By Jenny F. Manongdo - Manila Bulletin
February 14, 2013, 6:47pm
MANILA, Philippines --- The Philippine Health Insurance Corporation (PhilHealth) yesterday announced a menu of expanded package rates for illnesses that are considered limb-threatening and requiring prolonged hospitalization and expensive treatments and therapies.
In PhilHealth’s 18th anniversary celebration yesterday, DOH Secretary and acting President and CEO Dr. Enrique T. Ona revealed the expanded hospitalization benefits for five catastrophic illnesses under the Expanded Z benefits including open heart surgeries for children, leukemia, breast cancer, prostate cancer, kidney transplantation, cervical cancer and external lower limb prosthesis.
“Before the Expanded Z benefits, we already have an amount but now we are giving maximum coverage,†Ona said.
Dr. Robert So, OIC senior manager of the Benefits Development Department, said the Expanded Z benefit package will give quality care to beneficiaries including drugs and doctor’s fees. In the case of cervical cancer patients, four sessions of chemotherapy is covered and radiation therapy, if needed. Poor patients will also experience “no-balance billing†in government hospitals.
“It is called Z because we have case types from A to D. The message here is that it is at the end because it is catastrophic. The amount is big but it is totality of care. The claim will be given as a whole,†So said.
The following is a list of diseases belonging to the case type Z and their corresponding payment benefits: acute lymphocytic lymphoblastic leukemia, P210,000; breast cancer, P100,000; prostate cancer, P100,000; kidney transplantation (low risk), P600,000; coronary artery bypass graft surgery, P550,000; surgery of tetralogy of fallot in Children (congenital heart defect), P320,000; surgery for ventricular septal defect in children (congenital heart defect), P250,000; cervical cancer (early stage), P120,000, (late stage), P175,000; and external lower limb prostheses, P15,000.
All eligible Philhealth members, including their qualified dependents, are entitled to avail themselves of the benefits.
The “no-balance billing†policy on sponsored members of Philhealth applies to type Z benefit packages. This means no other fees or expenses will be charged or paid by the member beyond the case packages.
Ona said they are targeting the enrollment of another 20 percent of poor Filipinos by the end of 2013 and 100 percent of Filipinos within three years.
“Very soon, we will be able to enroll those who are not yet enrolled at point of care. This means, when they are in the hospital and they are found to be really poor, they don’t need difficulties, we will enroll them right away,†Ona added
