May 24, 2024

The Philippine Health Insurance Corporation has come up with benefit packages for the financial protection of Filipinos against the Covid-19.

During the Regional Inter-Agency Task Group online media briefing last April 21, PhilHealth Regional Director Esperanza Pilando said there are already four memorandum circulars regarding benefit packages for Covid-19 patients.

PhilHealth Circular 2020-009 provides for benefit packages for inpatient care of probable and confirmed Covid-19 developing severe illnesses/outcome.

Circular 10 is about benefit packages for testing for SARS-CoV2 2. Circular 11 is the financial risk protection for Filipino health workers as set in the Bayanihan to Heal as One Act; and Circular 12 contains the guidelines for Covid-19 community isolation benefit package.

Pilando explained that as a general guideline, all Filipinos are covered. Those who are not registered with PhilHealth may still avail but must register before their discharge from the hospital. 

The Single Patient Confinement and 45-days confinement rule are not applicable.

No balance billing applies for both public and private hospitals though co-payment of some basic services is allowed.

Data sharing between the Department of Health and PhilHealth must be implemented for a comprehensive registry, and donated items shall not be charged to the patient, she added.

For health facilities, level 1 hospitals are limited to mild pneumonia treatment while a level 2 or level 3 hospital can be a treatment facility for severe and critical pneumonia packages. The amount of health benefit packages for confinement differs depending on the type of pneumonia being treated.

In availing of the benefit package, Pilando said there will be no direct filing by patients/members. For health facilities, filing is up to 60 days but if due to natural calamities or other fortuitous events, it can be extended up to 120 calendar days. All claims for Covid-19 testing shall be filed separately.

For Covid-19 patients, retroactive claiming of PhilHealth benefit package may be done for patients who were hospitalized or have availed medical/laboratory services from Feb. 1 to April 14, and for health workers from Feb. 1 onwards, she said.

PhilHealth is set to conduct orientation for hospitals/medical facilities to explain the Covid-19 financial risk protection packages. – Carlito C. Dar