THE Philippine Health Insurance Corporation (PhilHealth) is looking for institutions in the Davao Region to partner with them in rolling out its outpatient mental health benefit package.
“I am hoping that our eligible stakeholders will manifest interest in being accredited for this benefit package,” said PhilHealth-XI Healthcare Delivery Management Division (HCDMD) Medical Evaluator Dr. Gianelli Kristine Remocaldo during her December 22 guesting at the Philippine Information Agency’s One Davao Online Presser.
She said that currently there are no health care institutions (HCIs) in the region accredited for the outpatient mental health package, adding that PhilHealth is very willing to assist HCIs that would like to be accredited for the package.
“If you (HCI) have any questions, do not hesitate to contact us at the accreditation department in the region, and we will happily help you through the process,” Remocaldo said.
Mental health outpatient facilities, medication access sites, and mental health specialist centers can be accredited for the package.
The mental health outpatient facilities can be rural health units, city health offices, level 1 or level 2 hospitals, or freestanding facilities with trained family medicine, internal medicine, external medicine, pediatricians, or general practitioners with mental health Gap Action Program (mhGAP) training.
In the accreditation process, the health facility shall have a Memorandum of Agreement with the referral center to ensure the continuity of care for the patient.
“Accrediting our facilities is the first step for our members to benefit from the package,” Remocaldo said.
She admits that mental health specialists, like psychiatrists, are lacking in the region, which may hinder accreditation.
“There are only a handful of them; hopefully, in the coming years, mudaghan pa ang atong mga specialista (our specialists will increase). The more we talk about mental health, the more we see its importance. I am sure our friends from the healthcare services will see the need to step up to address these issues,” Remocaldo said.
Implemented on October 27, PhilHealth’s Outpatient Benefits for Mental Health provides coverage for mental health issues that have risen during the Covid-19 pandemic.
There are an estimated 3.6 million Filipinos (2020 Department of Health data) suffering from at least one kind of mental, neurological, or substance abuse disorder.
Remocaldo said that with the Covid-19 pandemic, they are seeing an increasing number of people with mental health issues, and people are becoming aware of these issues and no longer treating mental health problems as taboo, unlike in the past when individuals would tend to hide their problems.
Package benefit
There are two types of mental health packages available to PhilHealth members. The first is the General Mental Health Service Package, which includes: screening, assessment by a mhGAP-trained doctor, diagnostics, 12 follow-up visits, psychoeducation, psychosocial support, and 25 medicines in the Mental Health Medicines Access Program (mhMAP)
The General Mental Health Service Package is about P9,000 per person per year. The yearly coverage provides sustained and continuous management for the patient.
The Specialty Mental Health package includes: assessment, specialist diagnostics, 12 follow-up visits. 25 medicines in the mhMAP, other medicines in the PNF (Philippine National Formulary), and psychotherapy
The Specialty Mental Health Package will cover P16,000 per person every year. The yearly coverage will enable continuity of care for the member patient.
The new Outpatient Mental Health Package is in line with Republic Act 11036, or the Mental Health Act, which provides for the compulsory treatment of certain people suffering from mental disorders, and Republic Act 11223, or the Universal Health Care Act, which covers population-based and individual-based health services and medicines access programs for mental health. PIA DAVAO