[ PHIC PHILHEALTH CIRCULAR NO. 77-a, s. 2000, January 31, 2000 ]
NEW BENEFIT SCHEDULE FOR INDIGENT MEMBERS
Please be informed that in view of the recent equalization of medical care benefits for government and private sector employees and their dependents, the benefit schedule for indigent sector members has also been upgraded to the same level to ensure that all members of the National Health Insurance Program (NHIP) enjoy one Medicare benefit package. Following is the latest schedule of benefits for ALL members:
UNIFIED BENEFIT SCHEDULE
For Government Indigent and Private Sector Members,
including OWWA and Individually Paying Members and their Dependents BENEFIT ITEMS PRIMARY SECONDARY TERTIARYROOM AND BOARD 120 220 345not exceeding 45 days for each
member & another 45 days to
be shared by his dependents)
DRUGS & MEDICINES
(per single period of confinement)
Ordinary 1,165 1,595 2,670Intensive 2,430 3,280 7,660Catastrophic 0 6,575 11,885
X-RAY, LAB, ETC.
(per single period of confinement)
Ordinary 305 760 1,625Intensive 590 1,680 3,405Catastrophic 0 3,405 9,810
PROFESSIONAL FEES
(per single period of confinement shall not exceed:) P105/day for General Practitioner
P150/day for Specialist
Ordinary
General Practitioner 540 540 540Specialist 810 810 810Intensive/Catastrophic
General Practitioner 810 810 810Specialist 1,350 1,350 1,350
OTHERS
Hospital (OR)
a. RUV 5 & Below 385 670 1,060b. RUV 1.5 to 10 0 1,140 1,350c. RUV Above 10 0 2,160 3,490SURGEON Maximum of 15,390 @ 420/Relative Unit Value ANESTHESIOLOGIST Maximum of 4,785 @ 420/Relative Unit Value Outpatient Benefits Chemotherapy Radiotherapy HemodialysisCataract extraction Minor surgical procedure SURGICAL FAMILY PLANNING PROCEDURE Vasectomy 900 900 900 Tubal Ligation 1,125 1,125 1,125 Benepisyong Medicare Para sa LahatAdopted: 31 Jan. 2000
(SGD.) ENRIQUE M. ZALAMEA
President and CEO