ILOILO City – The Philippine Health Insurance Corp. in Region 6 has assured coverage of benefit packages for coronavirus disease 2019 (COVID-19) patients.
PhilHealth-6’s public affairs unit head Janimhe Jalbuna said they have recently received guidelines on the implementation of inpatient care and testing benefits, among others, which can be already accessed in this region.
From February 1 to April 14, PhilHealth
shouldered the full payment of COVID-19 patients admitted to accredited
facilities. Beginning April 16, however, they have set case rates for the
treatment of the virus’ patients.
“From February 1 to 14, all the expenses were. But starting April 15, we have
the case rates depending on the condition of the patient,” Jalbuna said
yesterday.
The package for mild pneumonia for the elderly or those with co-morbidities amounts to P43,997; moderate pneumonia, P143,267; severe pneumonia, P333,519; and critical pneumonia, P786,384.
“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 rates cover mandatory services such as hospital accommodation, laboratory, supplies, equipment, and professional fee, among others.
Suit rooms, of which could be paid by the patient personally on top of a PhilHealth benefit, meanwhile, is not covered.
The hospital will be the one to 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 applications, but Jalbuna said the case of the COVID-19 survivor from Guimbal, Iloilo is being processed at the hospital level.
She assured that COVID-19 survivors confined in hospitals before April 15 who were unable to avail 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 there.
“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 added that those probable and confirmed COVID-19 cases outside the hospital and are observing isolation in patient care centers can still avail PhilHealth’s community isolation benefit package.
The patient can claim a maximum of P22,449 if 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 he or she is at the patient care centers.
This claim, however, will take effect on May 11 as PhilHealth is still accrediting different 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,” Jalbuna said.(With a report from PNA/PN)
