Mechanics

Eligibility
Eligibility
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    All active, HMO-enrolled employees in the Philippines are eligible to participate in the program. Dependents are not covered.

Medicine Coverage
Medicine Coverage
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    Formulary includes ethical drugs, over-the-counter drugs, and essential vitamins.

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    Value brands will be provided when available.

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    Quantity dispensed annually is limited to the full-year regimen of requested medicines. For maintenance medicines, one to six months’ worth of medicines will be dispensed based on medical guidance.

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    MedGrocer may provide proactive refills of about one to six months’ worth of medicines for selected maintenance medicines. To ensure patient safety, MedGrocer may, at its sole discretion, require employees to attend a teleconsult or submit an updated prescription prior to processing employees’ refills.

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    Formulary is customized based on the employee population’s health profile and may be updated to ensure relevance and availability of essential medicines.

Prescriptions and Other Documents
Prescriptions and Other Documents
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    Prescriptions must be uploaded for all requested medicines (including for over-the-counter drugs and essential vitamins).

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    Prescription must:

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      Be named to employee,

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      Contain all the medicines requested for,

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      Contain doctor’s name and license number,

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      Have been issued within thirty (30) calendar days from request date for antibiotics and Schedule II drugs and within one (1) year from request date for other drugs, and

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      Include treatment duration or daily intake instructions.

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    For some chronic conditions, doctors may co-prescribe ethical drugs with essential vitamins. Employees who have a medical certificate indicating their chronic condition and who have been co-prescribed ethical drugs may request essential vitamins by uploading supporting documents.

Patient Safety
Patient Safety
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    To ensure patient safety, MedGrocer may:

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      Adjust the quantity to be served based on clinical guidelines and medical judgment,

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      Facilitate outbound teleconsult to clarify details in the prescription, and

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      Ask employees to provide additional documentation for exceptional cases, such as:

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        Asking the employee to present medical certificates if they claim medicines for conditions that they have not been recently diagnosed with, e.g. claiming medicines prescribed to another person,

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        Limiting the combined quantity claimed up to the employee's full-year regimen, and

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        Modifying prescriptions for medicines unavailable in the market with doctor-approved, therapeutically similar medicines.

Reminders
Reminders
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    To prevent inaccuracies and confusion, requests are considered final upon submission. For any revisions, the employee must request medicines through the website again.

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    Medicines must be claimed by the employee or their authorized representative.

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    Authorized representatives must present an authorization letter from the employee and a copy of employee’s valid ID to claim the medicines.