PhilHealth offers benefit for ‘case type Z’ illnesses
THE Philippine Health Insurance Corporation (PhilHealth) Regional Office based in Dagupan announced it is now offering a special healthcare package that covers case type Z illnesses.
Case type Z is any illness as primary condition that is life- or limb-threatening and requires prolonged hospitalization, expensive therapy or other treatments that are usually not covered in basic healthcare insurance.
Dr. Maricar Arzadon, PhilHealth division chief on health care delivery management, said the new benefit package improves financial risk protection of all members and their qualified dependents.
Covered are acute lymphocytic leukemia, breast cancer, prostate cancer and kidney transplant.
Regional Director Myrna Cabotaje of the Center for Health Development explained that these diseases are known to require expensive treatment but have good survival rates.
The benefit package will be provided by contracted private and government hospitals.
In Region I, PhilHealth designated the Ilocos Training and Regional Medical Center in La Union and the Mariano Marcos Memorial Hospital and Medical Center in Ilocos Norte.
If a member chooses to be treated in a non-contracted hospital, the PhilHealth benefit to be extended will be limited.
The package covers room and board, drugs and medicines, laboratory, operating room and professional fees and mandatory services for the entire course of treatment.
Other services, procedures, medicines and other necessities not included in the mandatory services but are deemed necessary shall also be covered by the package.
The No Balance Billing (NBB) Policy will be applied to all PhilHealth Sponsored Program members for the specified cases, meaning no other fees or expenses shall be charged or paid for by the patient-member above and beyond the package rates.
On the other hand, non-sponsored members shall be charged fixed co-pay. This means that a negotiated fixed amount will be shouldered by the member on top of the case type Z but not to exceed the benefit payment being paid for by PhilHealth. (PIA-Pangasinan/AMM)
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