PhilHealth MOVES
in San Carlos
The Philippine Health
Insurance Corporation (PhilHealth) is "very robust" said Atty.
Alexander Padilla, PhilHealth Executive Vice-President and Chief Operating
Officer.
Padilla with Dr. Alex Ayco- PhilHealth Board Member, and Dr.
Dennis Mas- Regional Vice-President PhilHealth VI was in San Carlos City for
the Mobile Orientation Validation and Enrollment Scheme (MOVES) on October 26
to 27 at the City Auditorium.
PhilHealth MOVES attracted hundreds of members from all over
the First District. Sponsored members from different barangays in San Carlos received
and validated their Philhealth cards.
Although PhilHealth now has higher benefit payment compared to
collection, MOVES was launched this year to recruit more members, orient them
on benefit packages and proper procedures in availing them, and to correct
errors in member date records.
Sponsored Members
Padilla explained that sponsored members are those who can
avail of PhilHealth benefits without having to pay the monthly contribution
because either the national or the local government pays for them. These members were chiefly identified
through the National Household Targeting System of the Department of Social
Welfare and Development. Local chief
executives and district representatives are also allowed to identify their own
sponsored members. The only common factor is that a sponsored member should
belong to the "poorest of the poor."
The only difference between voluntary and employed members and
those who are sponsored by the goverment is the zero balance billing policy.
This means that if a sponsored member is confined in a ward of a government
hospital, he or she need not pay any amount. Padilla
estimates that around 10 M indigent Filipino families are now covered by
Philhealth through this type of membership which is automatically renewed every
year through government funds.
Catastrophic Benefits
During the orientation, PhilHealth also informed that it now
has a new package called Catastrophic Benefits with fixed amounts of assistance
for members or dependents with cancer. Child-dependent
with acute lymphocytic leukemia can avail of up to P 210,000 worth of benefits;
women-members/dependents with breast cancer (stage 0 to 3) have P 100,000;
prostate cancer patients may avail of up to P 100,000.
Members/dependents in need of kidney transplant can avail of a
P 600,000 worth of benefit with out-patient services for dialysis.
Sponsored members may also avail of PhilHealth's Primary Health
Care Benefits Package which includes consultation, nebulization, pre-natal care
among others at accredited Rural Health Centers for free.
Not true
Padilla also debunked the accusations that PhilHealth is
failing to pay hospitals and doctors.
"Wala kaming pending back-logs [of payments],"
the COO categorically stated.
He explained that PhilHealth has 60 days to settle accounts in
a private hospital however, when payments do not arrive on time it means that
the documents submitted by the hospital or health facility are insufficient.
Accredited PhilHealth doctors, he added, are surely paid once
the proper documents are submitted.
With 27 M principal members, Philhealth has P 107 B worth of
reserves which can support the social health insurance company for two years.
The national government is to subsidize it should the company’s
funds prove insufficient for benefit payments to its members, Padilla assured.
PhilHealth for kids
Next year, PhilHealth’s major goal is to cover all Filipino
children below six years old, regardless of their parent’s non-membership.
The scheme is seen
to have long term effects on the population’s health and seeks to cover all
diseases in kids who will be confined in any hospital within the country.
No comments:
Post a Comment