Enrolled household employee is entitled to the following:
1. Any medically necessary consultations at any of the Fortune CARE full service clinics nationwide.
2. One time Hospitalization up to a maximum limit of P30,000.00, but can only be availed after 30 days from effectivity of membership.
Note: Please be advised that the Single Hospitalization Benefit can be availed at any Fortune CARE Accredited Hospitals included in your Welcome Kit or you may download the accredited list at this page.
3. Laboratory and Diagnostic Examination(For Out-Patient Availment) as requested by our FC Doctor at FC Clinics only
• Complete Blood Count (CBC)
Note: Please be advised that there are no Out-Patient Benefits in areas without Fortune CARE owned full service Clinics.
Fortune CARE Full Service Clinics:
4. Accidental Death Insurance Coverage of P 10,000.00
Fortune Care shall pay the principal sum to the legal beneficiary in case of accidental bodily injury that resulted to loss of life.
The terms and conditions stated herein as defined by Fortune CARE forms the basis and guidelines of the HELP Card Program and defines the rights and obligations of the HELP Card Member/payor.
1. The enrolled member must be 18-64 years old providing household services.
2. Only one application of household member is allowed per contract year.
3. After submitting the application form and payment of membership fee, the Welcome Kit shall be delivered to your employer's address through mail or your agent.
4. The effectivity date of the membership starts on the fifth day from date of enrollment and payment.
5. On the fifth day, member can already avail of the Out-Patient Benefits of the program.
6. The Fortune HELP Card ID Card ensures the member's access to medical services.
Card is non-transferrable.
7. Fortune CARE reserves the right to deny an individual without the HELP Card ID Card in availing the services.
8. Consultation and Out-Patient Availments are available in FC-owned full service clinics only.
9. Single Hospitalization up to P30,000.00 can be availed from any Fortune CARE accredited hospitals.
10. In case of emergency hospitalization at a non-FC accredited hospital, we shall reimburse you with the total hospital bill and PF based on our rates up to P30,000.00.
11. Reimbursement of hospital expense shall require submission of the necessary documents within ten days from date of discharge.
12. Coverage of Accidental Death Insurance Coverage shall take effect on the date of effectivity. Member shall be covered for one year.
13. In the event of accidental death, written notice of claim must be given to the company within 30 days after the accident causing any loss covered by the program. Completed claim forms and written proof of loss must be furnished to the company within 90 days after the date of such loss.
14. The program is non-Philhealth integrated. The enrolled member can file a separate reimbursement directly to Philhealth. Fortune CARE shall issue the waiver of PHIC benefit to the enrolled member upon receipt of request. A certification fee of P100.00 shall be collected by Fortune CARE from the requesting member.
15. If the hospital charges the excess of the hospital bill to Fortune CARE in spite of the Letter of Authorization indicating the P30,000 hospital coverage, Fortune CARE has the right to collect it from the employer of the enrolled member.
16. The following are the exclusions of the health program:
a. Treatment services for injuries/illnesses which are attributable to the member's own misconduct, negligence, intemperate use of drugs or alcohol liquor, vicious immoral habits, participation in the commission of a crime whether consummated or not.
b. Treatment services for injuries established to have been caused by a compensable act of a third party as in cases of criminal violence compensable under existing laws.
c. Treatment for injuries/illnesses resulting from war (declared or undeclared), riots, demonstrations or while in a military, police or paramilitary service.
e. Treatment resulting from injuries due to domestic violence.
g. Sexually transmitted diseases
h. Alcoholism, drug addiction or test substance
i. Congenital Abnormalities
k. Rehabilitative Therapy
l. Maternity Related Cases
m. Out-patient Emergency Care
17. The following are the exclusions of the Insurance Coverage
Death due to Bacterial Infections, disease, war, suicide, self-inflicted injury, murder or assault, medical or surgical treatment not resulting from accident, commission of a crime or resistance to lawful arrest, flying except as a passenger on commercial scheduled or non-scheduled flight shall not be covered by the Insurance coverage.
I have read and understood the terms and conditions of the HELP Card Program. Anything beyond the terms of the program shall be for my own account.
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