Supreme Court E-Library
Information At Your Fingertips


  View printer friendly version

(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
SECONDARY
TERTIARY
  
         
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
(per single period of confinement shall not exceed:)
P105/day for General Practitioner
P150/day for Specialist
 
 

 
  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
  
  SURGEON Maximum of 15,390 @ 420/Relative Unit Value  
  ANESTHESIOLOGIST Maximum of 4,785 @ 420/Relative Unit 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

© Supreme Court E-Library 2019
This website was designed and developed, and is maintained, by the E-Library Technical Staff in collaboration with the Management Information Systems Office.