PhilHealth Universal Health Care Logo Design Contest now open

Please visit this link http://www.philhealth.gov.ph/media/news/2011/contest.htm to know more about the logo design contest.

New Premium Contributions to PhilHealth

In support for the attainment of the Universal Health Care (UHC), Millennium Development Goals (MDGs) health targets by 2015 and to implement enhancements in the NHIP (National Health Insurance Program) benefit packages, PhilHealth Board Resolution No. 1571, series of 2011, approved the increases in the annual premium contribution effective CY 2012.  The new rates are as follows:

Membership Category	Premium	Effectivity
SPONSORED (NHTS-identified poor and LGU sponsored)	P2,400.00	January 1, 2012
INDIVIDUALLY PAYING MEMBERS (including OFWs)	P2,400.00	July 1, 2012
EMPLOYED SECTOR (private and government)	3%	January 1, 2013

Members particularly under the Individually-Paying Program are encouraged to pay their premium before the effectivity of the new premium rates to avail of the old rate (P1,200/annual) until June 30, 2012.  For more information regarding this update, please refer to PhilHealth Circular No. 022, series of 2011 that can be viewed at our website (www.philhealth.gov.ph).

Dr. Eduardo P. Banzon, MSc assumes New PhilHealth President post

We are pleased to announce that effective October 17, 2011, DR. EDUARDO P. BANZON, MSc, assumed his post as the new PhilHealth President and Chief Executive Officer.  The turn-over ceremony headed by the PhilHealth Chairman of the Board and Secretary of Health, Dr. Enrique T. Ona was held during the flag raising ceremony at the PhilHealth Central Office in Pasig City.

New PhilHealth Card Now Available!

Starting September 28, 2011, all interested PhilHealth members and non-members can avail of themselves the New PhilHealth Card at all SM Branches nation-wide.  With this new card, members do not need to be hospitalized in order to avail of incentives and benefits because this card is jam-packed with incentives like discounts from selected commercial establishments.

Availing the card is so easy.  For new applicant, he is required only to fill-out the PMRF (PhilHealth Member Registration Form), attach supporting document like birth certificate or any valid ID and pay a minimal fee.  For declaring qualified dependents, the documentary requirements should also be submitted.

The members will be notified within a month if the card is already available for pick-up.

Always remember, “Basta Kalusugan ng Pamilya, i-PhilHealth mo na!”

PhilHealth adopts New Case Rates and No Balance Billing

 

Effective September 1, 2011, the Philippine Health Insurance Corporation (PhilHealth) will be adopting the case rate method to pay for selected medical and surgical cases.  Various considerations include: (1) developments are taking place in the health care industry, most notable of which is the need to provide optimal financial risk protection especially to the most vulnerable groups, including the poorest of the poor; (2) to empower PhilHealth members more by letting them know how much they can now avail themselves of for certain medical conditions and surgical procedures; (3) the case rate method means faster processing of claims and therefore faster reimbursement for the services the health care providers have provided to members.

These medical conditions that will be paid for using the case rate method are as follows:

MEDICAL CASES (11)		SURGICAL CASES (12)
Dengue I	P  8,000.00	Radiotherapy	P 3,000.00
Dengue II	P16,000.00	Hemodialysis	P 4,000.00
Pneumonia I	P15,000.00	Maternity Care Package	P 8,000.00
Pneumonia II	P32,000.00	Normal Spontaneous Delivery Package in Level 1 hospitals Normal Spontaneous Delivery Package in Levels 2 to 4 hospitals	P 8,000.00 P 6,500.00
Essential Hypertension	P  9,000.00	Caesarean Section	P19,000.00
Cerebral Infarction	P28,000.00	Appendectomy	P24,000.00
Cerebro-vascular accident with hemorrhage	P38,000.00	Cholecystectomy	P31,000.00
Acute gastroenteritis	P  6,000.00	Dilatation & Curretage	P11,000.00
Asthma	P  9,000.00	Thyroidectomy	P31,000.00
Typhoid Fever	P14,000.00	Herniorraphy	P21,000.00
Newborn care package in hospitals and lying-in clinics	P  1,750.00	Mastectomy	P22,000.00
		Hysterectomy	P30,000.00
		Cataract Surgery	P16,000.00

These new rates are applicable for all types of members, and these include those who are employed in the private and government sectors, the lifetime members, the overseas workers, the individually paying members and the sponsored program members.  They can avail these case rates in PhilHealth-accredited health care facilities nationwide.

However, for Sponsored Program members, those whose enrolment in PhilHealth are paid for by the National Government, by the Local Government Units or by private individual and corporate sponsors, they are entitled to the “No Balance Billing” (NBB) policy when they avail themselves of any of these case rates in accredited government hospitals. 

NBB simply means that no other fees or expenses shall be charged or paid for by the patient-member above and beyond the packaged rates.  The NBB policy also applies when the Sponsored Program members avail themselves of outpatient surgeries, hemodialysis and radiotherapy in accredited non-hospital facilities that included free-standing dialysis centers (FSDCs) and ambulatory surgical clinics (ASCs).  It also applies when they are availing themselves of the existing outpatient packages for TB-DOTS, Malaria and HIV/AIDS.

At the same time, all other member-types are entitled to the NBB policy when availing themselves of the Maternity Care Packages (MCP) and the Newborn Care Package (NCP) in accredited MCP (non-hospital) providers.

PhilHealth will continue to move towards options that will redound to better benefits for all members and plans to include more approaches to benefit payments and constantly improve on benefit delivery ratio to continuously strengthen the mark in the lives of Filipinos especially where their health care is concerned.

                                               

PhRO1 Conducts Orientation on KaSAPI and e-Group System

An orientation was conducted by the PhilHealth Regional KaSAPI Action Team (RKAT) on the Kalusugang Abot-Kaya at Sigurado sa PhilHealth Insurance (KaSAPI) Program and the Electronic Group Enrollment and Management System (e-Group) on July 28, 2011 in Vigan City, Ilocos Sur.  KaSAPI program was launched to provide access to quality health care services to wider membership base in the Informal Sector, sustain their membership and implement an alternative payment scheme through PhilHealth’s partnership with organized group like TSPI.  The Electronic Group Enrollment and Management System (eGroup) is an online application developed to be used by the Organized Groups (OGs) in facilitating the enrollment of their members under the KaSAPI Program and let the OGs manage their own data.

Said orientation was attended by the managers and account officers of TSPI Development Corporation branches in Ilocos Sur Area II. During the orientation, the manager of TSPI Ilocos Sur Area II committed a minimum of 220 members for enrolment to the KaSAPI program for the third quarter of 2011 which is really a good news not only to PhilHealth but also for the members and their dependents as well.

Furthermore, TSPI representative from their main office presented the proposed schedule for orientation of their remaining 35 branches for KaSAPI e-Group system as follows:

Area	Branches	Target Date
Ilocos Norte	Batac, Dingras, Laoag City	August 16, 2011
Ilocos Sur 1	Balaoan, Bangar, Candon, Sta. Cruz	August 18, 2011
Pangasinan 5	Rosales, Tayug, Umingan, Urdaneta City	August 23, 2011
Pangasinan 2,3 and 4	Pangasinan 2 – Bugallon, Dagupan City, Lingayen, Mangatarem Pangasinan 3- Bayambang, Malasiqui, Mangaldan, San Carlos City Pangasinan 4 – Calasiao, Manaoag, Pozorrubio, San Fabian	August 25, 2011
Pangasinan 1	Alaminos City, Bolinao, Dasol, Sta. Cruz	August 26, 2011
La Union 1 and 2	La Union 1 – Agoo, Baguio, Rosario, Tubao La Union 2 – Bacnotan, Bauang, Naguilian, San Fernando City	September 5, 2011

PhRO 1 successfully conducts PhilHealth Sabado II

PhilHealth Regional Office 1 (PhRO 1) has successfully conducted the second part of Nationwide PhilHealth Registration Day dubbed as “PhilHealth Sabado Part II” throughout Region 1 last June 25, 2011.  The event was held in seven (7) sites specifically at the following : 

Province	Municipality/City	Specific Venue
Ilocos Norte	Bacarra	Bacarra National Comprehensive High School
Ilocos Sur	Magsingal	Magsingal National High School
La Union	Aringay	Aringay Central Elementary School
Pangasinan	Dagupan City	Dagupan City Astrodome
	San Carlos City	Speaker Eugenio Perez Nat’l Agric’l School (SEPNAS)
	Urdaneta City	Urdaneta Cultural Center
	Lingayen	Lingayen Central  1 Elementary School

During the event, 1,279 filipinos were enrolled as new members, collected premium contributions of about P96,800 and distributed 16,668 Family Health Cards (FHCs) to the identified National Household Targeting System for Poverty Reduction (NHTS-PR) list of recipients.  Also, more than 10,000 clients were informed and educated regarding their benefits, rights and responsibilities during the information and education campaign (IEC) despite the foul weather.

The Nationwide PhilHealth Registration Day dubbed as “PhilHealth Sabado, Magseguro, Magparehistro,” is a continuing advocacy program to attain universal coverage, to increase awareness and knowledge of every Filipino on the importance of becoming a PhilHealth member that will ensure access to an affordable and accessible quality health care.