Etiqa

Please send us an email request for a product orientation. Kindly provide the details below so we can forward your request to the trainer. The orientation will be conducted via a virtual Zoom meeting.

Required Details:

• • Company Name:

  • Date:

  • Time:

We look forward to assisting you!

You can request your LOG or LOA through the Online Portal or the Smile App. 

1. Online Portal

• Log in to the portal using the link below:
  👉 Etiqa Member Portal

2. Smile App

• Download the Smile App using the link below:
  👉 Download Smile App

Need Help with Registration?

Click the link below for a step-by-step guide on the registration process:
📌 Registration Guide

Dental Availment Process

1. Obtain Proof of Membership

Your membership card serves as proof of eligibility and contains important details for accredited clinics.

2. Find an Accredited Dentist

Dental benefits can only be availed at accredited clinics. Refer to the provider list for options.

3. Schedule an Appointment

Contact the nearest accredited clinic to set an appointment at your convenience.

4. Avail Your Dental Benefits

Visit the dentist for a consultation or procedure, ensuring a brighter and healthier smile.

5. Complete the Dental Availment Form

Fill out and sign the required form. No payment is needed for procedures covered under your dental plan.

Annual Physical Examination (APE)

Includes:

1. Complete Physical Examination, which covers:

   • Oral Exam

   • Visual Acuity

   • Medical History

2. Chest X-ray

3. CBC (Complete Blood Count)

4. Routine Urinalysis

5. Routine Fecalysis

6. ECG (Electrocardiogram) (For ages 35 & up)

7. Pap Smear (For ages 35 & up)

📌 (100% Participation by Rank Required)

Scheduling Your APE:

• Schedule your APE at least 2-4 weeks before your preferred date.

• Send an email to Jen at ape@etiqa.com.ph, and CC clientcare@idealifeph.com; admin@idealifeph.com and Lala/Argem at moo@purplecow.ph.

• A minimum of 50 participants is required for a mobile APE.

Activate your Etiqa health card coverage:

1. Sign up to Doctor Anywhere app

2. Tap "Continue" under "Membership & Health Plan" > "Link Membership" > Etiqa

3. Enter your Etiqa ID and date of birth

INPATIENT CLAIMS REIMBURSEMENT PROCESS

Step-by-Step Flowchart

1. Seek Medical Treatment

   • The member goes to their chosen accredited or non-accredited hospital as a Private Patient for reimbursement.

   • Do not present the membership card.

2. Medical Diagnosis & Treatment

   • The member undergoes diagnosis and treatment at the hospital.

3. Settle Hospital Bill & File PhilHealth

   • The member files their PhilHealth claim (if applicable) and settles the full bill directly with the hospital.

4. Discharge from the Hospital

   • The member is discharged after completing the medical treatment.

5. Submit Reimbursement Claim

   • The member downloads and completes the Inpatient (IP) Claim Form and gathers all supporting documents.

   • The completed claim is filed with Etiqa Claims through Purple Cow Submission Portal.

6. Waiting Period for Reimbursement

   • Etiqa processes the claim within 15 days and deposits the reimbursement directly into the member’s bank account.

Requirements for Inpatient (IP) Claims

1. Completed and signed IP Claim Form

   • Download IP Claim Form

2. Hospital Statement of Account (photocopy accepted).

3. BIR-approved invoices for professional fees and hospital bills.

4. Receipts for medications purchased externally, including the corresponding doctor's prescription (Rx).

5. Original copies of all required documents (except Statements of Account, where photocopies are accepted).

6. Erasures must be countersigned by an authorized signatory.

Additional Notes:

• For claims exceeding PHP 10,000, original receipts must be submitted.

• Etiqa reserves the right to request additional documents on a case-to-case basis.

• Submit claims through the Purple Cow Submission Portal: Submit Here.

OUTPATIENT CLAIMS REIMBURSEMENT PROCESS

Step-by-Step Flowchart

1. Seek Medical Treatment

   • The member visits their chosen accredited or non-accredited hospital/clinic as a Private Patient for reimbursement.

   • Do not present the membership card.

2. Medical Diagnosis & Treatment

   • The member undergoes diagnosis and treatment at the clinic/hospital.

3. Settle the Bill

   • The member pays the total bill directly to the provider.

4. Discharge from the Hospital/Clinic

   • The member leaves the facility after treatment.

5. Submit Reimbursement Claim

   • The member downloads and completes the Outpatient (OP) Claim Form and gathers all supporting documents.

   • The completed claim is filed with Etiqa Claims through Purple Cow Submission Portal.

6. Waiting Period for Reimbursement

   • Etiqa processes the claim within 15 days and deposits the reimbursement directly into the member’s bank account.

Requirements for Outpatient (OP) Claims

1. Completed and signed OP Claim Form

   • Download OP Claim Form

2. Medical Certificate in place of the doctor’s diagnosis on the claim form.

3. BIR-approved invoices for professional fees and hospital bills.

4. Lab Requests for any laboratory tests, signed by the doctor (photocopies accepted).

5. Original copies of all required documents (except lab requests, where photocopies are accepted).

6. Erasures must be countersigned by an authorized signatory.

Additional Notes:

• For claims exceeding PHP 10,000, original receipts must be submitted.

• Etiqa reserves the right to request additional documents on a case-to-case basis.

• Submit claims through the Purple Cow Submission Portal: Submit Here.

Important Reminders

✅ Ensure that all documents are complete and accurate before submission.
✅ Claims processing takes approximately 15 days from the date of submission.
✅ Always retain copies of your documents for personal reference.

For inquiries and claim status follow-ups, please contact Etiqa Claims Support.

This document serves as a guide to help members efficiently file for inpatient and outpatient claim reimbursements. Ensure compliance with all requirements to avoid delays in processing.

1. Masterlist (download)

   • Input the complete details of all employees and their dependents (if applicable)

   • At the left side of the effective date, indicate ADD

     • Dependents (if applicable)

       • Full Name of the principal applicant should be indicated in the MISC column of the masterlist

       • Relationship should be indicated in STATUS / HIERARCHY RULE column.

       • Heirarchy Rule (if a dependent bypassed the heirarchy rule, please provide either proof of coverage for the bypassed dependent or a death certificate) 

         • Married

           1. Legal Spouse who is not more than 65 years old

           2. Natural born or legally adopted children age 15 days to 21 years old

         • Single

           1. Common law spouse

              • Must provide affidavit of co-habitation

              • Each individual is required to submit a Certificate of No Marriage (CENOMAR)

           2. Same sex partner

              • Must provide affidavit of co-habitation

              • Each individual is required to submit a Certificate of No Marriage (CENOMAR)

           3. Parent who is not more than 65 years old

           4. Sibling age 15 days to 21 years old

         • Single Parent

           1. Common law spouse

              • Must provide affidavit of co-habitation

              • Each individual is required to submit a Certificate of No Marriage (CENOMAR)

           2. Same sex partner

              • Must provide affidavit of co-habitation

              • Each individual is required to submit a Certificate of No Marriage (CENOMAR)

           3. Natural born or legally adopted children age 15 days to 21 years old

2. Submit the masterlist (in pdf and excel) to file the request

TO: accounts@idealifeph.com

CC: clientcare@idealifeph.com; admin@idealifeph.com

SUBJECT: Inclusion Request | Company Name

BODY:

Dear iDealife,

We would like to submit our inclusion request. Thank you.

Activation of the coverage is effective immediately after the acknowledgement of the customer service. 

Premium for included members will be pro-rated.

1. Masterlist (download)

   • Input the complete details of all employees and their dependents (if applicable)

   • At the left side of the effective date, indicate DEL

   • For the dependents, full Name of the principal applicant should be indicated in the MISC column of the masterlist

2. Submit the masterlist (in pdf and excel) to file the request

TO: accounts@idealifeph.com

CC: clientcare@idealifeph.com; admin@idealifeph.com

SUBJECT: Deletion Request | Company Name

BODY:

Dear iDealife,

We would like to submit our deletion request. Thank you

3. If the member has no utilization in any kind aside from APE, the company will receive a pro-rated refund in form of credit note or in cash.