IN-PATIENT BENEFITS
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1. Room and Board
a. In case hospitalization arises either through the advise of the Insular Health Care Medical Coordinator or by way of an "emergency" situation, Insular Health Care shall:
b. secure the room chosen by its member using a step-ladder" system (lowest to highest).
c. For genuine emergency cases (as defined in the agreement), in the event that the room accommodation pre-selected by the member under his Insular Health Care package is not readily available, the member shall automatically be upgraded to the next higher room classification for the first TWENTY FOUR (24) HOURS and the ancillary price difference shall be borne by Insular Health Care with absolutely no obligation on the part of the member. After the first twenty-four (24) hours and there still is no room available under the member’s original room classification, in the succeeding days of his confinement, the member shall pay for the difference in room rate as well as the difference in ancillary expenses between the higher room category and the original room category.
d. Room amenities vary according to actual hospital set-up.
2. Services of all accredited specialists
3. General nursing services
4. Use of operating room
5. Use of recovery room
6. Anesthesia and its administration
7. Drugs and medications for use in the hospital
8. Oxygen and its administration
9. Dressing, standard plaster or fiberglass cast
10.Transfusion of blood and other blood elements except donor-screening services.
11. Chemotheraphy/radio therapy (including out-patient)
12. ICU confinement covered up to Maximum Benefit Limit
13. Dialysis (inclusive of out-patient dialysis) covered up to Maximum Benefit Limit
14. Physical therapy (inclusive of out-patient physical therapy) covered up to Maximum Benefit Limit
15. Services and supplies related to the medical management of the patient subject to program provisions including confirmatory tests for pre-existing conditions except those related to health conditions listed under "Permanent Exclusions"
16. Other hospital charges deemed necessary by the Insular Health Care accredited Physician in the treatment of the patient subject to program provisions
17. Ambulance services (hospital to hospital transfers, limited to P 3,500 per conduction), if requested by an Insular Health Care physician
18. Admission Kit is covered.
a. In case hospitalization arises either through the advise of the Insular Health Care Medical Coordinator or by way of an "emergency" situation, Insular Health Care shall:
b. secure the room chosen by its member using a step-ladder" system (lowest to highest).
c. For genuine emergency cases (as defined in the agreement), in the event that the room accommodation pre-selected by the member under his Insular Health Care package is not readily available, the member shall automatically be upgraded to the next higher room classification for the first TWENTY FOUR (24) HOURS and the ancillary price difference shall be borne by Insular Health Care with absolutely no obligation on the part of the member. After the first twenty-four (24) hours and there still is no room available under the member’s original room classification, in the succeeding days of his confinement, the member shall pay for the difference in room rate as well as the difference in ancillary expenses between the higher room category and the original room category.
d. Room amenities vary according to actual hospital set-up.
2. Services of all accredited specialists
3. General nursing services
4. Use of operating room
5. Use of recovery room
6. Anesthesia and its administration
7. Drugs and medications for use in the hospital
8. Oxygen and its administration
9. Dressing, standard plaster or fiberglass cast
10.Transfusion of blood and other blood elements except donor-screening services.
11. Chemotheraphy/radio therapy (including out-patient)
12. ICU confinement covered up to Maximum Benefit Limit
13. Dialysis (inclusive of out-patient dialysis) covered up to Maximum Benefit Limit
14. Physical therapy (inclusive of out-patient physical therapy) covered up to Maximum Benefit Limit
15. Services and supplies related to the medical management of the patient subject to program provisions including confirmatory tests for pre-existing conditions except those related to health conditions listed under "Permanent Exclusions"
16. Other hospital charges deemed necessary by the Insular Health Care accredited Physician in the treatment of the patient subject to program provisions
17. Ambulance services (hospital to hospital transfers, limited to P 3,500 per conduction), if requested by an Insular Health Care physician
18. Admission Kit is covered.
