ILOILO City – The Philippine Health Insurance Corp. (PhilHealth) has paid over P40 million claims for coronavirus disease 2019 (COVID-19) benefit packages in Western Visayas.
“For COVID-19 cases alone, we have paid around P40.9 million. Diri na masulod ang nagkalain-lain nga benefit packages that we are giving to our members,” said Janimhe Jalbuna, head of PhilHealth Region 6’s public affairs unit.
In yesterday’s virtual conference, Jalbuna said the benefits included swab testing and isolation of suspect, probable and confirmed COVID-19 cases at PhilHealth-credited community isolation units.
PhilHealth already paid a total of P7.8 billion in benefit payment for the year 2020, according to Jalbuna.
The state insurer, she said, registered an increase of more than 34.4 percent from last year’s total payment of P5.8 billion
“Nagtaas ang bayad naton subong nga tuig because isa na dira ang aton sini nga COVID-19 benefits,” Jalbuna said.
The top medical conditions with the highest claims this year and even in previous years are pneumonia, acute gastroenteritis, and normal deliveries for medical and dialysis for surgical.
“May ara kita pneumonia due to COVID-19 and may ara man pneumonia not because of the disease, so indi tanan nga pneumonia, COVID-19,” she clarified.
The package for mild pneumonia for the elderly or those with comorbidities is P43,997; for moderate pneumonia, P143,267; severe pneumonia, P333,519; and critical pneumonia, P786,384.
“This case policy says that there is no co-payment for our patient whether he or she is confined in a public or private hospital. That means, the patient will not be paying anything,” Jalbuna previously said, adding that the case rates apply to probable or confirmed COVID-19 cases.
The case rates cover mandatory services such as hospital accommodation, laboratory, supplies, equipment, and professional fee, among others.
Suit rooms, which could be paid by the patient personally on top of a PhilHealth benefit, meanwhile, is not covered.
The hospital will be the one to file the patient’s documents within 120 days from the date of discharge./PN
