The Philippine Health Insurance Corporation (PhilHealth) revealed on Thursday, Jan. 18, the ongoing coordination with board officials as they await agreements on the proposed rate hike deferral, aligning with the call made by the Department of Health (DOH) Secretary Teodoro Herbosa.
In a televised interview on Bagong Pilipinas Ngayon, PhilHealth's Acting Vice President of Corporate Affairs Group, Rey Baleña expressed the organization's “respect” for Herbosa's perspective.
"Ito naman po ay pinag-aaralan ng Pangulong Bongbong Marcos Jr. at tayo ay mag-aatabay sa magiging direktiba po nila ukol sa issue na ito (This is currently being studied by President Bongbong Marcos Jr., and we will abide by their directive regarding this issue)," Baleña said.
Dependent members' benefits
Meanwhile, addressing benefits, particularly for dependents, Baleña emphasized that there is “no distinction” from independent contributors in availing benefit packages.
"Kung ano ang benefit na naa-avail ng isang principal member ay 'yun din ang naa-avail ng kanyang dependents (Whatever benefits a principal member can avail are also available to their dependents)," he noted.
Baleña also clarified that a principal member can declare any number of qualified dependents, including legal spouses, children below 21 years, those above 21 with medical conditions, or senior citizen parents aged 60 and above.
Dependents are entitled to a separate 45-day coverage per calendar year, shared among all dependents, allowing families to distribute dependents across PhilHealth memberships, he added.
"Kaya maganda na sa isang pamilya, 'yung mag-asawa ay principal members sapagkat lalo na kung 'yung mga anak nila ay marami, maaari nilang i-distribute ang kanilang mga dependents sa kani-kanilang PhilHealth membership (It's good for a family if the spouses are principal members, especially if they have many children; they can distribute their dependents across their respective PhilHealth memberships)," he stated.
Moreover, Baleña highlighted that principal members do not incur additional charges for declared dependents.
"We are looking at six more medical conditions that truly represent the burden of disease and are frequently claimed under PhilHealth. These will be subject to rationalization," he said.
In response to inflation, Baleña announced a 30 percent increase in all PhilHealth case rate packages to mitigate its impact.
He mentioned that this is aimed at catching up with the effects of inflation from the past period.
"Talagang mararamdaman ng mga miyembro na bababa ang kanilang mga out of pocket expense na babayaran pa sa ospital kung hindi man, e na-wipe out na po ng PhilHealth (Members will truly feel a decrease in their out-of-pocket expenses that they would otherwise have to pay at the hospital, if not completely wiped out by PhilHealth)," he assured.
Benefit Package Enhancement
On the other hand, the PhilHealth official said that for 2023, PhilHealth introduced benefit enhancements, starting with dialysis coverage.
Previously covering 90 sessions annually, PhilHealth approved an increase to 156 sessions, meeting the full year's dialysis requirement for patients.
"So 'yung pang buong taong requirement na ng mga pasyente for dialysis ay sinasagot na ng PhilHealth (So, PhilHealth is now covering the entire yearly requirement for patients undergoing dialysis)," he said.
In collaboration with the DOH, PhilHealth launched an outpatient mental health package in October, featuring two sub-packages valued at P9,000 and P16,000, depending on patient needs.
PhilHealth also initiated the rationalization of packages, starting with three conditions and procedures significantly affecting patients.
Baleña detailed the enhancement of stroke packages, with ischemic stroke increasing from P28,000 to P76,000 and hemorrhagic stroke escalating from P38,000 to P80,000.
Also, high-risk pneumonia coverage rose from P32,000 to P90,100.
In addition, he noted that PhilHealth improved the Z-Benefit package for colorectal cancer, showcasing accomplished initiatives from the previous year.
READ: https://mb.com.ph/2024/1/17/doh-opposes-phil-health-premium-rate-hike
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