(NAR) VOL.8 NO. 1 / JANUARY-MARCH 1997

[ POEA MEMORANDUM CIRCULAR NO. 04, S. 1997, February 04, 1997 ]

INCREASE IN NATIONAL HEALTH INSURANCE (NHI) BENEFITS OF OVERSEAS FILIPINO WORKERS (OFWs) AND DEPENDENTS



Pursuant to Philippine Health Insurance Corporation (PHIC) Circular No. 9, Series of 1996, advising the concerned offices to disseminate information regarding the new NHI benefits of OFWs and their legal dependents, the following benefits and corresponding increased rates are hereby issued for the guidance of all concerned:
Particular Benefit
I. Room and Board not exceeding 45 days for each member and another 45 days to be shared by his dependents
From
To
1. Primary Care Hospitals
P55/day
P85/day
2. Secondary Care Hospitals
100/day
150/day
3. Tertiary Care Hospitals
145/day
220/day
II. Medical Expense benefit per single period confinement


1.For ordinary cases
a. Drugs and Medicines


Primary
595
895
Secondary
790
1,185
Tertiary
1,015
1,525
b. X-ray/Lab/Others

Primary
150
225
Secondary
360
540
Tertiary
635
955
2. Intensive Cases

a. Drugs and Medicines
Primary
1,350
2,025
Secondary
1,620

2,430
Tertiary
2,915
4,375
b. X-ray/Lab/Others
Primary
325
490
Secondary
630

1,245
Tertiary
1,280

1,890
3. Catastrophic Cases

a. Drugs and Medicines


Secondary
3,650
5,475
Tertiary
4,170
6,255
b. X-ray/Lab/Others
Secondary
1,620
2,430
Tertiary
3,845

5,770
III.. Medical/Dental Practitioner's Fee per day for
1. General Practitioner
55
85
2. Specialist
80
120
The Practitioner's Fee per single period of confinement shall not exceed:
1. For Ordinary Cases
a. General Practitioner 300 450
b. Specialist
450
675
2. For Intensive/Catastrophic Cases
a. General Practitioner
450

675
b. Specialist
750
1,125

IV. Surgeon's Fee shall be in accordance with the Relative Value Scheme not to exceed P10,620.00

V. Anesthesiologist's Fee (30% of Surgeon's Fee) not to exceed P3,190.00.

VI.. Operation Room Fee for Surgical Procedure under the following brackets of Relative Unit Value (RUV):

1. RUV of 5.0 and below
Primary
170
255
Secondary
295
445
Tertiary
470
705
2. RUV of 5.1 to 10 units
Secondary
505
760
Tertiary
600
900
3. RUV of above 10 units
Secondary
960
1,440
Tertiary
1,550
2,325
VII.. Fee for Surgical Family Planning Procedures (for members and spouses only):
Vasectomy
400
600
Tubal Ligation
500

750

This insurance scheme is in addition to other schemes the employer should provide under the employment contract and existing laws.

For information.

Adopted: 04 February 1997


(SGD.) FELICISIMO O. JOSON, JR.
Administrator


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