Maxicare Individual Quotation

Thank you for your interest in a health insurance package. Please fill up the form, and we will revert to you within 3 hours.



*Email address

*Birthday (Date-Month-Year)

*Mobile Number
Landline Number (if available)

*Should we have any queries, what is your preferred Mode of Communication
Call Via Mobile PhoneCall Via LanlineWhatsAppEmail


PLAN TYPE Room & Board Accomodation MAXIMUM BENEFIT LIMIT (Per Treatment)
Platinum Plus Large Private Php 200,000.00
Platinum Regular Private Php 150,000.00
Gold Regular Private Php 100,000.00
Silver Semi - Private Php 60,000.00
*Preferred Plan Type
SilverGoldPlatinumPlatinum Plus

*Purchasing for yourself or family?
MyselfMyself & Family

If for Yourself & Family, please state D.O.B for each member:

*Dental Coverage: