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standard benefits of Fortune Care card holder:
Members may avail of any of the following Health Care Benefits under our Standard Program at any Fortune CARE Clinics and/ or affiliated institutions.
PREVENTIVE HEALTH CARE SERVICES
The following healthcare services are available at Fortune CARE-owned clinics:
- Immunization excluding cost of sera
- Consultations and advice on diet, exercise and other healthy habits
- Family Planning and Counseling
- Well-baby care (for member's unenrolled baby less than 3 months of age)
Annual Physical Examination at Fortune CARE clinics or at company premises upon corporate account�s request
- Physical Examination and Medical History Taking
- Chest X-ray
- Urinalysis and Fecalysis
- CBC
- ECG, Pap Smear, FBS (for 35 years old and above or if indicated)
OUT PATIENT CARE SERVICES
The out-patient benefits are provided for the diagnosis and treatment of illness or injury,which does not require hospitalization. The following OPD services shall only be availed in any of our Fortune CARE owned clinics or through our Medical Coordinator in Fortune CARE accredited hospitals in provincial areas where there are no Fortune CARE Owned clinics.
- Consultation during clinic hours
- EENT (Eyes, Ears, Nose, Throat) Care
- Treatment of minor injuries, such as lacerations, abrasions, mild burns, sprains, etc.
- Minor Surgical procedures available at Fortune CARE Clinics for covered lesions
- Necessary routine laboratory test and commonly available diagnostic procedures, including ECG & X-ray
examinations, as prescribed by Fortune CARE physicians & specialists
- Pre and post-natal care in Fortune CARE-owned clinics only
- Out-patient services will include first dose of anti-rabies, anti-tetanus, anti-venom during emergency cases
up to P5,000.00 per year (single availment only)
- Cauterization of warts except genital and sexually transmitted warts up to P2,500.00 per year.
PREVENTIVE HEALTH CARE SERVICES
The following healthcare services are available at Fortune CARE-owned clinics:
- Immunization excluding cost of sera
- Consultations and advice on diet, exercise and other healthy habits
- Family Planning and Counseling
- Well-baby care (for member's unenrolled baby less than 3 months of age)
Annual Physical Examination at Fortune CARE clinics or at company premises upon corporate account�s request
- Physical Examination and Medical History Taking
- Chest X-ray
- Urinalysis and Fecalysis
- CBC
- ECG, Pap Smear, FBS (for 35 years old and above or if indicated)
OUT PATIENT CARE SERVICES
The out-patient benefits are provided for the diagnosis and treatment of illness or injury,which does not require hospitalization. The following OPD services shall only be availed in any of our Fortune CARE owned clinics or through our Medical Coordinator in Fortune CARE accredited hospitals in provincial areas where there are no Fortune CARE Owned clinics.
- Consultation during clinic hours
- EENT (Eyes, Ears, Nose, Throat) Care
- Treatment of minor injuries, such as lacerations, abrasions, mild burns, sprains, etc.
- Minor Surgical procedures available at Fortune CARE Clinics for covered lesions
- Necessary routine laboratory test and commonly available diagnostic procedures, including ECG & X-ray
examinations, as prescribed by Fortune CARE physicians & specialists
- Pre and post-natal care in Fortune CARE-owned clinics only
- Out-patient services will include first dose of anti-rabies, anti-tetanus, anti-venom during emergency cases
up to P5,000.00 per year (single availment only)
- Cauterization of warts except genital and sexually transmitted warts up to P2,500.00 per year.
IN-PATIENT CARE / HOSPITALIZATION CARE SERVICES
1.Extended for the treatment of illness/injury of the Fortune CARE accredited hospitals under the care of
affiliated specialists.
2.Room and board up to the maximum daily rate stated in the contracted plan
3.Professional services of the Fortune CARE affiliated doctors/physicians
4.Use of Operating and Recovery Room
5.Whole blood, packed RBC, platelet concentrate, plasma and intravenous fluids
6.Drugs and medications during confinement
7.Oxygen and its administration
8.Dressings, plaster casts, sutures and other miscellaneous supplies directly used in the treatment of the
covered ailment
9.Indicated use of ICU, CCU and special units subject to the maximum limit for the underlying dreaded disease
10.Routine laboratory examinations and commonly available diagnostic procedures as ordered by the Fortune
CARE affiliated attending physician/ surgeon
EMERGENCY ROOM CARE SERVICES
Out-patient or In-patient services shall at anytime be provided to the member when he/she is brought to the emergency room (ER), i.e. the condition is one of immediate danger of death, loss of vital bodily function, member in severe chest and abdominal pain that would require immediate attention.
1.Doctor's Services
2.Medicine for immediate relief of pain and other symptoms administered in the Emergency Room
3.Oxygen and other intravenous fluids
4.Dressings, plaster casts and sutures
5.X-ray, laboratory and other tests necessary for patient'emergency management.
6.For emergency treatment in a non-accredited hospital, Fortune CARE reimburses as much as 80% of what
it would cost if treatment was done by an affiliated physician in an accredited hospital. Fortune CARE must
be notified within 24 hours after patient is admitted or treated in a non-accredited hospital.
1.Extended for the treatment of illness/injury of the Fortune CARE accredited hospitals under the care of
affiliated specialists.
2.Room and board up to the maximum daily rate stated in the contracted plan
3.Professional services of the Fortune CARE affiliated doctors/physicians
4.Use of Operating and Recovery Room
5.Whole blood, packed RBC, platelet concentrate, plasma and intravenous fluids
6.Drugs and medications during confinement
7.Oxygen and its administration
8.Dressings, plaster casts, sutures and other miscellaneous supplies directly used in the treatment of the
covered ailment
9.Indicated use of ICU, CCU and special units subject to the maximum limit for the underlying dreaded disease
10.Routine laboratory examinations and commonly available diagnostic procedures as ordered by the Fortune
CARE affiliated attending physician/ surgeon
EMERGENCY ROOM CARE SERVICES
Out-patient or In-patient services shall at anytime be provided to the member when he/she is brought to the emergency room (ER), i.e. the condition is one of immediate danger of death, loss of vital bodily function, member in severe chest and abdominal pain that would require immediate attention.
1.Doctor's Services
2.Medicine for immediate relief of pain and other symptoms administered in the Emergency Room
3.Oxygen and other intravenous fluids
4.Dressings, plaster casts and sutures
5.X-ray, laboratory and other tests necessary for patient'emergency management.
6.For emergency treatment in a non-accredited hospital, Fortune CARE reimburses as much as 80% of what
it would cost if treatment was done by an affiliated physician in an accredited hospital. Fortune CARE must
be notified within 24 hours after patient is admitted or treated in a non-accredited hospital.
BENEFITS FOR SPECIAL DIAGNOSTIC PROCEDURES:
The member shall be entitled to any of the following procedures upon the request of a Fortune CARE affiliated Physician and approval by the Utilization Management Committee, except in emergency cases as herein defined:
Immunologic and Special Laboratory Examinations:
- Hepatitis profile, e.g. HbeAG, HBS AG, Anti HBC (IgM) and Anti-HAV (IgM)
- ANA profile, e.g. Anti-Nuclear-Antibody, Anti native-DNA, Anti-Sm, Anti-SSA, Beta-HCG, ANA
- Thyroid Profile, e.g. T3 T4, TSH, FTA-ABS.
- TORCH profile, e.g. Anti-Toxoplasma Gondii (IgM), Anti-Rubella, Anti-Cystomegalo-Virus (Total IgG).
- SLE test, FAT, Widal Test, ASO Titer, Serum IgG, Alpha-Feto protein, ESR
- Urine/ blood culture and sensitivity test.
- 24-hour protein determination
- Troponin
- Glycosylated Hemoglobin
- Prostate Specific Antigen (PSA)
Special and Computer-Based Diagnostic and Therapeutic Procedures:
1. Mammography P 5,000.00/disease/year
2. All types of Ultrasound No limit
3. Stress Testing (all types) P 10,000.00/year
4. All types of Cat Scan P 5,000.00/disease/year
5. Nuclear Imaging (including Parathyroid Scan) P 5,000.00/disease/year
6. Total Body Scan P 5,000.00/disease/year
7. Bone Scan P 5,000.00/disease/year
8. Renal Scan P 5,000.00/disease/year
9. Pulmonary Scan P 5,000.00/disease/year
10. Thallium Scan/ Thyroid Scan P 5,000.00/disease/year
11. Echocardiography (all types) P 5,000.00/disease/year
12. Fluorescein Angiography or P 2,500.00/eye/year
Angiography of Eye Total
13. Warts, Except Genital and P 2,500.00/year
Sexually Transmitted Warts
14. Breast Scintigraphy P 5,000.00/breast/year
15. Magnetic Resonance Imaging (MRI) P 5,000.00/disease
The member shall be entitled to any of the following procedures upon the request of a Fortune CARE affiliated Physician and approval by the Utilization Management Committee, except in emergency cases as herein defined:
Immunologic and Special Laboratory Examinations:
- Hepatitis profile, e.g. HbeAG, HBS AG, Anti HBC (IgM) and Anti-HAV (IgM)
- ANA profile, e.g. Anti-Nuclear-Antibody, Anti native-DNA, Anti-Sm, Anti-SSA, Beta-HCG, ANA
- Thyroid Profile, e.g. T3 T4, TSH, FTA-ABS.
- TORCH profile, e.g. Anti-Toxoplasma Gondii (IgM), Anti-Rubella, Anti-Cystomegalo-Virus (Total IgG).
- SLE test, FAT, Widal Test, ASO Titer, Serum IgG, Alpha-Feto protein, ESR
- Urine/ blood culture and sensitivity test.
- 24-hour protein determination
- Troponin
- Glycosylated Hemoglobin
- Prostate Specific Antigen (PSA)
Special and Computer-Based Diagnostic and Therapeutic Procedures:
1. Mammography P 5,000.00/disease/year
2. All types of Ultrasound No limit
3. Stress Testing (all types) P 10,000.00/year
4. All types of Cat Scan P 5,000.00/disease/year
5. Nuclear Imaging (including Parathyroid Scan) P 5,000.00/disease/year
6. Total Body Scan P 5,000.00/disease/year
7. Bone Scan P 5,000.00/disease/year
8. Renal Scan P 5,000.00/disease/year
9. Pulmonary Scan P 5,000.00/disease/year
10. Thallium Scan/ Thyroid Scan P 5,000.00/disease/year
11. Echocardiography (all types) P 5,000.00/disease/year
12. Fluorescein Angiography or P 2,500.00/eye/year
Angiography of Eye Total
13. Warts, Except Genital and P 2,500.00/year
Sexually Transmitted Warts
14. Breast Scintigraphy P 5,000.00/breast/year
15. Magnetic Resonance Imaging (MRI) P 5,000.00/disease
WORLDWIDE EMERGENCY CARE
Fortune CARE will cover eighty percent (80%) of the total approved treatment and hospitalization charges incurred by the member when treated in a foreign country not to exceed the amount of what it could have cost if treatment was done by a Fortune CARE accredited Physician in an accredited hospital.
Fortune CARE will cover eighty percent (80%) of the total approved treatment and hospitalization charges incurred by the member when treated in a foreign country not to exceed the amount of what it could have cost if treatment was done by a Fortune CARE accredited Physician in an accredited hospital.
FOR MORE INFORMATION ABOUT THE PROGRAMS, BENEFITS, COVERAGE AND RATES PLEASE CALL ONLINEPINOY @ (02) 501-4544