Philhealth, How Much They Pay

[Call me bubba]

althou I have not found this on the philhealth website it can be helpful to those who may need(aka supporting the family) in case its needed.

Philhealth now pays for Kidney transplants

here is the info and link

MANILA, Philippines—The Philippine Health Insurance Corp. (PhilHealth) will pay for kidney transplant procedures of members and their dependents suffering from end-stage renal disease.

“We are affording every member and dependent with kidney failure the chance to enjoy a superior quality of life. We are now subsidizing the full cost of a kidney transplant procedure up to P600,000,”

said Dr. Eduardo Banzon, PhilHealth president and chief executive officer, in a statement.

The PhilHealth benefit can be availed of at specialized centers with proven capabilities for providing first-rate kidney transplant services and care.

These are the National Kidney and Transplant Institute in Quezon City,

Vicente Sotto Memorial Medical Center in Cebu City,

Southern Philippines Medical Center in Davao City

and Davao Regional Hospital in Tagum City.

“These centers have excellent track records of more than 98-percent survival rates for kidney transplant patients,” Banzon said.

He added: “We are balancing high-quality service with accessibility. We’re starting with only four centers where members can avail themselves of the benefit, but we have at least one facility each in Luzon and the Visayas plus two in Mindanao. We may add to the four later on.”

“The four centers will apply the ‘no balance billing policy’ with respect to kidney transplant patients from families earning P30,000 or less annually. Patients will not be charged extra expenses on top of what PhilHealth pays. The P600,000 benefit already covers everything, including medication, hospitalization and professional fees,” Banzon said.

“This is our way of giving every member considerably greater value for their money. They will be entitled to a P600,000 benefit in return for premium contributions of as low as P2,400 per annum, or less than P7 per day, by Jan. 1, 2013,” Banzon said, noting that the subsidy would be PhilHealth’s single largest benefit payout ever.

According to Banzon, PhilHealth has members as young as 23 years old with chronic kidney disease.

“While they have their whole lives ahead of them, they have to undergo constant dialysis. Some of them die young. Hopefully, not anymore with this new benefit,” he said.

Some 12,000 Filipinos, or 120 per one-million population, develop kidney failure every year. They have a mean age of 53 years, with six out of 10 of them male, according to the National Renal Disease Registry.

Despite being the “gold standard” of care for patients with end-stage renal disease, Banzon said less than a thousand kidney transplants are performed in the country every year, largely due to the steep cost of the procedure.

With the P600,000 benefit, Banzon sees a dramatic increase in life-saving kidney transplants.

PhilHealth previously covered only up to eight percent of the total medical bill for the procedure.

“With this new benefit, our members and dependents with kidney failure, especially those from poverty-stricken households, can readily avail of a transplant procedure and look forward to more productive and fuller lives,” Banzon said.

The leading causes of kidney failure among Filipinos are diabetes, inflammation of the kidneys and high blood pressure.

To stay alive, patients with end-stage renal disease have only two treatment options—lifetime dialysis or a one-time kidney replacement.

http://business.inquirer.net/84714/philhealth-will-now-pay-for-kidney-transplants

[Call me bubba]

newest info what Philhealth will pay.

Philhealth covers child’s leukemia

The Philippine Health Insurance Corp. has set a P210,000-benefit payment for standard-risk acute lymphocytic leukemia,

or fast-growing cancer of the blood in children.

Philhealth president and chief executive officer Dr. Eduardo Banzon said this is their second-largest single benefit payment for a catastrophic illness, next to our P600,000-package for end-stage renal disease requiring a kidney transplant.

http://manilastandardtoday.com/2012/11/01/philhealth-covers-childs-leukemia/

[i am bob]

PhilHealth - well worth the little bit it costs!

Thanks Ed!

[Dr. Cockroach]

PhilHealth - well worth the little bit it costs!

Thanks Ed!

I agree. What's 2 USD a month?

If you go for a private US health insurance here in the US, it would be around $300-$400 USD a month and they would start asking you about not meeting this and that when it's time to pay!

[Mike S]

If you go for a private US health insurance here in the US, it would be around $300-$400 USD a month and they would start asking you about not meeting this and that when it's time to pay!

Well in a short it will soon cost you nothing in the US ...... unless of course you have a job ..... then you will have the extreme privilege of paying for those that don't or won't ...... but then what else is new .... didn't we always do that??????????? ...... just saying .... :mocking:

[Call me bubba]

Thanks. If your family, including in-laws don't have Phil Health, funding membership is a bit of proactive protection if the budget allows.

This is the a very good post. being PRO-ACTIVE to help the family.

before they do need help

[Call me bubba]

http://www.philhealth.gov.ph/circulars/2011/circ16_2011.pdf

On page 3 & 4 there are some businesses that Offer discounts when you use your PHILHEALTH ID CARD,

Wastons drug store is one of the stores that is offering a discount of 15% on medicines

(please read the circular to know more about the discount )

even a 20% discount on Vaccines at healthway clinics(PQ health shield)

[Americano]

Recently I have had some experience with PhilHealth. My wife and I live in Cebu but all of her family are in Mindanao. During the last 2 months some of her family members, Grandmother, 2 brothers, and a niece have been in and out of the hospital a few times for different reasons. All of them have PhilHealth except for one brother who is over 21 years old. All fees were paid by PhilHealth leaving zero balance except for the brother with no coverage. We paid his hospital bills.

I have read for a few years that PhilHealth pays on average about 30%, so this experience leads me to believe that 30% is the foreigner's rate and poor Filipinos may not have to pay anything unless they know you have a foreigner in the family.

[Call me bubba]

philhealth & pregnancy

 

in another thread , it was discussed how long do you need to have philhealth to cover a pregancy

 here is the info and link

 

 

1. I am a new member. When will I
become eligible to avail of PhilHealth benefits?

For one to become eligible for the benefits,

payment of at least
three (3) months within the immediate six (6) months prior to the
month of confinement shall be required.

However, payment of at least
nine months within the last 12 months shall be asked of Individually
Paying Members availing of the following procedures/packages:

• *** Pregnancy-related cases***
•  
• • Dialysis (except those undergoing emergency dialysis service
  during confinement)
• • Chemotherapy
• • Cataract Extraction
• • Radiotherapy
• • Selected surgical procedures

Individually Paying Members and Employed Members will now
be required to have

at least nine (9) months contributions within
twelve (12) months prior to the month of availment for all confinements
including availment of outpatient benefits).

 

http://www.philhealth.gov.ph/members/individually_paying/faqs.html

 

 

1. I just missed a quarter's payment
due to an unforeseen event. Is there a chance that I can still pay for
the missed quarter?

As per PhilHealth Circular No. 06, series of 2001, retroactive
payments are not allowed except when a member can show proof of
sufficient regularity of premium contributions or payment of nine
(9) consecutive months or three consecutive quarters within the
last 12 months prior to the missed quarter. If you meet this condition,
you shall be given a grace period of one month immediately after
the missed quarter to pay retroactively including the current calendar
quarter.

For newly enrolled members

(with less than 12 months reckoned from
date of enrollment),

retroactive payment** for the missed quarter
including the current calendar quarter shall also be allowed within
the month immediately following the missed period.

This privilege is granted only once every 12 months.

 

 

and its been said before and i will post it again,

 yes that foreigner living here can obtain PHILHEALTH coverage

 

5. Can a foreign national enroll as
an Individually Paying Member?

YES, the Implementing Rules and Regulations of RA 7875, as amended
by RA 9241, provides for the inclusion to the National Health Insurance
Program the citizens of other countries residing and/or working
in the Philippines.

If the foreign national is employed, he/she
shall be registered under the Employed Sector Program.

 

Meanwhile,
if he/she is self-employed or merely residing in the country, he/she
may enroll as an Individually Paying Member.

He/she only needs to
accomplish and submit to any PhilHealth office,

the PhilHealth Member
Registration Form (PMRF)

and a photocopy of his/her Alien Certificate of Registration (ACR) issued by the Bureau of Immigration (BI) to
prove his/her residency in the country.

[Call me bubba]

seems that PHILHEALTH is expanding its benefits again,

 

Now it will cover maintenance meds of diabetic  or hypertensive cases 

also it has some info on other conditions that it will now treat.

 

this  news story is not from the philhealth .gov.ph site

 

Philhealth expands coverage

 

Good news for close to 15 million Filipinos who are diabetic or hypertensive

the Philippine Health Insurance Corp. will include maintenance medicines for the two illnesses in its primary care benefit package.

PhilHealth president Alexander Padilla rolled out the additional benefits

after the agency drew flak for its decision to push through with the increase of premium rate to P2,400 annually for individual paying members with a monthly income of P25,000 and below starting next year.

 

“PhilHealth benefits are constantly being expanded.

PhilHealth now pays about P1.2 billion every week where it was only P300 to P400 million in 2010. For 2012, we paid something like P47 billion and for 2013,

I think we will be paying something like P64 billion,” he said in a press briefing at the Palace.

 

“Primary care benefit package would soon include maintenance medicines for diabetes and hypertension.”

The Association of Clinical Endocrinology-Philippines estimates about 3.4 million diabetics in 2010 while the Philippine Society of Hypertension said some 11.5 million Filipinos have hypertension as of 2011.

 

PhilHealth also has packages for low-risk and end-stage renal worth P600,000;

childhood leukemia worth P 210,000;

and P100,000 each for early stage breast cancer,

and low to intermediate risk prostate cancer.

The agency introduced catastrophic packages for coronary artery bypass at P550,000;

surgery for tetralogy of fallot for P320,000; surgery for ventricular septal defect for P250,000;

cervical cancer chemo-radiation with cobalt and brachytherapy (low dose) for P120,000, and cervical cancer with linear accelerator and brachytherapy (high dose) for P175,000.

 

Nine out of 10 hospitals licensed by the Department of Health are now PhilHealth accredited.

 

For the 2014 budget, the government has proposed P35.3 billion for PhilHealth from P12.6 billion this year to provide preventive healthcare services and health insurance coverage to 14.7 million qualified families.

 

http://manilastandardtoday.com/2013/10/15/philcare-expands-coverage/

Edited October 17, 2013 by Pittman apartments Sgn