Effective immediately, the maximum benefit amounts for medical care services under the National Health Insurance Program (NHIP) are hereby increased to make the Program more responsive to the health care needs of its members. The new benefit schedule are as follows:

For Private Sector Members (including Overseas Filipino Workers) and their Dependents:

	Benefit Item	Primary Hospital	Secondary Hospital	Tertiary Hospital
ROOM & BOARD		120	220	345
DRUGS & MEDICINES
1. Ordinary Case		1,165	1,595	2,670
2. Intensive Case		2,430	3,280	7,660
3. Catastrophic Case		0	6,575	11,885
X-RAY, LAB. ETC.
1. Ordinary Case		305	760	1,625
2. Intensive Case		500	1,680	3,405
3. Catastrophic Case		0	3,405	9,810
DOCTOR'S FEES
1. Ordinary Case
	a. Gen. Practitioner	540	540	540
	b. Specialist	810	810	810
2. Intensive/Catastrophic
	a. Gen. Practitioner	810	810	810
	b. Specialist	1,350	1,350	1,350
OTHERS
1. Hospital (OR)
	a. RUV 5 & below	385	670	1,060
	b. RUV 5.1 to 10	--	1,140	1,350
	c. RUV above 10	--	2,160	3,490
2. Doctor
	a. Surgeon		Maximum of P15,390, RUV = 420
	b. Anaesthesiologist		Maximum of P4,785
SURGICAL FAMILY PLANNING
1. Vasectomy		900	660	660
2. Tubal Ligation		1,125	825	825
For Government Sector and Indigent Program Members and their Dependents
	Benefit Item	Primary Hospital	Secondary Hospital	Tertiary Hospital
ROOM & BOARD		90	170	255
DRUGS & MEDICINES
1. Ordinary Case		1,095	1,550	1,955
2. Intensive Case		2,050	2,650	5,610
3. Catastrophic Case		0	5,745	8,750
X-RAY, LAB. ETC.
1. Ordinary Case		230	590	1,295
2. Intensive Case		495	1,360	2,650
3. Catastrophic Case		0	2,550	8,520
DOCTOR'S FEES
1. Ordinary Case
	a. Gen. Practitioner	425	425	425
	b. Specialist	600	600	600
2. Intensive/Catastrophic
	a. Gen. Practitioner	600	600	600
	b. Specialist	990	990	990
OTHERS
1. Hospital (OR)
	a. RUV 5 & below	235	405	645
	b. RUV 5.1 to 10	----	885	1,050
	c. RUV above 10	----	2,020	2,710
2. Doctor
	a. Surgeon		Maximum of P10,620, RUV = 420
	b. Anaesthesiologist		Maximum of P3,185
SURGICAL FAMILY PLANNING
	1. Vasectomy	660	660	660
	2. Tubal Ligation	825	825	825

These increased benefits may be availed of by NHIP members in the government and private sectors, including their dependents, who were discharged from PhilHealth-accredited hospitals starting June 1.

All accredited health care providers are advised to use the new benefits schedules in granting Medicare benefits to qualified NHIP members.

Please be guided accordingly. Thank you.

Adopted: 10 May 1999

(SGD.) ENRIQUE M. ZALAMEA
President and CEO