MANILA – Based on the government's tiered coverage, the cost of treating COVID-19 ranges from P43,000 to close to P800,000 with at least 2 patients saying they were billed close to P100,000.
Until April 14, state-run PhilHealth will shoulder all costs, after which a 4-tier criteria for coverage, based on the severity of pneumonia, will be applied. Health insurance from private firms, if available, will offset more of the bill.
One COVID-19 patient told ABS-CBN News he was billed P93,805 for his 8-day treatment at a Makati hospital. He paid only P170 after his health insurance covered about P89,000 and PhilHealth another P4,000. The bill included the cost for his room, medical supplies, laboratory procedures, and medicine.
Single parent Ariane Khey said she paid for treatment with her family's emergency fund, unable to process her PhilHealth benefits.
“Paano yun, wala kaming trabaho, walang work ‘yung parents ko? Eh ‘yung pera na yun very important sa pang araw-araw mong gastusin, hindi ba? Medyo masakit, given na walang trabaho lahat. So parang pilay na pilay ka,” she told ABS-CBN News.
(How will that be, when we all don’t have work, my parents are not employed? That money is very important in everyday expenses, right? That’s quite painful, given that everyone doesn’t have work. You will really be crippled.)
HOW MUCH WILL GOVERNMENT COVER?
PhilHealth earlier said it would cover the full cost of treatment for COVID-19 patients until April 14. For patients admitted April 15 onwards, the state-run insurance agency will cap the amount depending on their condition.
Those with mild pneumonia are entitled to P43,000 coverage, P143,000 for moderate pneumonia, P333,000 for severe pneumonia, and P786,000 for critical pneumonia, PhilHealth said.
Patients can apply for additional support should the allotted amount be insufficient, said PhilHealth President and CEO Ricardo Morales.
They will also get P22,000 in quarantine support for expenses incurred within 14 days of self-isolation and P8,000 for testing expenses, he said.
The new schedule of fees is based on the average expenses incurred by patients in the 4 tiers, said Morales. This scheme was outlined for PhilHealth to ensure sustainability and take care of patients with other illnesses, he said.
"According to our data, there are 4 levels of severity. This depends on the diagnosis of the attending physician...We think this will provide sustainability to the anti-COVID campaign," Morales said.
"We’re confident that with this schedule of fees, yung 4 na levels of severity (the 4 levels), we can have some sustainability. We don’t know how long this pandemic is going to last. That’s why we’re configuring for the long term," he added.
As of April 13, the PhilHealth released some P8 billion out of its P30 billion budget to shoulder COVID-19 hospital fees, Morales said. Additional funding sources are being considered, he said.
Based on patient records, the cost of COVID-19 treatment ranges from P5,000 to as much as P3.8 million in rare cases, Morales said. Confinement, food, linen, medicine and use of the Intensive Care Unit (ICU) are part of the total bill, he said.
Treatment for the patient with a P3.8 million bill, incurred after a month in the ICU, will be paid until April 14.
WILL GOVERNMENT REIMBURSE?
Recovered patients who paid for their own treatments can also request for reimbursements starting this week using the same format, Morales said.
"Ang mangyayari pag lumagpas (what happens when they exceed), we will ask the patient to apply, to ask for additional support, so we can now see if meron bang insurance ang patient as some means of covering the costs," Morales said.
PhilHealth is unable to offer "unlimited" COVID-19 treatment coverage since it serves millions of others with various ailments, Morales said. It also eyeing other fund sources in case the pandemic drags on, he said.
"Ang masasabi lang ho ng PhilHealth, hindi ho kayo mamumulubi kung kayo ay magkakaroon ng sakit na COVID-19 kahit na after April 14," Morales said.
(What PhilHealth can say is that you won't go bankrupt if you contract COVID-19 even after April 14.)
"We will see how this goes and make adjustments accordingly," he said.
The Philippines had 4,932 cases of COVID-19, with 315 fatalities and 242 recoveries as of April 13. The entire island of Luzon and several other areas in the country are under lockdown in a bid to stop the spread of the disease.