Individual Health Plans — JuanHealthcare

Our Health Plans

Comprehensive Services Designed to Keep You and Your Family Protected

We believe you and your family deserve a healthcare plan that is strong, simple, and instantly protective—a plan that truly works when you need it most.

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Protect Your Savings

Shield your finances from high hospital bills with coverage built for real-life medical costs.

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Peace of Mind in Emergencies

Get dependable protection when emergencies happen—so you can focus on recovery, not expenses.

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Quality Care Without Delay

Help your loved ones access quality care through a trusted HMO network of hospitals and clinics.

Why JuanHealthcare

Healthcare That Works When You Need It

JuanHealthcare individual plans are designed to be accessible, hassle-free, and dependable—backed by trusted HMO partners so you and your family can move forward with confidence.

Juan Basic Care

60K MBL

Ward

30K PEC Coverage

starts at starts at Php 18,888 / year

Key Benefits

✓Inpatient Care
✓Emergency Care
✓Outpatient Care
✓Laboratories & Diagnostic Procedures
✓Annual Physical Exam

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Juan Plus Care

100K MBL

Semi-Private

50K PEC Coverage

starts at starts at Php 24,888 / year

Key Benefits

✓Inpatient Care
✓Emergency Care
✓Outpatient Care
✓Laboratories & Diagnostic Procedures
✓Annual Physical Exam

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Juan Elite Care

200K MBL

Regular Private

100K PEC Coverage

starts at starts at Php 34,888 / year

Key Benefits

✓Inpatient Care
✓Emergency Care
✓Outpatient Care
✓Laboratories & Diagnostic Procedures
✓Annual Physical Exam

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Juan OKKids Care

Up to 150,000 MBL

Semi-Private or Regular Private

Up to 55K PEC Coverage

starts at Starts at 26,888 / year

Key Benefits

✓Inpatient Care
✓Emergency Care
✓Outpatient Care
✓Laboratories & Diagnostic Procedures
✓Annual Physical Exam

Avail Now

About Our Agency

JuanHealthcare is the exclusive distributor of JuanHealthcare Corporate Plans and JuanHealthcare Health Plans. We specialize in providing accessible, compliant, and cost-efficient healthcare solutions for individuals, SMEs, and large enterprises.

Our commitment is to:

✓Deliver fast and hassle-free onboarding
✓Provide transparent pricing and dependable service
✓Offer end-to-end account management and after-sales support
✓Ensure clients receive quality healthcare access nationwide

We simplify healthcare so your organization can focus on what matters most—your people.

Who is PhilCare?

PhilCare is one of the Philippines’ largest, most trusted Health Maintenance Organizations (HMO), recognized for:

✓A nationwide network of hospitals, clinics, and specialists
✓Decades of industry expertise
✓Technologically advanced member servicing
✓Financial strength and reliability

With PhilCare as our partner HMO, your organization gains access to premium-quality medical care backed by a strong infrastructure and proven credibility.

We believe you and your family deserve a healthcare plan that is strong, simple, and instantly protective—a plan that truly works when you need it most.

JuanHealthcare Health Plans are designed to:

✓Protect your savings from high hospital bills
✓Give you peace of mind in emergencies
✓Ensure your loved ones can access quality care without delay

We would be honored to be your partner in securing your family’s health and future.

If you’re ready, we can:

✓Finalize your chosen plan
✓Assist you with application and payment instructions
✓Guide you step-by-step until your plan is officially active

We look forward to helping you get your JuanHealthcare Health Plan started.

FREE Added Benefits in Every JuanHealthcare Plan

Enjoy more protection at no extra cost. Every plan comes with built-in essential benefits to keep you secured, protected, and cared for.

✓ Life Insurance
✓ Accidental Death & Dismemberment
✓ Accident Medical Reimbursement
✓ Terminal Illness Benefit
✓ Burial Assistance Benefit
✓ Mental Health Care

More value. More protection. Zero added cost.

Note: Except Juan OKKids Care

Annex A: Full Schedule of Benefits

*Terms & conditions apply

Complete schedule of benefits for your selected JuanHealthcare Health Plan. Please refer to your plan variant for applicable limits.

ANNUAL PHYSICAL EXAMINATION ▼

Benefit	Coverage
1 Taking of Medical History	Covered
2 Physical Examination	Covered
3 Chest X-Ray	Covered
4 Routine Urinalysis	Covered
5 Routine Fecalysis	Covered
6 Complete Blood Count (CBC)	Covered
7 Electrocardiogram (ECG) for members 35 years old and above or if indicated	Covered
8 Pap Smear for female members 35 years old and above or if indicated	Covered

PREVENTIVE HEALTH CARE ▼

Benefit	Coverage
1 Health Education Counseling on diet or exercise	Covered
2 Periodic Monitoring of Health Problems	Covered
3 Family Planning Counseling	Covered

OUT-PATIENT CARE ▼

Benefit	Coverage
1 Pre and Post Natal consultations	Covered excluding laboratory & diagnostic procedures
2 Eye, ear, nose and throat (EENT) treatment prescribed by an affiliated physician/specialist	Covered
3 Treatment for minor injuries such as lacerations, mild burns, sprains and the like	Covered
4 Dressings, conventional casts (plaster of Paris) and sutures.	Covered
5 X-Ray, laboratory examinations, routine, diagnostic and therapeutic procedures prescribed by an affiliated physician/specialist, provided however that the cost of diagnostic and therapeutic procedures covered shall be limited to a specific amount.	Covered
6 Minor surgery not requiring confinement prescribed by an affiliated physician / specialist	Covered
7 Cauterization of Warts prescribed by an Affiliated Physician/Specialist except genital warts and condyloma acuminatum	If Medically necessary & For therapeutic purposes (e.g. plantar warts, etc.) covered up to MBL;
8 Speech Therapy	Not Covered
9 Initial treatment of animal bites	Covered subject to MBL except cost of vaccines which is
10 Passive and active vaccines for treatment of tetanus and animal bites (including immunoglobulin)	Not Covered

IN-PATIENT SERVICES ▼

Benefit	Coverage
1 Use of operating room, Intensive Care Unit (ICU), isolation room (if prescribed by attending Affiliated Physician) and recovery room.	Covered subject to MBL or PEC*
2 Professional fees in accordance with PhilCare Schedule of Rates.	Covered subject to MBL or PEC*
a. Attending Physicians	Covered subject to MBL or PEC*
b. Surgeons	Covered subject to MBL or PEC*
c. Anesthesiologists	Covered subject to MBL or PEC*
d. Cardio-pulmonary clearance before surgery and cardiac monitoring during surgery.	Covered subject to MBL or PEC*
3 Standard Nursing Services	Covered subject to MBL or PEC*
4 Medicines for in-patient use	Covered subject to MBL or PEC*
5 Blood products transfusions and intravenous fluids, including blood screening and cross matching.	Covered subject to MBL; blood screening of donor's blood not included
6 X-Ray, laboratory examinations, diagnostic tests and therapeutic procedures incidental to confinement	Covered subject to MBL or PEC*
7 Dressings, conventional casts (plaster of Paris) and sutures	Covered subject to MBL or PEC*
8 Anesthesia and its administration	Covered subject to MBL or PEC*
9 Oxygen and its administration	Covered subject to MBL or PEC*
10 Standard Admission kit	Covered subject to MBL or PEC*
11 All other items directly related in the medical management of the patient, as deemed medically necessary by the attending Affiliated Physician	Covered subject to MBL or PEC*
12 Assistance in administrative requirements through a Liaison Officer	Covered subject to MBL or PEC*

SPECIAL MODALITIES OF TREATMENT ▼

Benefit	Coverage
1 Laparoscopic Cholecystectomy	Php35,000 or subject to MBL; whichever is lower; limited to once per contract year
2 Lithotripsy	Php35,000 or subject to MBL; whichever is lower; limited to once per contract year
3 Magnetic Resonance Imaging (MRI)	Php5,000
4 Use of Nuclear/Radioactive Isotopes	Php5,000
5 Hysterescopic Myoma Resection	Php20,000
6 Laparoscopic Adrenalectomy (Unilateral)	Php75,000 or subject to MBL; whichever is lower
7 Laparoscopic Adrenalectomy (Bilateral)	Php85,000 or subject to MBL; whichever is lower
8 Transurethral Microwave Therapy of Prostate	Php35,000 or subject to MBL; whichever is lower; limited to once per contract year
9 Hysteroscopic Guided D&C/Biopsy	Php10,000 or subject to MBL; whichever is lower
10 Percutaneous Ultrasonic Nephrolithotomy	Php40,000 or subject to MBL; whichever is lower; limited to once per contract
11 Ureterolithotripsy	Php35,000 or subject to MBL; whichever is lower; limited to once per contract year
12 Stereotactic Brain Biopsy	Php120,000 or subject to MBL; whichever is lower
13 Cryosurgery	Php1,000/area; limited to once per contract year
14 Sleep Study/Polysomnograms (Sleep Recording)	Php5,000; with or without CPAP
15 Continuous Positive Airway Pressure (CPAP) titration for sleep study	Covered subject to Php 5,000; with separate limit for sleep study
16 Neuroscan	Php5,000
17 All Special Modalities of treatment and/or diagnostic procedures for which there are no comparable conventional or traditional equivalent or counterparts	Covered up to Php 5,000/ procedure/member /year
18 Sclerotherapy for varicose veins as prescribed by an Affiliated Physician, to be availed through Affiliated vascular surgeons.	Up to Php 5,000/member/year; aggregate limit.

EMERGENCY CARE ▼

Benefit	Coverage
1a. Doctor's services	Covered subject to MBL or PEC*
1b. Emergency Room Fees	Covered subject to MBL or PEC*
1c. Medicines used for immediate relief during treatment	Covered subject to MBL or PEC*
1d. Oxygen, Intravenous fluids and blood products.	Covered subject to MBL or PEC*
1e. Dressings, conventional casts (plaster of Paris) and sutures.	Covered subject to MBL or PEC*
1f. X-Rays, laboratory and diagnostic examinations, and other medical services related to the emergency treatment of the patient.	Covered subject to MBL or PEC*
1g. Room Upgrade in case of room unavailability	Room upgrade will be subject to rules on room upgrading (with additional charge -Waived for the first 24 hours except Suite room.
2 In Non-Affiliated Hospitals	100% of hospital bills & professional fees based on PhilCare rates up to Php 15,000 /case /member /year (Reimbursement Basis)
3 Outside the Philippines	100% of hospital bills & professional fees based on PhilCare rates up to Php 15,000 /case /member /year (Reimbursement Basis)
4 Areas w/o Affiliated Hospital	Covered subject to PhilCare rates up to MBL (using the 50-km radius rule)
5 Ambulance Service (Affiliated/Non- Affiliated to Affiliated) if within Metro Manila	Covered provided that case is fully coordinated with PhilCare
6 Ambulance Service (Affiliated/Non- Affiliated to Affiliated) if in Provincial areas	Covered up to 2K per conduction (reimbursement)

PRE-EXISTING CONDITIONS ▼

50% of CHOSEN PLAN LIMIT (Aggregate Limit for Kids) (KNOWN OR UNKNOWN PEC)

OTHER BENEFITS/SPECIAL SERVICES ▼

Benefit	Coverage
1 Work Related Conditions based on conditions covered by ECC	Covered subject to MBL or PEC*
4 Scoliosis including necessary procedures	Not Covered
5 Epilepsy, Seizure Disorder	Covered if acquired
6 Hepatitis B (if acquired, excluding STD) & Hepatitis C	Covered if acquired & not related to STD. Screening test is not Covered
7 Sports-related injuries	covered; except extreme
8 Unprovoked Assault, including domestic violence, whether initiated by a known or unknown third party	Covered

DIAGNOSTIC PROCEDURES ▼

Benefit	Coverage
1 Coronary Angiography	Covered subject to MBL or PEC*
2 24 hour EEG Monitoring	Covered up to MBL*
3 Esophageal Manometry	Covered up to MBL*
4 Positron Emission Tomography	covered up to Php5, 000/member/year
5 CT Pulmonary Angiography	Covered up to MBL*
6 Photodynamic Therapy	covered up to Php5, 000/member/year
7 24-hour Holter Monitoring	Covered subject to MBL or PEC*
8 Adrenocortical Function	Covered subject to MBL or PEC*
9 Anti-Nuclear Antibody, C-Reactive Protein, Lupus Cell Exam	Covered subject to MBL or PEC*
10 Arterial Blood Gas	Covered subject to MBL or PEC*
11 Arthroscopic Procedures, Orthopedic Arthroscopy	Covered subject to MBL or PEC*
12 Audiograms and Tympanograms	Covered subject to MBL or PEC*
13 Bone Density Test (Dexa Scan/BMD Studies)	Covered subject to MBL or PEC*
14 Computed Tomography Scans	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: a. Biliary tract: Cholecystogram and Cholangiogram	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: b. Chest, ribs, sternum and clavicle	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: c. Digestive: Plain film of the abdomen, Barium Enema, Upper GI Series, Lower GI Series, Small Bowel series	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: d. Face (including sinuses), Head and Neck	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: e. Urinary: KUB, Pyelograms and Cystograms	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: f. X-ray of the extremities and pelvis	Covered subject to MBL or PEC*
15 Diagnostic Radiographs: g. X-ray of the spine (cervical, thoracic, lumbo-sacral)	Covered subject to MBL or PEC*
16 Diagnostic Ultrasounds: a. 2D-Echo with Doppler	Covered subject to MBL or PEC*
16 Diagnostic Ultrasounds: b. Abdomen	Covered subject to MBL or PEC*
16 Diagnostic Ultrasounds: c. Duplex Scan	Covered subject to MBL or PEC*
16 Diagnostic Ultrasounds: d. Digestive and Urinary Systems	Covered subject to MBL or PEC*
16 Diagnostic Ultrasounds: e. Ultrasound of the Lungs	covered up to Php5,000
16 Diagnostic Ultrasounds: f. 4D Ultrasound except for maternity- related cases	Covered subject to MBL or PEC*
Electroencephalogram	Covered subject to MBL or PEC*
Electro myelography and Nerve Conduction Studies	Covered subject to MBL or PEC*
Endoscopic Procedures	Covered subject to MBL or PEC*
Fluorescein Angiography	Covered subject to MBL or PEC*
Impedance Plethysmography	Covered subject to MBL or PEC*
Lead Electrocardiogram	Covered up to Php5,000
Magnetic Resonance Angiography (MRA)	Covered subject to MBL or PEC*
Mammography and Sono mammogram	Covered subject to MBL or PEC*
Myelogram	Covered subject to MBL or PEC*
Pap`s Smear	Covered subject to MBL or PEC*
Perfusion Scan	Covered subject to MBL or PEC*
Plasma Urinary Cortisol, Plasma Aldosterone	Covered subject to MBL or PEC*
Polysomnograms (Sleep Recording)	Covered subject to MBL or PEC*
Pulmonary Function Tests	Covered subject to MBL or PEC*
17 Radioisotope Scans and Function Studies: a. Cardiac	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: b. Gastrointestinal	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: c. Liver	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: d. Parathyroid Bone, Pulmonary (Perfusion/ Ventilation Lung Scans)	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: e. Renal	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: f. Thyroid Scans	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: g. Total Body Scans	subject to special modalities limit ; Php5T limit per service
17 Radioisotope Scans and Function Studies: h. Cardiac Stress Tests (Thallium and Dipyridamole Stress Tests)	subject to special modalities limit ; Php5T limit per service
Radionuclide Ventriculography	subject to special modalities limit ; Php5T limit per service
Surface Electromyography (SEMG)	subject to special modalities limit ; Php5T limit per service
Thallium Scintigraphy	subject to special modalities limit ; Php5T limit per service
TMST-Treadmill Stress Test	Covered subject to MBL except Nuclear TMST
Cataract extraction except cost of lens	Covered subject to MBL or PEC*
X-Ray, laboratory examinations, routine, diagnostic and therapeutic procedures prescribed by an accredited physician/specialist, provided however that the cost of diagnostic and therapeutic procedures covered shall be limited to a specific amount.	Covered subject to MBL or PEC*
Tuberculin test	covered up to Php600/member/year
Blood Chemistries	Covered subject to MBL or PEC*
Chest X-Ray	Covered subject to MBL or PEC*
Complete Blood Count (CBC)	Covered subject to MBL or PEC*
Fecalysis	Covered subject to MBL or PEC*
Urinalysis	Covered subject to MBL or PEC*

THERAPEUTIC PROCEDURES ▼

Benefit	Coverage
Angioplasty / Coronary Artery Bypass Graft	Covered subject to MBL (Stent or Balloon not covered)
Gamma Knife Surgery	covered subject to prevailing rate/RUV of conventional method
Laparoscopy (except those listed in the Special Modalities of Treatment)	Covered subject to MBL or PEC*
Conventional	Covered subject to MBL or PEC*
Scalpel Hemorrhoidectomy	Covered subject to MBL or PEC*
Stapled Hemorrhoidectomy	covered subject to MBL except cost of staple
Mammotome	subject to special modalities limit; Php5T limit per service
Botox which is not cosmetic in nature nor for beautification purpose	subject to special modalities limit; Php5T limit per service
Dialysis	Covered subject to MBL or PEC*
Intravenous Chemotherapy	Covered subject to MBL or PEC*
Physical therapy/Occupational Therapy excluding subspecialties such as cardiac rehabilitation, pulmonary rehabilitation and the like.	For OP: PT & OT is shared/aggregate limit & whichever comes first (either 12 sessions or MBL); For IP: subject to aggregate MBL - For Rehabilitative purposes only
Therapeutic Radiology: a. Brachytherapy	Covered subject to MBL or PEC*
Therapeutic Radiology: b. Cobalt	Covered subject to MBL or PEC*
Therapeutic Radiology: c. Linear Accelerator Therapy	Covered subject to MBL or PEC*
Therapeutic Radiology: d. Radioactive Cesium	Covered subject to MBL or PEC*
Therapeutic Radiology: e. Radioactive Iodine	Covered subject to MBL or PEC*
Therapeutic Radiology: f. Intensified Modulated Radiotherapy	Covered up to Php5, 000/member/year
Treatment for minor injuries such as lacerations, mild burns, sprains and the like	Covered subject to MBL or PEC*
Minor surgery not requiring confinement prescribed by an Affiliated Physician / Specialist	Covered subject to MBL or PEC*
Eye laser therapy for retinal tear, retinal hole, retinal detachment and glaucoma prescribed by an affiliated Physician/Specialist , excluding eye correction such as Lasik, PRK and the like	covered up to MBL, except for correction of EOR such as myopia, astigmatism and hyperopia
Blood products transfusions and intravenous fluids, including blood screening and cross matching	Covered up to MBL except blood donor screening test

DENTAL CARE BENEFIT (AFTER 1 MONTH OF EFFECTIVE DATE) ▼

Standard Package

Benefit	Coverage
Annual Oral Prophylaxis (excluding deep scaling, periodontal surgery)	Covered
Unlimited Consultation / check-up	Covered
Unlimited Temporary Fillings	Covered
Unlimited Simple Tooth Extraction	Covered
Emergency Dental Treatment for relief of pain (excluding root canal treatment)	Covered
Simple Adjustment of dentures	Covered
Dental Certification	Covered
Treatment Planning	Covered
Recementation of loose crowns, inlays and onlays	Covered

GROUP LIFE WITH AD&D, ACCIDENT MEDICAL REIMBURSEMENT, TERMINAL ILLNESS, BURIAL ASSISTANCE ▼

For Principal Members from 18 year old to 65 year old ONLY

Benefit	Coverage
1 Death	Php 100,000
2 AD&D Coverage	Php 50,000
a. life	100% of amount of insurance
b. entire sight of both eyes	100% of amount of insurance
c. both hands or both feet	100% of amount of insurance
d. one hand and one foot	100% of amount of insurance
e. either hand or foot and sight of one eye	100% of amount of insurance
f. Arm at or above elbow	70% of amount of insurance
g. Leg at or above knee	60% of amount of insurance
h. One hand at or above wrist	50% of amount of insurance
i. One foot at or above the Ankle	50% of amount of insurance
j. Hearing of both ears	50% of amount of insurance
k. Sight of one eye	50% of amount of insurance
l. Four fingers and thumb of one hand	50% of amount of insurance
3 Accident Medical Reimbursement	up to Php 5,000
4 Terminal Illness	50% of Death Coverage
5 Burial Assistance	50,000 worth of Funeral Service provided by PhilPlans

MENTAL HEALTH CARE BENEFIT ▼

For Principal Members Only – Age 18 to 65

Benefit	Coverage
1 60-minutes Mental Health Screening via mindscapes platform	One-time only
2 Mental Health Helpline Call & Chat Support	Unlimited via mindscapes platform

Member Quick Guide

Fast, Simple, Hassle-Free Healthcare Access

How to Request Your LOA (Easy Options)

Members may request their Letter of Authorization (LOA) using either of the options below. Once approved, the member may proceed with medical services.

Option 1: Use the Mobile App

Download the HeyPhil 2.0 Mobile App

Available on Google Play Store and Apple App Store

Use the app to:

•View membership details
•Request and monitor LOA approvals
•Generate your LOA in as fast as under 10 seconds*
•Receive real-time updates
•Access healthcare services conveniently

Processing time may vary depending on provider and service type.

Option 2: Face-to-Face Request (HMO Department)

Visit the HMO Department of any PhilCare-accredited hospital or clinic and present:
Your JuanHealthcare Health Card
A valid government-issued ID for verification
The HMO staff will assist in processing your LOA request.

LOA Approval & Availment

Once the LOA is approved—whether requested via the mobile app or in person—you may proceed with consultation, diagnostic tests, or treatment, subject to plan coverage, limits, and exclusions.

How to Request an Advance LOA (For Scheduled Services)

(Not available in the HeyPhil app)

Advance LOA requests for scheduled consultations, diagnostic procedures, and planned treatments must be submitted via email only.

Email Subject Format: LOA REQUEST_JuanHealthcare Health Card_Policy Holder Name

Include the following in the email body:

Policy Holder Name
Contact Number
Email Address
Name of Provider
Type of Availment (Outpatient / Inpatient / Emergency)
Date of Availment (must be on or after plan activation)
Chief Complaint / Diagnosis
Hospital / Clinic Name
Name of Attending Physician

For procedures, attach a copy of the doctor’s request or medical order.

Accredited Hospitals & Clinics

View accredited hospitals and clinics →

Important Reminders

✓Your plan must be activated before any medical availment
✓LOA approval is required for non-emergency services
✓Benefits are subject to plan terms, conditions, and exclusions
✓Availments without an approved LOA may be denied or subject to reimbursement rules

Health plans for groups and organizations

We also provide JuanHealthcare plans for group accounts—perfect for companies, organizations, and teams looking for reliable and affordable healthcare benefits.

View corporate plans

Ready to get your plan started?

We can help you finalize your chosen plan, assist with application and payment, and guide you step-by-step until your coverage is active.

Apply now Contact us

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