BENEFITS ASSURED. The Philippine Health Insurance Corp. (PhilHealth) 6 (Western Visayas) assured that Filipinos confined in hospitals for probable or confirmed Covid-19 could avail of benefit packages. Janimhe Jalbuna, head of PhilHealth-6’s public affairs unit, said on Friday (April 17, 2020) that they recently received guidelines on the implementation of inpatient care and testing benefits, among others, which can be accessed in the region. (Photo courtesy of PhilHealth-6)
ILOILO CITY – The state-run Philippine Health Insurance Corp. (PhilHealth) 6 (Western Visayas) has assured coverage for coronavirus disease 2019 (Covid-19) benefit packages.
Janimhe Jalbuna, head of PhilHealth-6’s public affairs unit, said they recently received guidelines on the implementation of inpatient care and testing benefits, among others, which can already be accessed in the region.
From February 1 to April 14, PhilHealth shouldered the full payment of patients admitted to accredited facilities.
Jalbuna said starting Thursday, the state-owned corporation has set case rates for Covid-19 treatment.
“From February 1 to 14, all the expenses (were) covered but starting April 15, we have the case rates depending on the condition of the patient,” she told the Philippine News Agency (PNA) on Friday.
The package for mild pneumonia in the elderly or those with co-morbidities amounts to PHP43,997; moderate pneumonia, PHP143,267; severe pneumonia, PHP333,519; and critical pneumonia, PHP786,384.
“This case policy says that there is no co-payment for our patient whether he or she is confined in a public or private hospital. That means, the patient will not be paying anything,” Jalbuna said, adding that the case rates apply to probable or confirmed Covid-19 cases.
The case rate covers mandatory services, such as hospital accommodation, laboratory, supplies, equipment, and professional fee, among others.
However, the policy does not cover suite rooms, use of which would be paid by the patient personally on top of the PhilHealth benefit.
The hospital will file the patient’s documents within 120 days from the date of discharge.
The benefits section of PhilHealth-6 has not yet received any claim application but Jalbuna said the case of the Covid-19 survivor from Guimbal, Iloilo was being processed at the hospital level.
She assured that Covid-19 survivors confined in hospitals before April 15 and were unable to avail of the full payment benefit from PhilHealth would be given a refund.
Meanwhile, the Western Visayas Medical Center (WVMC) sub-national laboratory is accredited by the Department of Health (DOH) and PhilHealth can cover the testing expenses of probable or confirmed Covid-19 cases.
“In terms of testing, we have no limit since some of the probable or confirmed cases follow repeat testing before being discharged from the hospital,” Jalbuna said.
She also said those probable and confirmed Covid-19 cases outside the hospital and observing isolation in patient care centers can still avail of PhilHealth’s community isolation benefit package.
The patient can claim a maximum of PHP22,449 granted that he or she is linked to a referral hospital.
The claim will be used for the patient’s sustenance and health care needs while at the patient care center.
This claim, however, shall take effect on May 11 as PhilHealth is still accrediting community isolation units.
“We are giving assurance that we will be providing our members of these benefits, especially during this crisis. For those who are not yet members or have gaps in paying their contributions, we guarantee you automatic membership and even automatic eligibility of the PhilHealth benefits,” she said. (PNA)
