What to do if COVID-19 hospital bill exceeds PhilHealth’s rate package

The Philippine Health Insurance Corporation (PhilHealth) will first assess if patients have the capacity to pay if they exceed the rate package for the treatment of the coronavirus disease 2019 (COVID-19), its president Ricardo Morales said Wednesday.

This comes after the state insurer began limiting the assistance for COVID-19 patients starting Wednesday, April 15, after it previously said it will shoulder the full cost of treatment for the respiratory illness.

Starting Wednesday, the cost rates that will be implemented for the treatment of COVID-19 patients will be P43,997 for those with mild pneumonia; P143,000 for moderate pneumonia; P333,000 for severe pneumonia; and P786,000 for critical pneumonia.

According to Morales, if the patient does not have the capacity to pay the hospital bill, he/she does not have to pay anything but will have to request for additional funding from PhilHealth.

However, if the patient has the capacity to pay, he/she will have to work on an arrangement with PhilHealth regarding his/her hospital bill.

“The patient still does not have to pay anything but he has to request for additional funding,” Morales said in Ivan Mayrina’s report on “24 Oras.”

“If they have the capacity to pay then we will work on something. Mayroon naman kasing mga pasyente na kaya nilang magbayad so it has to be a case-to-case basis,” he added.

This way, Morales said PhilHealth will be able to make use of its funding longer for future situations.

He said the previous P30 billion budget given by the government is not enough due to the rising cases of COVID-19 in the country.

To implement universal health coverage in the country, PhilHealth asked for an additional P153 billion funding but was only given P71 billion.

However, he added an additional P30 billion is still in place to cater all Filipinos affected by the illness.

Meanwhile, according to Malacañang, in case the budget is still inadequate, patients can approach agencies that give out assistance such as the Philippine Charity Sweepstakes Office and the Department of Social Welfare and Development.

“Starting tomorrow, case rates will already apply. So if this will not be enough to cover expenses, the patient can go to the Malasakit Center which has the DSWD, PCSO, who can help with the balance of the bill. For hospitals without Malasakit Centers, they can opt to go to the PCSO,” presidential spokesperson Harry Roque said.

A total of 5,453 cases have so far been reported in the Philippines, including 353 recoveries and 348 deaths. —Ma. Angelica Garcia/LDF, GMA News