INDIVIDUALS and their families in need of medical care treatment in areas recently affected by three succeeding earthquakes may continuously have access to health care benefits especially during times of fortuitous events.
The Philippine Health Insurance Corporation (PhilHealth) made the assurance following reports that several victims were injured in consecutive quakes that rocked Cotabato and affected several nearby areas in Mindanao including Davao Del Sur, Sarangani, cities of Davao: Kidapawan and Koronadal.
While PhilHealth members may continue to experience responsive health care benefit access, non-members can likewise avail themselves of the PhilHealth benefits even if confined in non-accredited facility subject to certain conditions as specified in PhilHealth Circular 34, s. 2013.
This policy, which is in accordance with the provision of special privileges to those affected by fortuitous events stipulated in the said Circular, covers members, non-members and their dependents; admission to accredited or non-accredited facilities that are Department of Health (DOH)-licensed or DOH-certified; and treatment and management by accredited or non-accredited health care professionals who are duly licensed by the Professional Regulations Commission.
It also cover claims for medical treatment done as an outpatient or inpatient relative to the direct and indirect effects of the fortuitous event within the Health Care Institution or an improvised/satellite facility; and patients transferred from or managed by health care personnel from accredited facilities in an evacuation area, or improvised health care facilities.
In addition, the policy extends to certain privileges like exemption from the 45 days annual benefit limit, Single Period of Confinement and the less than 24-hour confinement policies; extension of filing up to 120 days, payment of premium contributions or extension of coverage, reimbursement for both referring and receiving health care institutions; priority in the processing of claims, extension of the deadline for submission of health care facility reports and extension of accreditation of providers, as applicable.
In these trying times, PhilHealth assures the public that despite these seemingly insurmountable situation, the state-health insurance company remains committed to its promise of providing the best quality health care services for every Filipino people./PN
