These Terms and Conditions (“Terms”) govern the availment of healthcare and related services provided by Maxicare Health Services Inc. (“MHSI”) through its Primary Care Clinics (“PCCs”) and other authorized service channels.

These Terms may apply to:

1. individuals covered by or enrolled in PRIMA or other MHSI clinic-based products (“Members”); and
2. individuals who avail of MHSI healthcare services without an existing PRIMA or MHSI membership (“Walk-In Patients”).

Additional product-specific terms, benefit limitations, eligibility requirements, and conditions may apply to Members depending on the healthcare product or program under which services are availed.

1. Definitions

1. Member – An individual enrolled in or entitled to avail of healthcare services under PRIMA or another MHSI clinic-based healthcare product.
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3. Walk-In Patient – An individual who avails of healthcare services from an MHSI PCC without using an existing PRIMA or other MHSI healthcare membership or product entitlement.
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5. Patient – A collective reference to a Member or Walk-In Patient, where the provision applies to both.
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7. Patient Identification Number – A unique electronic identifier generated or assigned to a Patient for purposes of registration, identification, healthcare service delivery, medical record management, and continuity of care. Assignment of a Patient Identification Number does not, by itself, constitute membership in PRIMA or any other MHSI healthcare product.
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9. Primary Care Clinic (“PCC”) – An MHSI healthcare facility providing outpatient consultations, laboratory, diagnostic, and other healthcare services.
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11. Healthcare Services – Consultations, laboratory examinations, diagnostic procedures, medical services, and other healthcare-related services made available by MHSI.

2. Registration and Patient Account

1. Before availing of Healthcare Services, a Patient may be required to register through an MHSI-authorized registration platform, kiosk, tablet, computer, or other registration channel.
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3. The Patient shall provide accurate, complete, and updated information necessary for identification, healthcare delivery, medical record management, billing, regulatory compliance, and other legitimate purposes.
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5. MHSI may assign a unique Patient Identification Number to facilitate identification and retrieval of the Patient’s records across authorized MHSI healthcare information systems.
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7. A Walk-In Patient’s registration or issuance of a Patient Identification Number does not constitute enrollment in, purchase of, or entitlement to benefits under PRIMA, Maxicare HMO, or any other healthcare membership product.

3. Walk-In Healthcare Services

1. Walk-In Patients may avail of healthcare services made available by MHSI on a pay-per-use basis, subject to:
   1. availability of the requested service;
   2. applicable service fees;
   3. physician or healthcare professional assessment, where required;
   4. applicable medical or clinical requirements;
   5. operating hours and capacity of the PCC; and
   6. other reasonable operational and regulatory requirements.
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3. Payment of a consultation or service fee does not entitle the Walk-In Patient to healthcare benefits, coverage, reimbursement, or services other than those specifically purchased or paid for.

4. Fees and Payment

1. Walk-In Patients shall be informed of the applicable fees for the healthcare services being availed.
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3. Additional services, procedures, laboratory tests, diagnostic examinations, medications, or referrals recommended following a consultation may be subject to separate fees.
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5. Payment shall be made through payment channels authorized by MHSI.
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7. MHSI may require payment before the performance of certain services, subject to applicable laws, emergency medical considerations, and MHSI policies.

5. Members and PRIMA Patients

1. Where Healthcare Services are availed using PRIMA or another MHSI healthcare product, the Patient’s entitlement to services shall remain subject to the applicable product-specific:
   1. coverage;
   2. inclusions and exclusions;
   3. service limits;
   4. validity period;
   5. eligibility requirements; and;
   6. other Membership Terms and Conditions.
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3. Nothing in these general Terms shall expand or modify the benefits provided under a particular MHSI healthcare product unless expressly provided by MHSI.

6. Healthcare Services and Clinical Judgment

1. Healthcare services shall be provided based on applicable clinical standards and the independent professional judgment of the attending physician or healthcare professional.
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3. Registration or payment does not guarantee that a specific treatment, diagnostic procedure, prescription, medical certificate, referral, or other requested medical action will be provided.
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5. The attending healthcare professional may recommend another facility, specialist, emergency department, or appropriate level of care when clinically necessary.

7. Personal Data and Medical Records

1. MHSI will process personal data and sensitive personal information in accordance with the MHSI Privacy Notice, the Data Privacy Act of 2012, its Implementing Rules and Regulations, applicable healthcare laws and regulations, and relevant issuances of the National Privacy Commission.
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3. Personal and medical information may be processed through MHSI-authorized healthcare information systems for purposes including patient registration, identification, healthcare delivery, medical record management, billing, continuity of care, regulatory compliance, and other purposes permitted by law.
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5. The Patient may access the applicable MHSI Privacy Notice before completing registration.
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7. Any consent required for purposes that are not necessary or inherent to the provision of healthcare services, including certain marketing activities, shall be obtained separately where required by law.

8. Accuracy of Patient Information

1. The Patient represents that the information provided during registration and healthcare availment is accurate and complete to the best of their knowledge.
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3. The Patient shall promptly inform MHSI of material inaccuracies in their identifying or contact information.
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5. MHSI may implement reasonable identity-verification procedures to prevent duplicate records, patient misidentification, fraud, or unauthorized access to medical information.

9. Electronic Facilities

1. MHSI may use electronic systems, kiosks, tablets, websites, applications, and other digital facilities for registration, payment, healthcare processing, and management of Patient records.
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3. Patients shall use such facilities only for legitimate purposes and shall take reasonable measures to protect any credentials, reference numbers, or authentication information issued to them.
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5. MHSI shall implement reasonable and appropriate organizational, physical, and technical safeguards for its electronic facilities.

10. Availability and Limitations of Services

1. Healthcare services are subject to the availability of physicians, healthcare personnel, facilities, equipment, supplies, and other operational resources.
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3. MHSI may temporarily suspend, reschedule, redirect, or limit services when reasonably necessary due to:
   1. emergencies or disasters;
   2. equipment or system failures;
   3. facility limitations;
   4. safety or security concerns;
   5. regulatory requirements;
   6. unavailability of appropriate medical personnel; or
   7. circumstances beyond MHSI’s reasonable control.
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5. MHSI shall take reasonable measures to minimize disruption and appropriately advise affected Patients.

11. Refusal or Discontinuation of Non-Emergency Services

1. Subject to applicable laws and professional obligations, MHSI may refuse or discontinue non-emergency services when a Patient:
   1. provides materially false information;
   2. engages in fraudulent transactions;
   3. refuses to comply with reasonable clinic safety and operational policies;
   4. engages in threatening, violent, abusive, or unlawful behavior; or
   5. otherwise creates circumstances that make the safe provision of healthcare services impracticable.
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3. Any decision involving medical care shall remain subject to applicable healthcare laws, professional standards, and ethical obligations.

12. Product Offering

1. A Walk-In Patient may be informed of PRIMA or other MHSI healthcare products that may be relevant to their future healthcare needs.
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3. The purchase of such products shall be voluntary and shall not be a condition for receiving healthcare services that are otherwise available on a walk-in or pay-per-use basis.
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5. Enrollment in a PRIMA or other MHSI product shall be governed by the applicable Membership Terms and Conditions.

13. Amendments

1. MHSI may amend these Terms when reasonably necessary to reflect changes in its healthcare services, operations, systems, regulatory requirements, or applicable laws.
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3. The current version of these Terms shall be made reasonably available through MHSI’s authorized channels.

14. Governing Law

1. These Terms shall be governed by and construed in accordance with the laws of the Republic of the Philippines.
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3. Nothing in these Terms shall be interpreted to waive or restrict any right or remedy that cannot legally be waived under applicable law.

Form Template Control: Compliance / September 1, 2026 / MHSI-FO-COM-045 / Rev. 03