Since the creation of the Republic Act (R.A.) No. 11223 or also known as the Universal Health Care law, the Philippine Health Insurance Corporation or PhilHealth has been more active than ever. With the outbreak of the 2019 Coronavirus Disease (COVID-19), they have since released PhilHealth COVID-19 packages.
In this article, we will be teaching you how you can avail the PhilHealth COVID-19 packages. These packages are different depending on the case or the situation of the patient.
What you need to avail the PhilHealth COVID-19 packages
According to the agency, patients would just need to present a copy of their Confirmatory Test along with their Claim Form.
The Confirmatory Test is the test that would prove a patient to be infected with the virus. This test involves the detection of rare and uncommon sequences of the viral nucleic acid. Furthermore, it is detected through real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) that would be from the Research Institute for Tropical Medicine (RITM).
On the other hand, the Claim Form is the receipt or the proof that you have claimed the test as proof for the COVID-19 PhilHealth package.
Upon the discharge of the Patient, the following requirements would need to be submitted; this is how to avail the PhilHealth COVID-19 packages or benefit:
- Duly Accomplished PhilHealth Claim Signature Form
- Duly Accomplished PhilHealth Claim Forms 1, 2, and 4
- Photocopy of the tests and the results for the COVID-19
- Statement of Account (SoA)
For non-PhilHealth members, the PhilHealth Membership Registration Form (PMRF) would be needed.
The COVID-19 PhilHealth packages
As of this moment, the country’s health sector (DOH) made arrangements in classifying certain patients. There are patients who are considered Under Investigation (PUI); patients under monitoring (PUM); and COVID-19 confirmed patients.
Eligible for this package:
- People placed under investigation due to the showing of symptoms
- PUIs who tested negative for COVID-19
- COVID-19 patients who tested positive
This package is made available to PhilHealth members as well as dependents who have been ordered to be on quarantine. This would apply to people showing some of the subtle signs and symptoms of the coronavirus.
In addition to that, patients who are under the isolation package can avail the isolation package at Level 2 and Level 3 accredited hospitals.
Benefit Amount: P14,000
Because of the fact that only a select few Philippine hospitals have been named to be an official hospital to manage infectious diseases such as the COVID-19; some hospitals would refer patients to a hospital more capable of working on and managing the disease.
Should this happen to a PhilHealth member they can claim the referral package which would usually cover the following:
- Initial Management
- PUI transfer from Level 1 hospitals to the referred hospital (Level 2 or 3)
Benefit Amount: P4,000
Existing Case Rates
For patients who would show symptoms and have existing cases, it would be different from the usual claiming. With this, the benefit amount they can claim will depend on the severity or the medical condition the patient has.
If a COVID-19 patient is diagnosed with severe respiratory-like diseases, they can get the existing medical case rate package offered by PhilHealth. The prices for each of the medical conditions are:
- Moderate-risk type of pneumonia – P15,000
- High-risk or severe type of pneumonia – P32,000
- Adult respiratory or distress syndrome – P32,000
Free COVID-19 Testing
Now that you know how to avail the PhilHealth COVID-19 packages, it is also imperative to know that the testing for COVID-19 is free; this is shouldered by PhilHealth. So if you experience any of the symptoms, for example, and you have yourself tested, it’s for free.
In addition to that, this is added to the PhilHealth coverage for hospitalization and quarantine costs and benefit.
Just to be clear, the COVID-19 testing is free – you wouldn’t have to shell out any amount.
No Balance Billing
Furthermore, everyone also needs to remember that those people in the minorities in the likes of the poor and the elderly who qualify for the No Balance Billing Policy is also applicable for the claims of the COVID-19 PhilHealth packages.
Basically, they need not to pay for anything that would be in excess of their PhilHelath coverage when after they have been held and confined in public hospitals.
If you have further questions about how to avail the PhilHealth COVID-19 packages, you can contact PhilHealth at the following channels:
- Email: [email protected]
- SMS: (0917) 898-7442
- Facebook: @PhilHealthOfficial
- Twitter: @TeamPhilHealth
- Action Center: (02) 8441-7442
What do you think about the process on how to avail the PhilHealth COVID-19 packages? Is it easy and justifiable?