PhilHealth offers more benefits

The Manila Times

PhilHealth offers more benefits   Deputy Majority Leader for Communications and ACT-CIS Partylist Rep. Erwin Tulfo meet with Philippine Health Insurance Corp. (PhilHealth) Executive Vice President Eli Dino Santos on May 28, 2024 to discuss a proposal to fund medicines needed by dialysis patients. Santos said that the proposal has yet to be approved by the PhilHealth's board but hopes that it could be implemented by June. PhilHealth has been offering free dialysis services to all diabetic patients. Tulfo also said that PhilHealth was studying the possibility of paying 10 percent of the total hospital bill of all patients.   Video by Red Mendoza  Subscribe to The Manila Times Channel - https://tmt.ph/YTSubscribe   Visit our website at https://www.manilatimes.net     Follow us:  Facebook - https://tmt.ph/facebook   Instagram - https://tmt.ph/instagram   Twitter - https://tmt.ph/twitter   DailyMotion - https://tmt.ph/dailymotion     Subscribe to our Digital Edition - https://tmt.ph/digital     Check out our Podcasts:  Spotify - https://tmt.ph/spotify   Apple Podcasts - https://tmt.ph/applepodcasts   Amazon Music - https://tmt.ph/amazonmusic   Deezer: https://tmt.ph/deezer  Tune In: https://tmt.ph/tunein  #themanilatimes  #philhealth #medical #tour

Transcript

00:00 With me right now is Mr. Eli Santos of the EBP and COO of PhilHealth.

00:06 We just had our meeting upon instruction of the speaker.

00:11 We asked PhilHealth about medicine for dialysis patients.

00:20 Well right now everybody knows that PhilHealth has already answered the entire year session of dialysis.

00:29 The problem that they encounter now is the vaccines, the shots.

00:35 After every session, they don't have shots.

00:39 So they go to congressmen, mayors, senators, asking for vaccines.

00:44 Little did we know, it's already included in the PhilHealth package of 2,600, right?

00:51 It's already included there.

00:52 But there are hospitals, there are facilities, dialysis centers that don't have medicine.

00:57 So what we're going to do now, we studied it, and PhilHealth is saying to give them one month.

01:03 It's per the instruction of the speaker.

01:05 That's why we brought this up.

01:07 There are people who approached the office of the speaker who have diabetes.

01:11 They have a problem with medicine.

01:13 They always approach congressmen, mayors, senators.

01:16 To solve this problem, what PhilHealth will do is to double the 2,600 package for dialysis.

01:25 PhilHealth will do 5,200 for all-in.

01:29 So that the diabetics won't have to cash out for dialysis.

01:34 They won't have to cash out.

01:35 This one, what PhilHealth will do, they will increase their package from 2,600 to 5,200, but all-in.

01:47 Even the injections.

01:49 So the people who are on dialysis won't have to pay out.

01:54 So what they will do is, PhilHealth will arrange the mechanics for the next 30 days.

02:00 They will look at how and what to do.

02:05 But they will be able to answer the medicines of PhilHealth.

02:10 Because that's the most important thing.

02:12 Every session, after every session, there will be an injection.

02:15 Now, there is another thing that PhilHealth is saying.

02:19 Because now, the deductions are so small.

02:23 What Speaker Romualdez wants is, maybe it's possible, maybe it's possible,

02:28 to do a total bill for a patient, whether it's private or government hospital,

02:33 to increase it by 10%, to give a 10% discount to all the members.

02:39 Hopefully by next month, no one will have to cash out for dialysis, especially those who are on 3 times a week.

02:47 Because now, they need to buy vials, in the boutique, they will bring it to the dialysis center for injections.

02:55 Now, PhilHealth will answer all of those, so that they won't have to spend anything,

03:00 even if they are on 3 times a week for dialysis.

03:03 So, I just want to add, what we also talked about last month,

03:08 May 15 started, the free mammogram, free ultrasound for everybody, is already in the consulta package.

03:17 If you want to get a mammogram or your beneficiary, just go to the website of PhilHealth,

03:25 and you will see where the hospitals are located.

03:27 We have private hospitals that are accepting the consulta package, free mammogram, free ultrasound.

03:35 Speaker Martin Rinaldes, and to the effort of our congressman Erwin Tulfo,

03:41 PhilHealth issued an improvement for enhancement of the consulta package.

03:47 And based on the instruction that we followed, now, under consulta, breast ultrasound and mammogram are covered.

03:56 And aside from that, we also increased the capitation per person.

04:01 So now, what PhilHealth is reimbursing through consulta is P1,700 per person.

04:07 So we increased that in the private sector from P750 to P1,700, and in public facilities from P500 to P1,700.

04:19 Because this is not, again, in the efforts of our congressman Erwin Tulfo.

04:25 Let me just add there, because there are packages now for mammogram, ultrasound, and diagnostics,

04:34 that are around P2,000 plus in the most popular hospitals here in NCR.

04:39 So in PhilHealth, P1,700, it covers just about everything.

04:44 In ordinary hospitals, in private, it's already covered. That's their price.

04:49 The P1,700 for mammogram, ultrasound, etc. is already covered by PhilHealth.

04:56 So this started with May 15?

04:59 We implemented this last May 15, 2024.

05:03 However, the coverage of my P1,700 capitation is January 1, 2024.

05:10 So our private hospitals, facilities, and government, will be able to avail this P1,700 starting January 1, 2024.

05:19 So what is covered or included in the whole package?

05:25 What are the dialysis, what is happening, what are the patients buying that are already covered by PhilHealth?

05:35 So all the medicines that are used in hemodialysis is covered by PhilHealth.

05:45 And at P2,600 per session.

05:49 So now, through the efforts of our Comm Erwin Tulfo, PhilHealth is studying on increasing this to P5,200.

06:01 We were given a one-month study period.

06:06 And then, we will cover everything.

06:08 Our goal, our directive from Comm Erwin Tulfo, our goal is that there are no out-of-pocket dialysis patients.

06:18 Sir, how many medicines are those? And then, what happens when they are being dialysed?

06:23 Because I know that they are just sitting and there are tubes.

06:26 But what really happens when someone undergoes dialysis?

06:30 And how many of those medicines are being given?

06:35 The specifics as to the medicines, I don't have the data now.

06:40 But usually, what they use, this erythrocoetine, what happens is they buy it outside the facility.

06:48 This is usually what is added to the expense of the patients.

06:52 Actually, this is covered by PhilHealth.

06:56 But on the side of PhilHealth, what we will do is to remind all facilities that provide hemodialysis that this should be covered and there are no out-of-pocket patients.

07:08 So, the private dialysis center hospital will procure those medicines for the patients?

07:16 Exactly. So that the patients will not buy it.

07:18 Because right now, that is the problem. They are coming to the congressman, to the mayor, to the governor to buy medicines.

07:26 And then, the other thing that they are studying now, it is a bit difficult, the 10% that will be deducted from the discount of your bill.

07:36 So, what we see is that you should present it immediately that you will use PhilHealth when you are accepted.

07:43 Then, the 10% that you will deduct from your hospital bill will be reduced.

07:48 Sir, just for clarification, how many sessions of dialysis are there in the whole summer?

07:56 How many sessions?

07:57 156.

07:58 156 sessions over the whole year.

08:02 That's three times a week, right? That's three times a week, close? 156.

08:06 Because we have a lot of people who do it three times a week.

08:10 In the PhilHealth fund, you don't need to raise premiums?

08:17 For the record, Sir Eli, how much is in PhilHealth's pocket right now?

08:24 The current assets of PhilHealth right now, just to assure the Filipinos that PhilHealth has enough contents.

08:31 During the past hearing, P173 billion pesos came out from the excess funds from the contributions of PhilHealth, aside from the government subsidy.

08:48 And you, as a champion, low to middle class people, even last year during the budget deliberations, the PhilHealth fund was in a huge amount.

09:01 Just suspend the collection of PhilHealth premiums and even the W&W.

09:10 How is it, Sir, when you talk about PhilHealth and Sir Eli?

09:18 Initially, during our first meeting, we talked about PhilHealth, don't reduce or stop the contributions.

09:26 But that's why they're able to do it right now.

09:30 The mammogram is free, the ultrasound is free.

09:34 Now, even when you double the hemodialysis.

09:38 But don't reduce it.

09:41 Before, we talked to Congressman Quimbo and the Speaker of the Office of the Speaker.

09:47 What PhilHealth is saying is, even if it's DOH, don't reduce or stop the contributions.

09:55 Continuously. But there's no increase.

09:57 But there are more benefits.

09:59 That's why we're saying, the dialysis, double, 10% discount on hospital bills, PhilHealth will answer.

10:10 Because they have funds. We know that.

10:13 They declared it to us.

10:15 Go ahead, Sir.

10:17 How much do you have that they asked you?

10:19 I made from the total assets of PhilHealth as of 2023 is P589.5 billion.

10:27 So, PhilHealth's fund is P1.3 billion, including the reserve funds, right?

10:34 The P463 is part of the P589.

10:40 The Philippines earlier, they have a debt to PhilHealth.

10:45 So, they're on process, they're paying the debts.

10:48 There are others, there are COVIDs.

10:50 So, it's a big amount, but it's not that big.

10:54 That's why what Stella is saying, it's better if they don't contribute or reduce.

11:01 Maybe they can contribute continuously, but we'll make a way to use your PhilHealth card more.

11:08 You'll get more benefits than the former administration, it's just limited.

11:14 And now, there's a universal healthcare loan, you should really use it as long as you have that PhilHealth.

11:21 Because we're 5% now, you can't reduce it.

11:26 You're already studying it, you're already studying to decrease the collection.

11:33 Until what?

11:35 The possibility of what level can be decreased is, I don't have data now, what's our projection here.

11:46 But definitely on the side of increasing the benefits, I already have a program, I'm directing it to your director.

11:53 Maybe on the decrease, the committee will talk about it.

11:57 Because they'll also be the resource persons there.

12:00 They'll talk about it.

12:01 But definitely, who doesn't want to reduce the contribution?

12:07 All of us, I'm contributing there.

12:09 It's better if it's smaller.

12:11 Especially for our poor people, because they can use that money somewhere else, the deduction or reduction.

12:20 But if our future in UHC is, there should be no more copayment, at least no more copay.

12:26 So are we hopeful that in the future, copayment will be gone?

12:32 Definitely, we need to study it well, the PhilHealth in the near future.

12:38 Maybe the government will subsidize, there will be no more contribution.

12:42 Because it's better if there's no more reduction, especially for our brothers and sisters who have a small salary,

12:47 then a minimum or below minimum, it's better.

12:50 Maybe we'll study it.

12:51 When the session opens, I will talk to the committee on health.

12:54 If they'll look at it, if you're minimum or below minimum, don't pay anymore, right?

12:58 Don't pay for now, so you can save.

13:01 Now, if you're a bit above minimum wage, we'll look at it.

13:04 But with discount, maybe it's reduced.

13:08 Sir Eli, just a clarification.

13:10 The payment for COVID, the program you had before COVID, how much debt do you have?

13:18 I heard that you're paying 99%, but how many billions are left in hospitals that you haven't paid due to COVID?

13:28 I do not have the data right now as to the status of the COVID case.

13:35 And we'll provide the office of COVID.

13:39 All right, thank you.

13:41 Okay.

13:42 Thank you.

13:43 Thank you.

13:44 Thank you.

13:46 Thank you.

13:48 Thank you.

13:49 [BLANK_AUDIO]

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