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Expansion of Philhealth coverage to reach more poor people, says Padilla

Posted on October 14, 2013

MANILA, (PNA) — The Philippine Health Insurance Corporation (PhilHealth) is continuously expanding its benefits to serve more Filipinos especially the poor based on President Benigno S. Aquino III’s pro-poor agenda, its chief operating officer said.

In a press briefing in Malacanang on Monday, Padilla said that the agency benefits include room and board, medicines, supplies, laboratories and diagnostics, operating room fees as well as professional fees.

For out-patients benefits include minor surgical procedures, chemotherapy, radiation, dialysis and other ambulatory-surgical procedures including primary care benefits for sponsored members and dependents of overseas Filipino workers members.

Aside from its previous packages, Padilla said PhilHealth introduced five more catastrophic benefit packages such as coronary artery bypass; tetralogy of fallot, closure of ventricular septal defect, cervical cancer chemo-radiation and lower lymprostesis at P15,000.

Special benefits include the Millennium Development Goals (MDGs) benefit packages such as out-patient HIV package, animal bite package, malaria, TB-DOTS package, blood transfusion, and leptospirosis.

Padilla added that primary care benefit package would soon include maintenance medicines for diabetes and hypertension, and there will be a sheet to provide a payment mechanism to all case-rates expanding the no-balance billing for the sponsored members to all cases in government facilities.

“This is in line with our President’s declaration sa kanyang SONA na ang sabi n’ya ‘lahat ng mga mahihirap na magpupunta sa ating mga pampublikong ospital ay dapat walang bayaran ni singko’ sa kanilang serbisyo na ibibigay sa kanilang in public hospitals,” Padilla said.

There are currently 23 illnesses being paid through case rates with no-balance billing for sponsored members said Padilla. These include room as well as medicines, radiation treatment, diagnostics and others, Padilla explained.

In 2012, PhilHealth introduced Type-Z benefits, providing for four catastrophic benefit packages that include pediatric leukemia; P210,000, breast cancer and prostate cancer; both at P100,000, and end stage renal requiring kidney transplant at P600,000, Padilla said.

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