PHIC Philhealth Circular No. 77-A (2000)

(NAR) VOL. 14 NOS. 3-4 / OCTOBER - DECEMBER 2003

[ 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 SECONDARYTERTIARY ROOM AND BOARD 120 220 345 not 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 2,670 Intensive 2,430 3,280 7,660 Catastrophic 0 6,575 11,885 X-RAY, LAB, ETC. (per single period of confinement) Ordinary 305 760 1,625 Intensive 590 1,680 3,405 Catastrophic 0 3,405 9,810 PROFESSIONAL FEES P105/day for General (per single period of Practitionerconfinement shall not P150/day for Specialist exceed:) Ordinary General Practitioner 540 540 540 Specialist 810 810 810 Intensive/Catastrophic General Practitioner 810 810 810 Specialist 1,350 1,350 1,350 OTHERS Hospital (OR) a. RUV 5 & Below 385 670 1,060 b. RUV 1.5 to 10 0 1,140 1,350 c. RUV Above 10 0 2,160 3,490 Maximum of 15,390 @ 420/Relative Unit SURGEON Value Maximum of 4,785 @ 420/Relative Unit ANESTHESIOLOGIST Value Outpatient Benefits Chemotherapy Radiotherapy Hemodialysis Cataract extraction Minor surgical procedure SURGICAL FAMILY PLANNING PROCEDURE Vasectomy 900 900 900 Tubal Ligation 1,125 1,125 1,125 Benepisyong Medicare Para sa Lahat Adopted: 31 Jan. 2000

(SGD.) ENRIQUE M. ZALAMEA President and CEO