Request Medicines

Members who have enrolled, completed their laboratory tests, and consulted a doctor from Maxicare’s Primary Care Network may request free medicines.

First Name

Last Name

Employer of Maxicare Principal

Maxicare Member Type

Principal

Dependent

Mobile Number

Secondary Contact Name

Secondary Contact Mobile Number

Weight Today (kg)

Blood Pressure Today

Prescription Source

Maxicare Corporate Clinic

Maxicare Primary Care Clinic (PCC)

Maxicare Videoconsult via Doctor Anywhere

Maxicare 24/7 Teleconsult

Maxicare-affiliated Doctor

Prescribing Doctor

Address Type

House Number

Street Address

Province

Metro Manila

City

Select city

Barangay

Select barangay

Delivery Notes (Optional)

Upload Guidelines

Lay document on a flat surface. Please take pictures in portrait mode.
Take the picture with good lighting. Do not block the light source.
Make sure the entire document is captured.
Move your phone closer and capture the document in segments if needed.
Tap to focus and make the document clearer.
Connect to WiFi for faster uploading.
You can only upload a maximum of six pictures, with a maximum file size of 2MB each. Set your camera's quality settings from High to Standard to ensure optimized file size.

Valid prescriptions should:

Have the patient’s name,
Be issued within the last three months,
Have the doctor’s name and PRC number, and
Be issued by a doctor from Maxicare’s Primary Care Network (PCN) or a Maxicare-affiliated specialist.

Upload prescription