Comprehensive Health Plans
Health Plans A, B and C are tiered to offer three levels of medical aid cover. Health Plan A is the entry-level option while Health Plan C is the executive health plan option.
If you are looking for a basic outpatient, affordable health option, then Health Plan AS is for you.
DESCRIPTION |
SCHEME A |
SCHEME B |
SCHEME C |
|
Single |
Family |
Single |
Family |
Single |
Family |
RECOMMENDED FOR |
Low income, relatively healthy employees. |
Middle income earning corporate clients. |
Executives and those who travel frequently. |
CONTRIBUTIONS AND BENEFITS |
Affordable, competitive and comprehensive to cover both outpatient and inpatient services. |
Affordable, competitive and comprehensive to cover both outpatient and inpatient services. |
Affordable, competitive and comprehensive to cover both outpatient and inpatient services. |
Annual Overall Cover |
274,145 |
290,772 |
866,532 |
1,009,686 |
1,351,121 |
1,785,000 |
Annual Dread Disease Cover |
Up to 236,250 |
252,000 |
Up to 813,225 |
931,350 |
Up to 1,249,500 |
1,485,750 |
Annual Hospital Cover |
89,250 |
105,000 |
393,225 |
511,350 |
1,249,500 |
960,750 |
Annual Normal Delivery Cover |
7,043 |
7,043 |
12,818 |
12,818 |
12,818 |
12,818 |
Annual Caesarean Section Cover |
12,404 |
12,404 |
19,229 |
19,229 |
21,122 |
21,122 |
Annual Chemo/Radio Therapy Cover |
31,500 |
42,000 |
136,500 |
157,500 |
157,500 |
168,000 |
Annual Renal Dialysis Cover |
31,500 |
42,000 |
136,500 |
157,500 |
157,500 |
168,000 |
Annual Chronic Medication Cover |
10,500 |
12,600 |
37,800 |
44,100 |
50,400 |
67,200 |
Annual HIV/AIDS Assistance Cover |
Per Beneficiary: 12,600 |
Per Beneficiary: 12,600 |
Per Beneficiary: 12,600 |
Annual Outpatient Cover |
16,790 |
23,568 |
30,255 |
43,545 |
43,798 |
60,638 |
Annual Dental Cover |
14,343 |
20,512 |
50,661 |
74,213 |
67,326 |
92,925 |
Optical Cover(2 year cycle) |
Full cover through designated providers |
Full cover through designated providers |
Full cover through designated providers |
Allied Health Cover |
2,909 |
4,541 |
7,881 |
11,294 |
10,924 |
17,174 |
Medical Travel Insurance |
None |
None |
None |
None |
International EMERGENCY Medical Travel cover P5 Million cover per life covered for Executive Members |
Executive Annual Medical Examination |
None |
None |
None |
None |
Covers member plus one adult dependant at designated service providers |
|
SCHEME A STANDARD |
SCHEME A |
SCHEME B |
SCHEME C |
10% co-payment |
 |
 |
 |
 |
VAT |
 |
 |
 |
 |
Outpatient |
 |
 |
 |
 |
Hospital Cover |
 |
 |
 |
 |
Managed Care |
 |
 |
 |
 |
Chronic medication |
 |
 |
 |
 |
Safe Male circumcision |
 |
 |
 |
 |
Screening & Prevention |
 |
 |
 |
 |
Waiver of Premiums |
 |
 |
 |
 |
MRI Cover |
 |
 |
 |
 |
Funeral Cover |
 |
 |
 |
 |
BOMbaby Programme |
 |
 |
 |
 |
Alternative treatment |
 |
 |
 |
 |
P1 million travel insurance |
 |
 |
 |
 |
Annual Executive Med Exam |
 |
 |
 |
 |
Delivery of chronic conditions |
 |
 |
 |
 |
|
SCHEME A |
SCHEME B |
SCHEME C |
BENEFIT CATEGORY |
SINGLE |
FAMILY |
SINGLE |
FAMILY |
SINGLE |
FAMILY |
Overall Scheme Benefit |
P274,145 |
P290,772 |
P866,532 |
P1,009,686 |
P1,351,121 |
P1,785,000 |
In-Patient Dread Disease Cover |
In-Patient Dread Disease Cover |
240,000 |
P813,225 |
P931,350 |
P1,249,500 |
P1,,485,750 |
Hospitalization |
P85,000 |
P100,000 |
P374,500 |
P487,000 |
P724,500 |
P960,750 |
Maternity Cover |
P85,000 |
P100,000 |
P374,500 |
P487,000 |
P724,500 |
P960,750 |
Out-patient Cover (Unlimited Consult; Invest; Drugs) |
P16,790 |
P16,790 |
P30,255 |
P43,545 |
P43,798 |
P60,638 |
Chronic Medication (excl. HIV Benefit) |
P10,500 |
P12,600 |
P37,800 |
P44,100 |
P50,400 |
P67,200 |
ARV DRUGS & Monitoring per person @ P1,000 per month |
12,600 |
P12,600 |
P12,600 |
P12,600 |
P12,600 |
P12,600 |
Dental Cover |
P3,842 |
P4,672 |
P4,672 |
P10,163 |
P8,256 |
P14,175 |
Optical/Ophthalmic(Inclusive of appliance limit) |
AS PER BENEFIT SCHEDULE |
AS PER BENEFIT SCHEDULE |
AS PER BENEFIT SCHEDULE |
AS PER BENEFIT SCHEDULE |
AS PER BENEFIT SCHEDULE |
AS PER BENEFIT SCHEDULE |
Appliances |
P5,250 |
P6,195 |
P9,450 |
P11,340 |
P11,340 |
P13,650 |
Allied health services(rehab & alternative |
P2,909 |
P4,541 |
P7,881 |
P11,294 |
P10.924 |
P17,174 |
Severe Illness Benefit (PM & Spouse |
P20,000 |
|
P20,000 |
|
P20,000 |
|
Child Dependant |
P4,000 |
|
P4,000 |
|
P4,000 |
|
Funeral (PM ,Spouse & child dep.(14-21) |
P10,000 |
|
P10,000 |
|
P10,000 |
|
Child(6-13years) |
P5,000 |
|
P5,000 |
|
P5,000 |
|
Child (1-5 years) |
P2,500 |
|
P2,500 |
|
P2,500 |
|
Under 1 year |
P1,500 |
|
P1,500 |
|
P1,500 |
|
2020 Bomaid Health Plan Guide (7.51 MB)