Intellicare HMO Plans and Coverage in the Philippines (2026 Guide)

Quick Answer: Intellicare (Asalus Corporation) is one of the largest HMOs in the Philippines and was the #1 HMO by net income for 2025. Unlike Maxicare or MediCard, Intellicare does not openly sell individually-priced personal HMO plans — it is primarily a corporate and SME (group) HMO, so comprehensive coverage is quote-only and usually arranged through your employer. The only products an individual can buy directly are limited-scope prepaid health cards. Intellicare's network includes 43,500+ affiliated doctors and specialists and around 800 hospitals, clinics, and diagnostic centers, plus its own Aventus clinics. It is owned by the Fullerton Health Group.

If you're researching Intellicare as an individual, the first thing to know is that you generally can't just buy a full Intellicare HMO plan online the way you can with Maxicare PRIMA or MediCard. Intellicare's comprehensive coverage is sold to companies. This guide explains how it works, what it covers, and your realistic options.

Table of Contents

• How Intellicare is sold
• What Intellicare plans cover
• Network and own clinics
• How to enroll and file claims
• Key exclusions
• Who owns Intellicare?
• FAQ

How Intellicare is sold

Intellicare offers two main tracks, both quote-based with no published prices:

• Corporate Plan — for larger companies.
• SME Fit Plan — for small and medium enterprises.

Both are arranged via a proposal request, and pricing is negotiated per group. Group enrollment typically requires a minimum number of employees (commonly cited around 10–15, set per proposal). Intellicare has also been expanding into the regions with programs like Intellicare Locale, aimed at budget-conscious MSMEs outside Metro Manila.

For individuals without an employer plan, the only things you can buy directly are prepaid health cards — single-payment, one-year cards covering specific needs (e.g. consult/diagnostic bundles). These are not full HMO membership. Be cautious of any website quoting an exact "Intellicare individual annual price" — Intellicare does not publish one, so those figures are third-party estimates.

What Intellicare plans cover

Because benefits are set per group contract, there's no single public benefit table — exact limits depend on the plan your company chose. The general mechanics, however, are standard:

• Maximum Benefit Limit (MBL): assigned per member per year and tied to your room category. Complications of a covered illness share the same MBL (no separate limit).
• Room & board: tiered by plan (ward → semi-private → private → suite). If you voluntarily upgrade your room, you pay the difference.
• Outpatient: consultations, specialist referrals, ER/minor-injury care, and pre/post-natal consults.
• Lab / diagnostics: lab tests, X-ray, CT, and ultrasound (maternity ultrasound typically excluded).
• Dental: often an add-on — exams, annual oral prophylaxis, extractions, and gum treatment; major dental work is excluded.
• Emergency: at a non-accredited or foreign facility, reimbursement is generally up to ₱30,000 at ~80%; where no accredited hospital is available, up to ₱30,000 at 100%.
• Pre-existing conditions: covered after a 1-year waiting period from the coverage date (subject to full disclosure).
• Age eligibility: principals are typically 18–65; dependents fall within plan-defined age bands.

Treat specific peso figures here as typical examples — your actual MBL, room type, and limits are whatever your company's contract specifies.

Network and own clinics

Intellicare's network is one of its strengths:

• 43,500+ affiliated doctors and specialists
• ~800 hospitals, clinics, and diagnostic centers nationwide
• 1.2 million+ members
• Its own affiliated clinics — branded Aventus clinics plus primary-care clinics located inside major hospitals (such as Cardinal Santos Medical Center and St. Luke's QC)

Browse HMO-accredited clinics or search ClinicFinderPH to find accredited providers near you, including premium hospitals like Cardinal Santos Medical Center and Makati Medical Center.

How to enroll and file claims

• Enroll: corporate/SME only — submit a proposal request via Intellicare or a reseller. Individuals usually get covered through their employer.
• Card use: present your Intellicare card at an accredited hospital or clinic for cashless service — no pay-and-reimburse needed in-network.
• App: Intellicare Agora (iOS/Android) — view your profile, search accredited providers, teleconsult, and submit referral/consult forms online.
• Reimbursement: for emergency or non-accredited care, submit the Intellicare Reimbursement Form with attachments within 30 days of discharge; processing takes about 30 days.

Key exclusions

General exclusions include services from non-accredited providers (outside emergency rules), cosmetic procedures, pre-existing conditions during the 1-year waiting period, major dental procedures, and certain vaccine and maternity-imaging costs. Your specific benefit guidebook governs the exact list.

Who owns Intellicare?

Intellicare is the HMO brand of Asalus Corporation, founded in 1995. Since 2018 it has been majority-owned by the Fullerton Health Group, a pan-Asian integrated healthcare provider (which acquired 60% of Asalus and sister firms Avega and Aventus). It is not related to Maxicare — that's a separate competitor. In 2025, Intellicare (Asalus) reported the highest net income among Philippine HMOs.

FAQ

Can I buy an Intellicare plan as an individual? Not a full HMO plan. Intellicare's comprehensive coverage is sold to companies (Corporate and SME plans) and is quote-only. As an individual, you can only buy limited-scope prepaid health cards directly.

How much does Intellicare cost? There's no published individual price — comprehensive plans are quoted per company based on size, benefits, and member ages. Any exact "annual price" you see online for an individual Intellicare plan is a third-party estimate, not an official figure.

Is Intellicare a good HMO? It's one of the largest and most financially solid HMOs in the country (the top earner among PH HMOs in 2025), with a wide network of 43,500+ doctors and its own clinics. It's most relevant if your employer offers it.

Does Intellicare cover pre-existing conditions? Yes, but generally after a 1-year waiting period from your coverage start date, subject to full disclosure. Corporate plans may vary by contract.

What is the Intellicare Agora app? Agora is Intellicare's member app for viewing your profile, finding accredited providers, teleconsulting, and submitting online consult/referral forms.

Is Intellicare the same as Maxicare? No. Intellicare (Asalus, owned by Fullerton Health) and Maxicare are separate, competing HMOs.

The bottom line

Intellicare is a heavyweight HMO, but it's built around employer and SME group coverage, not individual retail plans. If your company offers Intellicare, you're in a strong network with its own clinics. If you're shopping as an individual, you'll likely be choosing between providers that sell direct — like Maxicare, MediCard, or PhilCare.

Not sure which HMO fits? Read our how to choose an HMO guide, or find accredited clinics near you on ClinicFinderPH.