PhilHealth to shoulder one COVID-19 patient’s expenses worth P2.8-M, says agency chief

COVID-19 patients who have already paid for treatment can reimburse at PhilHealth

MANILA--The head of the Philippine Health Insurance Corp. on Saturday said his office will cover the treatment of one COVID-19 patient amounting to P2.8 million, backing the state agency’s promise to shoulder the medical expenses of people afflicted with the coronavirus disease.

"So far ang mataas na sasagutin . . . mga P2.8 million. Hindi pa siya nadi-discharge. Sasagutin ng PhilHealth 'yan," PhilHealth chief Ricardo Morales told radio DZMM.

(So far the highest cost we will be covering is about P2.8 million. The patient has not been discharged yet. PhilHealth will be shouldering the treatment costs.)

Earlier, the state health insurance agency said it will cover the cost of treatment for COVID-19 patients until April 14, 2020.

The PhilHealth explained that it set a deadline "due to the novelty and the wide range of severity" of COVID-19 cases in the country, for "which no existing case rate or package based on accepted protocols hast yet been established."

Morales said that after April 14, the Philippines will have a case rate, a fixed amount the PhilHealth will reimburse for a specific illness.

"Wala pa tayong case rate, bago kasi itong COVID-19 na ito. Iba talaga 'yung gamot na gagamitin panglunas ano. By April 14, meron na tayong datos. Confident na tayo na may case rate," he said.

(We still don't have a case rate, since COVID-19 is new. The medicine for treatment for this is new. By April 14, we will have data. We're confident we will have a case rate by that time.)

Morales assured that whether under treatment at public or private hospitals, treatment of COVID-19 patients will be financially supported by the PhilHealth.

"Lahat ire-reimburse ng PhilHealth 'yon (All of them will be reimbursed by PhilHealth)," he said, adding that patients only need to show a receipt or certified documents proving they were treated for COVID-19.

The retired military general called on hospitals not to bill COVID-19 patients since the PhilHealth is mandated under law to pay for their treatment.

Meanwhile, COVID-19 patients who have paid for their treatment can reimburse the costs from the state agency.

"Kung nakapagbayad na siya (If they already paid) . . . we will reimburse fully all the expenses," Morales said.

He also clarified that deceased COVID-19 patients, whose families paid for treatment, can also get their money back.

"Makapag-ugnayan lang sila sa aming (They only need to contact our) office, and will reimburse them fully," the PhilHealth chief said.

However, patients who underwent self-administered treatment and medical tests, and not at accredited hospitals, will not be eligible for endorsement, Morales stressed.

"Doon lang po tayo sa accredited hospitals (We will only help those at accredited hospitals)," he said.

The Philhealth earlier said it was offering an "isolation package" and a "referral package" for its members and dependents with possible symptoms of the coronavirus.

Dr. Shirley Domingo, vice president of the PhilHealth's corporate affairs group, said patients under observation for the coronavirus or those under "isolation package" are entitled to P14,000.

Those referred to hospitals capable of performing isolation procedures and manage infectious diseases, or those under "referral package," are entitled to P4,000.

Patients exhibiting moderate pneumonia due to COVID-19 are entitled to P15,000 while those with severe pneumonia are entitled to P32,000, Domingo said.

Covered by the package are those admitted starting Jan. 31.

The no balance billing (NBB) policy, which enables the vulnerable sectors of the program such as the poor and the elderly to pay no more in excess of their PhilHealth coverage when confined at government facilities, will be applied to COVID-19 claims.

• PhilHealth to shoulder costs of COVID-19 testing

The Philippines has recorded more than 3,000 COVID-19 cases, with over deaths and at least 52 recoveries, as of Friday.