Philhealth coverage for Covid-19 patients

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CORONAVIRUS disease (Covid-19) patients in Davao City who can no longer be catered at the Southern Philippines Medical Center (SPMC) have nothing to worry in terms of medical expenses, an official from the Philippine Health Insurance Corporation (PhilHealth) said.

SPMC, initially the lone designed Covid-19 referral center in Davao City, is currently scouting for more beds after its utilization rate peaked beyond the "warning zone" due to the rising cases being brought to the hospital, which includes non-Davao City residents.

To address this, Davao City Mayor Sara Duterte-Carpio announced that the city decided to open last July another Covid-19 treatment facility -- the Dumoy Satellite Facility of the Davao Doctors Hospital (DDH) to decongest SPMC.

SPMC officer-in-charge Ricardo Audan, in a previous interview, said the hospital management will try its best to cater to every Covid-19 patient.

But Duterte-Carpio said patients will have to be referred to DDH once SPMC will be full.

But unlike in SPMC, which the government shoulders the hospital bills of the patients, the mayor said the DDH-Dumoy satellite hospital will be intended for "paying patients."

However, Duterte-Carpio said in a radio interview on Monday, August 3, that PhilHealth will shoulder the hospital bills of indigent patients who will be brought to the satellite facility.

PhilHealth Public Relations Officer Kleah Gayle Guevara told SunStar Davao in a phone interview on Tuesday, August 4, that patients should not worry as the government-owned insurance company will be shouldering the expenses from the testing, community isolation, and admission of the patients, whether public or private hospitals.

Guevara also said all Filipinos, either members, active or non-active, and non-members can avail themselves of the Covid-19 package benefits, as mandated by the health insurance's general coverage. These include probable and confirmed patients.

According to PhilHealth's Covid-19 benefit package, the testing package range from P901 to P3,409. However, testing must be done at DOH-Research Institute for Tropical Medicine accredited laboratories.

Meanwhile, community isolation packages reach a maximum amount of P22,449.

For patients who will be admitted, PhilHealth has four different packages called Pneumonia Package. A total of P43,997 can be availed by mild pneumonia elderly patients or those with co-existing conditions admitted at Level 1 to 3 hospitals.

Moderate pneumonia patients admitted at Level 1 to 3 hospitals can avail themselves of up to P143,267. Also, P333,519 for severe pneumonia patients, and P786,384 for critical pneumonia patients admitted at Level 2 to 3 hospitals.

But Guevara said that as of now, only SPMC in Davao City and Davao Regional Medical Center (DRMC) in Tagum City, Davao del Norte are the accredited Covid-19 testing laboratory and facilities in Davao Region by the Department of Health (DOH).

Under PhilHealth's guidelines, packages for Covid-19 benefits can only be availed at DOH-accredited facilities.

"Currently, ang DDH-Dumoy, they are only accredited for community isolation. These are mild cases na inaadmit (that are being admitted) for isolation or quarantine," she said.

But she said patients have nothing to worry because DDH is now complying with its accreditation for Covid-19 treatment.

Guevara also said that patients have nothing to worry about the duration of their confinement, which would result in the increase of hospital billings, as PhilHealth is implementing a "no co-payment" policy.

Under the "no co-payment" scheme, it eliminates the anxiety that every patient has each time they check their hospital bills. It immediately informs them of the amount that they ought to put up in advance, if there is any, thereby eliminating unnecessary stress and animosity at the point of discharge.

"In this case [Covid-19 pandemic], wala gyud dapat bayran ang pasyente because covered siya sa PhilHealth (patients should not release a single centavo as PhilHealth will be the one shouldering their expenses)," she said.

However, other requests, such as transfer of rooms, would have to be shouldered by the patients.


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