information of the data subject in its system throughout the term of the engagement between ALLCARE and its Client and for a period of 10 years thereafter.
SECTION 3 - THIRD-PARTY PRIVACY POLICIES AND STATEMENTS
In general, the third-party providers used by ALLCARE will only collect, use, and disclose user information to the extent necessary to allow them to perform the services that they provide to ALLCARE. However, certain third-party service providers, such as payment gateways and other payment transaction processors, have their own privacy policies and statements with respect to the information that ALLCARE is required to provide to them for user purchase-related transactions. For these providers, ALLCARE recommends that the data subject should read their privacy policies and statements so that such data subject can understand the manner of how his or her personal information will be handled by these providers.
In particular, the data subject is reminded that certain providers may be located in or have facilities that are located in different jurisdictions. Hence, if the data subject elects to proceed with a transaction that involves the services of a third-party service provider, then the information may become subject to the laws of the jurisdiction(s) in which such service provider or its facilities are located. As an example, if the data subject is located in the Philippines and the transaction is processed by a payment gateway located in the United States, then the personal information used in completing that transaction may be subject to disclosure under United States legislation, including the Patriot Act.
When the data subject clicks on links in ALLCARE’sstore, the data subject may be directed away from the ALLCARE site. ALLCARE is not responsible for the privacy practices of other sites and encourages the data subject to read their privacy statements
When the data subject enters his or her registration details and completes the membership process, the data subject is deemed to have given consent to the collection, use, and processing of his or her personal data in connection with the services of ALLCARE and any of the purposes mentioned in Section 2, including but not limited to: (i) allowing access to ALLCARE’s platform for enrollment of benefits/ awarding of incentives; (ii) purchasing items from ALLCARE’s benefits / incentives store; (iii) coordinating delivery of ALLCARE merchants to the data subject as an employee; (iv) coordinating with the data subject directly on request status; and (v) other situations where ALLCARE may require user data in order to fulfill its partnership agreement with the employer of the data subject.
When the data subject provides ALLCARE with personal information to complete a service request, it is implied that ALLCARE is allowed to collect and use such information for that specific service purpose only.
In the event that the data subject wants to withdraw his or her consent for the continued collection, use or disclosure of his or her personal information, the data subject may contact the Data Protection Officer at the details indicated in Section 2 of this Privacy Statement.
In general, the third-party providers used by ALLCARE will only collect, use, and disclose user information to the extent necessary to allow them to perform the services that they provide to ALLCARE. However, certain third-party service providers, such as payment gateways and other payment transaction processors, have their own privacy policies and statements with respect to the information that ALLCARE is required to provide to them for user purchase-related transactions. For these providers, ALLCARE recommends that the data subject should read their privacy policies and statements so that such data subject can understand the manner of how his or her personal information will be handled by these providers.
In particular, the data subject is reminded that certain providers may be located in or have facilities that are located in different jurisdictions. Hence, if the data subject elects to proceed with a transaction that involves the services of a third-party service provider, then the information may become subject to the laws of the jurisdiction(s) in which such service provider or its facilities are located. As an example, if the data subject is located in the Philippines and the transaction is processed by a payment gateway located in the United States, then the personal information used in completing that transaction may be subject to disclosure under United States legislation, including the Patriot Act.
When the data subject clicks on links in ALLCARE’s store, the data subject may be directed away from the ALLCARE site. ALLCARE is not responsible for the privacy practices of other sites and encourages the data subject to read their privacy statements.
SECTION 4 – USER CONSENT
When the data subject enters his or her registration details and completes the membership process, the data subject is deemed to have given consent to the collection, use, and processing of his or her personal data in connection with the services of ALLCARE and any of the purposes mentioned in Section 2, including but not limited to: (i) allowing access to ALLCARE’s platform for enrollment of benefits/ awarding of incentives; (ii) purchasing items from ALLCARE’s benefits / incentives store; (iii) coordinating delivery of ALLCARE merchants to the data subject as an employee; (iv) coordinating with the data subject directly on request status; and (v) other situations where ALLCARE may require user data in order to fulfill its partnership agreement with the employer of the data subject.
When the data subject provides ALLCARE with personal information to complete a service request, it is implied that ALLCARE is allowed to collect and use such information for that specific service purpose only.
In the event that the data subject wants to withdraw his or her consent for the continued collection, use or disclosure of his or her personal information, the data subject may contact the Data Protection Officer at the details indicated in Section 2 of this Privacy Statement.
SECTION 5 – RIGHTS OF THE DATA SUBJECT
Under and in accordance with the terms of the Data Privacy Act of 2012, the data subject whose personal information will be processed has the following rights: the right to object to processing of data, the right to access data, the right to correct any inaccurate data, and the right to erasure or blocking of data, among others. For concerns related to data privacy regulations or on how to reach the National Privacy Commission (NPC), please contact the Data Protection Officer (“DPO”), Joy Mica C. Hernandez of ALLCARE, at the details provided below:
- Name: Joy Mica C. Hernandez
- Email: joy@allcare.io
- Mailing Address: #74 Mangan-Vaca purok 1, Subic, Zambales 2209
SECTION 6 – PENALTIES
In case there is a breach of this Privacy Statement or violation of any of the provisions of the Data Privacy Act of 2012, applicable penalties and legal remedies ensuing from such law, its implementing rules, amendments and supplements thereto and any other applicable laws or regulations, shall be available to the aggrieved party.
Any external stakeholder found to have violated this Privacy Statement may also be subject to disciplinary action, which includes termination of contract and/or appropriate legal action.
SECTION 7 – CHANGES TO THIS DOCUMENT
ALLCARE reserves the right to modify this Privacy Statement at any time without prior notice. Accordingly, the data subject is advised to review this Privacy Statement frequently. In the event that any changes are made, the modified Privacy Statement will be posted on this page. The prior version of each Privacy Statement will be retained in an archive for the review of the data subject.
If ALLCARE is acquired by or merged with another company, the personal information may be transferred to the new owners in order that ALLCARE may continue to sell its products and servicesto the data subject. Nonetheless, ALLCARE will ensure that any personal information will remain confidential and ALLCARE will provide the affected data subjects with notice before the pertinent personal information is transferred or becomes subject to an updated or different Privacy Statement.
