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Monday, August 18, 2003
Amendment of PhilHealth contribution scheme urged
INDIVIDUAL paying members of the Philippine Health Insurance Corporation (PhilHealth) requested officials of the health plan to amend the contribution scheme from quarterly to monthly basis.
The request surfaced during the Kapihan sa PIA forum, Wednesday afternoon at City Burger.
A tricycle driver, representing the driver's federation in Dumaguete City, stressed that members like him who do not fall under the indigent members clause but as individual paying members, cannot afford to pay the quarterly payment scheme.
PhilHealth Dumaguete Officer-In-Charge Marites Que said during the forum that individual paying members should shoulder the 100 percent of the payment unlike those employed where the employee and the employer each pays half of the premium.
"Adunay posibilidad nga dili kami makabayad kay posibleng magamit sa ubang butang lagi ang kuwarta nga gitigum alang niini tungod sa panginahanglan (There is a possibility that we cannot pay, because the money intended for that could be used for other needs)," individual paying members at the forum stressed.
Que promised to endorse the proposal before the regional Philhealth officials in Cebu City.
She said the proposal is valid specially when the agency is scheduled to increase its monthly contribution effective January 1, 2004.
However, the premium contribution of individually paying members will remain at P100 per month payable on a quarterly, semi-annual or annual basis.
Marie Beatrix Y. Solis of the media relations staff of PhilHealth said the minimum monthly contribution of members in the employed sector would increase to P100 to be shared equally by the employer and employee.
The salary cap will be at P15,000 for a total monthly contribution of P375.
Solis said the salary cap will be increased to P20,000 with a total monthly contribution of P500 starting January 2005.
The salary cap is the maximum salary base with the highest monthly compensation bracket.
The Indigent Program annual premium will also increase from P1,880 to P1,200 per year.
She said the revision will compensate for the new benefit packages approved early this year that include the Outpatient Anti-Tuberculosis or Directly Observed Treatment Short-course (DOTS) Benefit Package and Maternity Care Package for second normal delivery, psychotherapy and substance abuse rehabilitation later this year.
Meanwhile, Que clarified that a professional fee, although not required by the agency is a benefit for a first normal delivery.
She was reacting to a follow-up story of Sun.Star Dumaguete dated August 3, 2003 entitled " PhilHealth-7 denies doctor's fee coverage".
Que explained that Philhealth does not "deny" the doctor's fee because the agency will pay it.
The regional PhilHealth office in Cebu City, earlier clarified that a professional fee or doctor's fee is not an agency requirement.
Loida Guaquina, in-charge of Philhealth's claims department, said in a long distance interview that a professional fee is an agreement between the doctor and the patient.
PhilHealth, she said, has nothing to do with a hospital's internal policy.
Guaquina issued the clarification after a PhilHealth member from Dumaguete City complained of alleged overpricing at Negros Oriental Provincial Hospital.
Lanilyn Maniacap, 23, of Lower Batinguel, who had a recent normal delivery complained against the NOPH for what she described as "suspicious and overpriced" billings. VLC
(August 16, 2003 issue)
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