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PhilHealth offers improved rates for COVID-19 patients

The cost of treatment of patients affected by the coronavirus disease 2019 (COVID-19) in the country would be covered by benefit packages from the Philippine Health Insurance Corporation (PhilHealth) with better rates.

According to President Rodrigo Duterte's second report to Congress, the state health insurer's Benefit Packages for the Spectrum of Care for COVID-19 will cover treatments during the period of February 1 to April 14, 2020.

The following are the proposed rates indicated in the report:

COVID-19 testing: 

  • P8,150 (all components covered by the package)                                             
  • P5,450 (if the kits are donated)
  • P2,170 (PRC testing unbundled) 

Community Isolation - P22, 449 (with LGU overhead)

Mild pneumonia (elderly) - P43,997

Moderate pneumonia - P143,267

Severe pneumonia - P333,519

Critical pneumonia - P786,384

"The coverage of the benefit packages both for pneumonia associated with COVID-19 and community isolation shall be reviewed within 30 days from the date of implementation in order to adjust the rates," Duterte's report read.

COVID-19 tests that were conducted in non-hospital facilities such as laboratories and drive-thrus shall also be paid by PhilHealth, provided that the facilities are accredited by the Research Institute for Tropical Medicine.

The Philippine Charity Sweepstakes Office (PCSO) will transfer P420.585 million to PhilHealth to fund the said packages, as directed by the inter-agency body handling the health emergency.

In previous reports in March, the package rates for COVID-19 patients were lower. For example, the package for moderate pneumonia amounts to only P15,000 while those suffering from severe pneumonia may claim P32,000.

PhilHealth president and CEO Ricardo Morales has earlier said it will continue to provide financial coverage to COVID-19 cases after April 14 through a "recomputed case rate."

“The reason for this accommodation window is due to the novelty and the wide range of severity of the disease in the country for which no existing case rate or package based on accepted protocols has yet been established,” Morales said.

“PhilHealth is confident that by the above mentioned date, more about the behavior of the disease in the Philippines can be learned, a final protocol established, and an appropriate case rate can be developed that will provide adequacy and sustainability to the anti-COVID-19 campaign.” --KBK, GMA News