Philhealth Covid-19 benefit packages available

BAGUIO CITY -- The Philippine Health Insurance Corporation or PhilHealth benefit packages are lined up for the financial risk protection of all Filipino against COVID – 19.

Dr. Esperanza Pilando of PhilHealth – Cordillera during the Regional Inter – agency Task Group online media briefing Tuesday, reported there are already four memorandum circulars regarding PhilHealth benefit packages for COVID – 19 patients.

Philhealth Circular No.   2020-009 provides for benefit packages for inpatient care of probable and confirmed COVID – 19 developing severe illnesses/outcome; Circular No.  10  is about  benefit package for testing for SARS–Cove–2, Circular  No. 11  is  the  financial risk protection for Filipino health workers as stipulated in RA 11469, otherwise known as Bayanihan to Heal as One Act,  Circular No. 12  is  the Guidelines for COVID – 19 Community Isolation benefit Package (CCIBP).

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

The Single Patient Confinement (SPC) and 45 - days confinement rule are  not applicable; No Balance Billing or NBB applies for both public and private hospitals though co – payment of some basic services are allowed. Data sharing between DOH and Philhealth must be implemented for a comprehensive registry, and donated items shall not be charged to the patient, she added.

Pilando also explained that for health facilities, Level 1 hospitals are limited to mild pneumonia treatment while a Level 2/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 the 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 can be done for patients who were hospitalized or have availed medical/laboratory services from Feb. 1 to April 14, while for health workers it will be February 1 onwards, she  said.

               Philhealth is set to conduct orientation for hospitals/medical facilities to explain further the COVID-19 financial risk protection packages. (JDP/CCD-PIA CAR)