PhilHealth to em­ploy­ers: Pre­mium ad­just­ment is nec­es­sary

Sun.Star Pampanga - - HEALTH! -

In re­sponse to pub­lic re­ac­tions on the ad­just­ment in pre­mium con­tri­bu­tion rates start­ing this month, the Philip­pine Health In­sur­ance Cor­po­ra­tion (PhilHealth) re­it­er­ated that the lat­est ad­just­ment af­fects only the mem­bers in the For­mal Sec­tor, and that the ad­just­ment in pre­mium rate is long over­due.

“The ad­just­ment will en­able the cor­po­ra­tion to strengthen its cur­rent fi­nan­cial po­si­tion so that it can boost the so­cial health in­sur­ance ben­e­fit pack­ages and front­line ser­vices that are cur­rently ac­corded to the coun­try’s work­force and their qual­i­fied de­pen­dents,” sai d PhilHealth In­terim/ OIC Pres­i­dent and CEO Dr. Ce­lestina Ma. Jude de la Serna.

Pri­mar­ily, de la Serna said that the pre­mium rate ad­just­ment is needed to en­able PhilHealth to con­tinue pro­vid­ing ben­e­fit pack­ages that re­spond to what its mem­bers need. For the last three (3) years, PhilHealth has in­tro­duced ben­e­fit pack­ages with­out rais­ing the pre­mium con­tri­bu­tion rate.

Ver y soon, PhilHealth is ex­tend­ing the avail­abil­ity of the Pri­mary Care Ben­e­fit (PCB) 1 Pack­age to em­ployed mem­bers. The pack­age in­cludes pri­mary care con­sul­ta­tions, risk pro­fil­ing for hyper­ten­sion and di­a­betes, pe­ri­od­i­cal breast ex­am­i­na­tion, among oth­ers.

This pack­age was ear­lier pi­lot-tested among teach­ing and non-teach­ing per­son­nel of the Depart­ment of Ed­u­ca­tion, thus, its roll-out to the rest of the For­mal Sec­tor is wel­come news.

Among the lat­est pack­ages were the med­i­cal detox­i­fi­ca­tion pack­age worth P10,000, Z ben­e­fit pack­age for small and pre-term ba­bies worth as much as P135,000, the up­grad­ing of cov­er­age for Acute Lym­pho­cytic Leukemia from P210,000 to P500,000, among other s.

Also up for im­ple­men­ta­tion soon are four (4) Z ben­e­fit pack­ages for chil­dren with dis­abil­i­ties, cov­er­ing hear­ing im­pair­ment, vis­ual im­pair­ment, mo­bil­ity and de­vel­op­men­tal dis­abil­i­ties.

While stud­ies are be­ing con­ducted to de­ter­mine the ap­pro­pri­ate amount of cov­er­age for hear­ing and vis­ual im­pair­ment, chil­dren with de­vel­op­men­tal dis­abil­i­ties are en­ti­tled to PhilHealth ben­e­fits rang­ing from P3,626 to P5,276; and claims for mo­bil­ity im­pair­ment starts at P13,110.

De la Serna added that the ad­just­ment is timely as PhilHealth puts into ef­fect pro­grams that im­proved its ser­vice stan­dards. For in­stance, the All Case Rates provider pay­ment mech­a­nism em­pow­ered mem­bers to im­me­di­ately know how much PhilHealth pays for each and ev­ery com­pens­able med­i­cal con­di­tion or sur­gi­cal pro­ce­dure.

The list of med­i­cal con­di­tions and the cor­re­spond­ing fixed, pre-de­ter­mined amount can now be viewed through a mo­bile ap­pli­ca­tion or through the PhilHealth web­site. (PhilHealth)

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