All members are policyholders of Caritas Health Shield. Choose a product that suits you from “Our Products” page to learn more.

To apply for a health plan, prepare the following:

• Accomplished Membership Application Form (MAF) along with the payment. Payments will not be accepted without MAF attached.
• Original or photocopy of any government-issued identification card bearing the applicant’s name, birthday, and signature. Valid IDs include the following:
  Passport
  Postal ID
  SSS card/ GSIS e-card
  Commission on Election/Voter’s ID
  Professional Regulations Commission (PRC) ID
  Driver’s License
  Senior Citizen’s Card
  Unified Multi-purpose Card
  
  For Kiddie Health Plan, the birth certificate of the child is needed.
  For minor applicant, other than the Kiddie Health Plan, a photocopy of the school ID bearing the date of birth or birth certificate plus the ID of the parent/guardian must be attached.
• Picture of applicant/member, 2x2 colored with a white background.
• The correct Membership Application Form (MAF) series.

Note: The payment of membership fee does not automatically mean approval of the application for the health plan. This is still subject to the applicable laws of IC, AMLA, BSP, and Medical Underwriting.

The Health Care Agreement and membership card will be sent to your preferred address upon approval of your application. You will be given a notification letter if your application was disapproved.

The payment of membership fee dues may be made through our various payment channels. For the complete list, click here.

A lost or damaged policy/membership ID card must be reported to Customer Relations immediately through these numbers, 8635-7150, 8635-7151, 0998-8412669, 0945-3694376, 0998-8412674, 0917-8786594. You may also contact them via customerrelations@chs.com.ph. They are available from 9:00am to 4:00pm, Monday to Friday.

• If payment is not made on or before the due date, the Agreement shall lapse. The Member will be given a one month grace period from the due date to pay the amount. Members with lapsed Agreements may only use the benefits once the amount is settled.
• If payment is not made before the end of the grace period, the Agreement, after sending a notice to the member, shall be terminated and no longer be in effect. The member shall lose all rights and privileges except the right to reinstate.

Yes, a lapsed plan can be reinstated within two years upon the request of the member and his compliance with the following requirements:

• Submission of an Application for Reinstatement and photocopy of any valid government-issued ID (with picture & signature) and three (3) specimen signatures
• Payment of the reinstatement fee

For more information, you may call our Customer Relations at 8635-7150, 8635-7151, 0998-8412669, 0945-3694376, 0998-8412674, 0917-8786594. You may also contact them via customerrelations@chs.com.ph. They are available from 9:00am to 4:00pm, Monday to Friday.

Where applicable, the member shall be allowed to transfer his rights under the Agreement while the same is in force. For more information regarding plan transfer, you may reach our Customer Relations.

A condition is pre-existing if, before the effectivity date of the plan:

• Its cause/origin is clinically determined to have already started
• It has manifested certain signs and symptoms; or,
• It has been diagnosed as such.

Yes, subject to the right of Caritas Health Shield to exercise the following options:

• Provide the Medical Expense Benefits for said pre-existing illness or injury only after the first year of membership, or only after the second year of membership if it would require a major surgery.
• Impose a Waiver of Coverage concerning pre-existing illness or injury.

Failure of the member to disclose a pre-existing illness or injury shall be grounds for Caritas Health Shield to declare the Agreement null and void from the beginning, forfeit as liquidated damages all payments made by the member, and/or demand for refund of the cost of health services and other expenses it may have incurred.

As our Member, you have a 15-day Free Look Period wherein you may cancel your policy without penalties or other charges. For guidelines and procedures on the cancellation of your policy, kindly click this link.

Update your contact information in 3 easy steps:

Step 1: Log in to the Member’s Information System (MIS) portal. If you are not yet registered, kindly click How to Register.

Step 2: Click the Contact Information Update tab and fill out the fields.

Step 3: Click Submit. Expect to receive an SMS notification within the day. The change/s in your Policy Information will take effect the next day.

The member should first secure a Letter of Authorization from any of the Clinica Caritas or Caritas branches. The member may also contact our 24-Hour Medical Hotline numbers at 8868-7000, 0969-5881623, 0945-3687305, 0945-3693891, 0945-3693942, 0945-3693945, 0917-5081023, 0945-3694180, 0945-3694120, 0945-3694140, 0917-3103327 and 0917-8563401. You may also email memberrelations@chs.com.ph for any utilization inquiries. The member must provide his/her Membership Card Number for identification purposes.

Yes. Our Medical Hotline service is available 24/7.

Coverability depends on the type of plan and your medical condition. For inquiries on your benefit coverage, you may visit any Clinica Caritas or Caritas Health Shield branch near you or you may also inquire from our Medical Hotline numbers at 8868-7000, 0969-5881623, 0945-3687305, 0945-3693891, 0945-3693942, 0945-3693945, 0917-5081023, 0945-3694180, 0945-3694120, 0945-3694140, 0917-3103327 and 0917-8563401. You may also send an email via memberrelations@chs.com.ph.

Caritas Health Shield defines an emergency as a condition wherein the member is in severe pain, in imminent danger or death, or disability due to an accidental injury and has a sudden and unexpected onset of illness. The member directly or through a representative, should notify Caritas Health Shield within 24 hours from the start of confinement.

If emergency care is availed at a non-accredited hospital or clinic, Caritas Health Shield shall reimburse up to eighty percent 80% of the documented actual cost of covered services and professional fees of the non-accredited physician. This will be based on our standard rates. The member directly or through his representative, shall notify Caritas Health Shield within 24 hours from the start of the emergency.

Non-emergency services availed from a non-accredited facility, hospital, or provider are not reimbursable. It is best to secure a Letter of Authorization prior to any utilization so that the Member Relations Assistants (MRAs) may discuss the coverability to the member.

Caritas Health Shield will not cover your confinement under the service of any unaccredited doctor. You must be admitted under our Accredited Provider’s care to be able to utilize your health care benefits.

If at the time of the confinement, the Accredited Hospital has no available room in accordance with the member’s room and board accommodations, the member may opt to avail of the next immediate higher room and board accommodations. Caritas Health Shield will cover the incremental rate differences for the room upgrade, professional fees, diagnostic and laboratory examinations, and other ancillary services for the first twenty-four (24) hours of confinement. The said charges and expenses shall be subject to the Member’s Benefit Limit. All incremental costs incurred after the first twenty-four (24) hours shall be charged to the personal account of the member. If the member opts to occupy a lower room category, incremental or excess charges do not apply.

You may check the Product Section of our website under Membership Privileges, which includes Annual Physical Examination and its components. Caritas Health Shield’s accredited physician, specialist, or dentist upon the written authorization and under direction of its Medical Director, or his authorized representative, administers the APE.

The Clinica Caritas branches service all APEs, where applicable. For LOA request, call our 24-Hour Medical Hotline numbers.

We cover immunization and vaccination administration however; the cost of drugs and vaccine shall be for the account of the member.

Benefits provided for under PhilHealth or ECC shall be deductible in the computation of the cost of health services covered by the Contract Provisions. Caritas shall be under no obligation to pay for or advance said PhilHealth of ECC benefits. It shall be the obligation of the member to pay for the benefits otherwise covered by PhilHealth should he be unable to comply with the requirements for PhilHealth benefit claim and/or membership.

In case the Medical Benefit Fund is exhausted, Caritas Health Shield shall no longer be liable and the member shall be responsible for all excess charges. The plan shall then be considered terminated and all obligations of Caritas Health Shield deemed fully complied with.

Contact our Customer Relations Representatives to request for your Maximum Benefit Limit computation via these numbers, 8635-7150, 8635-7151, 0998-8412669, 0945-3694376, 0998-8412674, 0917-8786594. They are available from 9:00am to 4:00pm, Monday to Friday. After proper verification by our Customer Relations Representative, the requested information shall be released to the member.