Availment Guides

1. Member proceeds to Etiqa Philippines accredited hospital.
2. Present Etiqa Philippines Healthcard to ER staff.
3. Evaluation & treatment.
4. ER staff calls for approval or notifies MIC of admission, if applicable.
5. Member settles excess or ineligible expenses prior to discharge.

1. Member proceeds to Etiqa Philippines accredited hospital or clinic.
2. Member presents Etiqa ID along with valid ID for verification and evaluation of membership and eligibility.
3. HMO Concierge issues referral or diagnostic request form to member if necessary.
4. Member proceeds to laboratory unit or specialty unit to avail of the approved out-patient services.
5. Member should file PhilHealth for OP-OR procedures, hemodialysis, endoscopic exam, chemo-radio theraphy, and other procedures with PHC equivalent prior to the procedure.
6. Member must settle excess over their benefit limit or ineligible expenses prior to discharge

1. Member proceeds to Etiqa accredited hospital.
2. Member presents Etiqa Membership Card (Physical or Virtual ID via SmilePH App) at the HMO/l Insurance Section, Emergency Room (ER), or Admitting Section.
3. Member occupies room based on plan limit.
4. Member undergoes treatment.
5. Member files Philhealth and settles ineligible expenses before discharge.

1. Member proceeds to Etiqa Philippines Primary Care Clinic.
2. Member secures number card and accomplishes the Patient Information Sheet for queuing, logging and triaging.
3. CCO calls number based on queuing. Member presents Etiqa ID along with valid ID for verification and evaluation of membership and eligibility.
4. Etiqa Customer Care Officer (CCO) inquires about the reason for the visit and validates the referral and diagnostic form that the member provided. The CCO then issues the Letter of Guarantee (LOG) based on the member’s benefit limit.
5. Member proceeds to the doctor’s clinic or laboratory unit to avail of the approved outpatient services according to their benefits plan.
6. For diagnostic /laboratory request: CCO provides approval based on member’s benefit limit and gives final instructions.
7. Member should file Philhealth for OP-OR Procedures, hemodialysis, endoscopic exam, chemo-radio therapy and other procedures with PhilHealth equivalent before the procedure.
8. The member must settle excess over their benefit limit or ineligible expenses prior to discharge.

1. The request is made by the company/member or through the broker/marketing/provider to the APE team of Etiqa Philippines via Etiqa LOG portal using this link https://etiqaph.freshdesk.com/en/support/tickets/new for individual LOG requests.
2. For mobile/onsite APE requests with volume availers, the request is made via email by the company/marketing/broker via email to the APE Unit of Etiqa Philippines at ape@etiqa.com.ph for scheduling of onsite APE.
3. APE Coordinator of Etiqa coordinates with accredited provider for client’s preferred schedule and location (if onsite).
4. APE Coordinator of Etiqa issues Letter of Guarantee (LOG) to member/company HR/broker/provider.
5. Member avails annual physical examination at preferred provider or office/site (if onsite) during their scheduled APE.
6. Directly to member/authorized representative with reference to Data Privacy Act.

Note: Executive Check-Ups (ECU) and Pre-Employment Medical Examinations (PEME) generally follow these same steps.