National Healthcare Shield FAQ

What is the Kaiser National HealthCare Shield?

Kaiser’s National HealthCare Shield is a group HMO program for government groups that provides comprehensive medical benefits to members and qualified dependents.

• Covers pre-existing conditions
• Includes major hospitals nationwide
• Provides preventive, outpatient, inpatient, emergency, and dental care
• No out-of-pocket during hospital admission
• Financial assistance for death or major injuries

National HealthCare Shield Details

Kaiser's NHS has a 5-point healthcare program,plus financial care program. Watch details here

what are these 5-points?

• Preventive Care Annual checkups, pap smear, ECG, vaccinations, family planning counseling
• Outpatient Consultations, diagnostic tests, minor surgery, EENT treatment
• Inpatient Confinement in semi-private room, surgery, ICU, dialysis, chemotherapy
• Emergency ER services, oxygen, IV, meds for urgent care
• Dental Oral prophylaxis, tooth extraction, fillings, dental checkups

Preventive Healthcare

• Annual Physical Examination
  (For Principal member only)
  • Physical Examination
  • Complete Blood Count (CBC)
  • Urinalysis
  • Fecalysis
  • Chest X-ray
  • Electrocardiogram (ECG) (adults age 40 and above, or if prescribed)
  • Pap smear (women age 40 and above, or if prescribed)
• Consultation on different specializations and sub-specialties
• Patient history taking upon consultation
• Periodic monitoring of health problems
• Health education and counseling on diet and exercise
• Health habits and family planning counseling
• Active vaccines for treatment of tetanus and animal bites
  (₱10,000/member/year)

In-Patient Healthcare

NO DEPOSIT ON ADMISSION!

• Room and board
• Operating / recovery room
• Administered medicines
• X-ray and other laboratory tests
• Professional fees
• In-patient medicine
• Intravenous fluids and transfusion of fresh whole blood
• ICU confinement
• Dialysis
• Chemotherapy
• Radiotherapy
• Various procedures

Out-Patient Healthcare

• Regular consultations and treatment (except prescribed medicines)
• Referral to specialists
• Laboratory, X-ray, and other diagnostic examinations prescribed by a Kaiser accredited physician
• Treatment of minor injuries and surgery not requiring confinement
• Ear, eyes, nose and throat (EENT) treatment
• Physical Therapy
• Pre- and Post- Natal Care (once a month)

Emergency Care

The following benefits are covered for members in an emergency case who is in a critical condition caused by an illness or injury:

• Physician’s services
• Medicines utilized during treatment or for immediate relief
• Casts, dressings and sutures
• Oxygen and intravenous fluids
• X-ray, laboratory and other diagnostic examinations directly related to the emergency management of the patient

Dental Care

(For Principal Members Only)

• Consultation and Dental Examinations
• Dental Nutrition and Dietary Counselling
• Dental Health Education
• Restorative and Prosthodontic Treatment
• Simple tooth extractions
• Unlimited Temporary filling (as needed)
• Annual prophylaxis (mild cases only)
• Simple tooth Adjustment of Dentures
• Recementation of loose crowns, in-lays and on-lays
• Permanent filling up to two (2) surfaces only

Financial Care

In the event of death or injuries / loss of limbs of member through natural or accidental means, Kaiser International Healthgroup will provide up to ₱20,000 financial assistance to the family of enrolled member.

Kaiser and NHS Quick Overview

NHS 5-Point Healthcare Program

• Preventive Care (para huwag magkasakit)
• Outpatient Consultations (konsulta sa doktor at labs)
• Inpatient Confinement (pag ma-ospital)
• Emergency ER services ((pag-emergency!)
• Dental Oral (alaga ng dentista)

Philhealth

Your Philhealth benefit is integrated with Kaiser

Once admitted, you will be advised to file your Philhealth reimbursement form. The Philhealth reimbursement due shall be deducted from the total hospital bill.

Kaiser members without Philhealth membership, shall shoulder and pay the Corresponding portion of Philhealth.

Pre-existing

Simple lang ang aming policy sa pre-existing.

Pre-existing conditions are covered.

• asthma?
• high blood?
• sakit sa puso?
• diabetes?

Maski ano pa iyan, COVERED!

Dependents

Application and payment for dependents must be made within 30 calendar days of effectivity of HMO Agreement

ELIGIBILITY FOR DEPENDENTS:

A) FOR SINGLE MEMBERS/EMPLOYEES:

• Parents of the principal member, up to age 65, unemployed and dependent on the principal member.
• Brothers and sisters 1 year old up to 21 years of age, unemployed and are living under the same roof as the principal member.
• Enrollment of dependents must follow an order of hierarchy; the parents must be enrolled first followed by the eldest sibling and so on.

B) FOR MARRIED MEMBERS/EMPLOYEES:

• The legal spouse of the principal member is at least 18 years old up to age 65.
• Legitimate and/or legally adopted children 1 year old up to 21 years of age and living under the same roof as the principal member.
• Enrollment of dependents must follow an order of hierarchy; the spouse must be enrolled first followed by the eldest children, second child and so on for married personnel.

Not All HMO Hospitalization Consult Plans are Created Equal!

Inexpensive plans usually have limited benefits. Budget permitting, comprehensive plans are best.

Some plans have misleading headlines, announcing supposedly high total limits but actually have lower itemized limits.

Be careful! Check the details of your HMO plan!

Definitely, NOT all HMO plans are created equal.

Not All HMO Hospitalization Plans are Created Equal!

Hospitalization plans are good, and provide immediate relief to those requiring emergency treatment or confinement. But please learn important details of your plans: many inexpensive hospital plans are one time use only, have low benefit limits, and often limited to viral, bacterial infection and accident cases.

Lifestyle diseases not covered, like those related to high blood pressure, heart problems, allergies. Inexpensive plans have NO ACCESS to major hospitals ( usually the most advanced medical facilities in the country).

Inexpensive hospital plans normally do not include outpatient benefits, and annual physical examination, and often expire UNUSED, because most people do not frequently need emergency care and confinement.

Comprehensive group HMO plans have slightly higher annual fees, but are frequently used for doctor consultation and annual physical exam. Given the benefits, comprehensive plans such as the Kaiser National Healthcare Shield provide much more value than limited individual HMO plans.

NHS for Informal Groups (e.g. teachers)

Here's how to implement Kaiser’s National Healthcare Shield (NHS) for unofficial groups for teachers in public schools in six easy steps

1. Call a faculty meeting and present NHS benefits.
2. Secure consensus from teachers
3. Collect premiums
4. Prepare documents
5. Memorandum of Agreement
6. Rollout

Legit nga ba ang Kaiser

Kaiser International Healthgroup is licensed as an HMO by the Insurance Commission.
Check the Insurance Commission website for the list of licensed Health Maintenance Organizations

Data privacy laws prevent Kaiser from divulging the names of its clients, but if the clients say that their HMO provider is Kaiser International Healthgroup, that is transparency.

The Supreme Court, in its own website declared it procured HMO from Kaiser Internation for the entire judiciary.

NHS Clients

NHS is a young plan, launched only last May 2025.
But happy clients declare in their social media accounts they got Kaiser National Healthcare Shield!
See Facebook posts

Contact me for details!