Home Care Packages and Home Care Services will be covered for all Pacific Cross Philippines medical plans. This implementation is in support of the Company’s prevailing decision to supersede the standard exclusion on pandemics to provide coverage for COVID-19. Here are the claims implementing guidelines effective 01 April 2021.

a. What packages and services are covered by Pacific Cross?

    • HOME CARE PACKAGES: These are packaged prices of medical services which may include virtual/online consultation, on-site (at home) visits of a doctor, nurse, radiologist, medical technologist and other medical practitioners, mobile diagnostics and medicine.
    • HOME CARE SERVICES: House calls or on-site (at home) visit of doctor and other medical practitioners for mobile diagnostics tests on a fee per service basis.
    • TELEHEALTH: The use of technology to deliver remote health care services (online or virtual consultation with a doctor or nurse) for home-care instructions, prescriptions of diagnostic tests and medicines.

b. Does Pacific Cross has a TeleHealth provider?

Yes. Pacific Cross’s TeleHealth provider is Kitika. This is available to all insured persons and members under Pacific Cross Medical Plans. Availing of services for reimbursement ONLY APPLIES TO PLANS with OUT-PATIENT BENEFITS.

c. What is the coverage for SEVERE COVID-19?

This case must be treated within a hospital facility. In-patient benefits and limitations will apply.

d. What is the coverage for MODERATE COVID-19?

Due to the hospital’s critical to full capacity, Pacific Cross will cover Home Care Packages up to PHP 30,000 and will be credited under the In-Patient Benefit of the Plan.

e. What is the coverage for MILD COVID-19?

ASYMPTOMATIC and MILD CASES are considered Out-Patient cases and will be covered under Home Care Services. Please take note that Home Care Package will NOT be covered while Home Care Services will only be covered for plans with Out-Patient Benefits.

f. How can I avail the packages and services?

This is through reimbursement only. Primary claim requirement shall include:

      • Medical Certificate from Attending Physician
      • Chest X-ray results

UPDATED: 03 Jun 2021

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