Philhealth unveils ailment treatment benefit package

By Ramon Dacawi

Persons covered by the Philippine Health Insurance Corp. (Philhealth) may now avail – if they are qualified - for fund support in case they’re suffering from any of four serious ailments covered by the newly launched “Case Type Z” benefit package of the government medical care system.

In Philhealth Circular 030 issued last June 13, Philhealth president Eduardo Banzon identified the initial afflictions covered:

 “The illnesses and their stages/risk classification included in the initial implementation (phase 1) ….are as follows: standard risk acute lymphocytic (lymphoblastic) leukemia (ALL) in children, early stage breast cancer, low to intermediate prostate cancer and end stage renal disease requiring kidney transplant (low risk).

 In other words, Case Type Z is for early stage cases that “have good survival rates based on medical literature and the success rate of the treatment is acceptable based on current standards of practice”, according to Philhealth Circular 029-2012.

 The package for ALL shall be P210,000 for the entire course of treatment for three years. It’s for kids aged one to less than 10 years, with white blood cell count <50,000/pL, no CNS leukemia at diagnosis, no testicular involvement of male patient at diagnosis and WHO classification:B or T lymphoblastic leukemia immunophenotype (mature B-cell All or Burkitt leukemia are excluded).

 For the Cordillera, Philhealth assistant regional director, Dr. Valeriano Lopez led Monday in launching the special benefit package at the Baguio General Hospital and Medical Center. With him were medical center chief, Dr. Manuel Factora, and Philhealth staff Lily Linggon, Dr. Glenn Cornelio Lamsis and Dr. Dominga Gadgad.

 The package for early breast cancer is P100,000 “for one year only for the complete course of first line surgical and anti-cancer drug care drug care with radiotherapy when indicated”. It’s for Stage 0 to Stage III-A, including stage III-A becoming III-B post-surgery which may require radiotherapy.

The package of P100,000 is also for “low to intermediate risk prostate cancer requiring prostatectomy”. It’s for patients up to 70 years old, with “localized cancer” with “no uncontrolled co-morbid conditions”. “Low risk” is indicated as “T1-T2a and gleason score 206, and PSA <10 ng/ml” while intermediate risk is qualified as “T2b to T2c,. Gleason score of 7, and PSA 10-20 ng/ml”.

 The package for end-stage renal disease is good for P600,000, to cover “low risk” kidney transplant. It’s for patients over 10 and under 70 years old, with low immunologic risk and other criteria, including “certification from the social service of the hospital that (he.she) can maintain anti-rejection medicines for the next three years”.

 Dr. Factora noted that non-government and charitable institutions may come in to cover the expenses not covered  by the amounts specified under the Case Type Z Program under a medical  public-private partnership of sorts..