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(NAR) VOL. 13 NOS. 1-2 / JANUARY-JUNE 2002

[ OWWA MEMORANDUM OF INSTRUCTION NO. 005 SERIES OF 2002, MARCH 11, 2002, March 11, 2002 ]

IMPLEMENTATION OF THE NEW BENEFIT CAPS ON MEDICAL EXPENSES IN ACCORDANCE WITH PHILHEALTH CIRCULAR NO. 35 S. 2001, DATED DECEMBER 18, 2001



In the interest of the service and pursuant to PHIC Circular No. 35, S. 2001, the following new rates of benefits ceiling shall apply to members and their dependents discharged from any of Philhealth's accredited hospitals nationwide from January 1, 2002 onwards.

In the case of confinements for catastrophic illnesses, however, the benefit caps under OWWA Memorandum of Instruction No. 007, Series of 2000, providing 200% increase, shall continue to be adopted.

Benefit Item

Hospital Category

 

Primary

Secondary

Tertiary

a.         Drugs and Medicines (per single period of confinement/availment)

Ordinary Case

P1,500

P1,700

P3,000

Intensive Case

P2,500

P4,000

P9,000

Catastrophic Case

(OWWA Rate)

 

b.         X-Ray, Laboratory, etc. (per single period of confinement/availment)

Ordinary Case

P350

P850

P1,700

Intensive Case

P700

P2,000

P4,000

Catastrophic Case

(OWWA Rate)

 

c.         Professional Fees (per single period of confinement/availment) P150/day for General Practitioners and P250/day for Specialists

Ordinary:

Gen. Practitioner

P600

P600

P600

 

Specialist

P1,000

P1,000

P1,000

Intensive:

Gen. Practitioner

P900

P900

P900

 

Specialist

P1,500

P1,500

P1,500

Catastrophic:

Gen. Practitioner:

(OWWA Rate)

 

 

Specialist:

(OWWA Rate)

 

This MOI supersedes the benefit caps for ordinary and intensive cases under MOI No. 007, Series of 1999.

For immediate compliance.

Adopted: 11 March 2002

(SGD.) WILHELM D. SORIANO
Administrator

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