Cabaero: PhilHealth to the Covid patient

Cabaero: PhilHealth to the Covid patient

THOSE who tested positive for the Sars-CoV-2 that causes the coronavirus disease (Covid-19) will think next about how to pay their medical bills should their symptoms worsen and they need hospital care.

Those who are asymptomatic although positive for the severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) will not have to worry about medical costs because they could either be isolated at home or placed in a quarantine center where the required 14-day stay is covered by the government or the private sector through donations.

But those with symptoms may see their fever, dry cough or shortness of breath worsen as the disease progresses. They would need hospitalization to stop the virus from causing further damage. At the emergency room, the hospital bills start to pile up and the patient once stabilized, begins to think about them.

PhilHealth is there to help cover the bills and ease the patient’s burden. The Philippine Health Insurance Corporation (PhilHealth) pays certain amounts based on the patient’s pneumonia category. Since the Sars-CoV-2 attacks the respiratory system, the immediate indication of Covid-19 is in the damage to the lungs.

Under the PhilHealth new case rates, a Covid-19 patient gets coverage for mild pneumonia in the amount of P43,997; moderate pneumonia, P143,267; severe pneumonia, P333,519; and critical pneumonia, P786,384. The money goes to the payment of hospital bills.

For my hospitalization for 10 days last month for Covid-19, PhilHealth covered P143,267 of my hospital bill because I had moderate pneumonia. That amount represented only 35 percent of my total bill which included the costs of addressing a blood infection, a usual complication for Covid-19 patients. I needed a dose of Tocilizumab to prevent blood clots and address the cytokine storm syndrome associated with severe Covid-19.

The PhilHealth was a big help, although the medical insurance paid for by my employer covered the bulk of the bill, and I had to add a small amount to cover the rest. Not all Covid-19 patients are as fortunate to have medical insurance.

Those confined in government hospitals do not pay for their treatment if they are charity cases. I know of a person who was considered a charity case and confined for a week for mild pneumonia and also treated for the blood disorder but she did not have to pay a centavo.

That is how important PhilHealth is in this time of the Covid-19 pandemic to patients and to their peace of mind. Although PhilHealth assured it is committed to paying benefits due to all Covid-19 patients, it is hardly reassuring when you know the PhilHealth leadership faces corruption allegations and there is uncertainty over how long the fund will last.

PhilHealth has to plug the leaks in its system and give the public the sense of security it needs.

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