Philhealth eases rules for benefit claims for lepto cases

After noting a surge in leptospirosis cases, government health insurance authorities have eased rules for those suffering from the disease, especially those in cyclone-hit areas. Philippine Health Insurance Corp. (PhilHealth) head Rey Aquino said Monday that PhilHealth members may avail of coverage, including allowances for hospital confinement. “Members who might be admitted in Level 3 and 4 hospitals may avail themselves of allowances for hospital room and board fees of up to P800 per day and allowances for drugs and medicines of up to P28,000 per single period of confinement," Aquino said in an advisory placed as an ad on the Philippine Daily Inquirer newspaper. Aquino said members may also avail of as much as P21,000 for supplies, X-ray and other laboratory exams that may be administered during the entire period of confinement. Members may avail of allowances of the professional fees of nephrologists and about P1,200 per session for the use of the hemodialysis room, he said. [See related story: State hospitals required to accept leptospirosis patients] But Aquino stressed this will be subject to medical evaluation and policies on claims payment. Contributions He advised employed and individually paying members to have at least three months’ premium contributions within a six-month period prior to the month of availment. Sponsored and overseas worker members may avail of special package within validity of PhilHealth coverage as reflected in PhilHealth cards and enhanced member data records. “They must have a copy of their member data records attached to their claim documents," he said. PhilHealth has made benefits availment easier by temporarily doing away with a requirement for affidavit of loss, Aquino said. PhilHealth usually requires such an affidavit from members requesting replacement of member data records of number cards. Aquino also said that from January to June 2009, PhilHealth paid P2.3 million in benefits for confinement of members due to leptospirosis. This represented the payment for about 324 claims with each claim worth P7,377, he said. Last Friday, the Department of Health (DOH) said that Leptospirosis has afflicted more people in Metro Manila and Rizal province in the last two weeks. In a press conference Friday morning, DOH Secretary Francisco Duque III attributed the spike to large numbers of people wading in floodwaters teeming with bacteria that causes the disease. Leptosis in north Luzon Secretary Duque has noted that leptospirosis cases have been reported in Pangasinan province and in Cordillera, especially in areas hit by typhoon “Pepeng" (Parma). In a radio interview Monday, Duque said that as of Sunday, there were over “1,600" cases in Metro Manila alone. “Ang fatalities 10 percent, siguro mga 160 (If we place death rate at 10 percent, we may have some 160 fatalities due to leptospirosis)," he said in an interview on dwIZ radio. Duque said that the government will tap 20 private hospitals for leptospirosis treatment, if state hospitals tasked to treat the disease for free can no longer cope with the number of patients. “Ipadadala natin sa 20 pribadong hospital na nagbibigay ng serbisyo sa leptospirosis cases ang ibang pasyente (If government hospitals cannot cope, we will send patients to 20 private hospitals)," he said in an interview on dwIZ radio. He did not name the private hospitals, but indicated 12 of them are in Metro Manila. Also, Duque said the government will channel to the Amang Rodriguez Medical Center in Marikina City part of the proceeds of a flash appeal by the United Nations for help for victims of tropical cyclones “Ondoy" (Ketsana) and Pepeng. “Isa ito sa tatabggap ng tulong (It will be one of the facilities to benefit from the flash appeal for help)," he said. He also said the DOH will send added personnel from other regions to the hospital to boost its manpower complement. The hospital earlier complained its personnel may get sick because of fatigue, as they attend to a big number of leptospirosis and other cases. - GMANews.TV