News
PhilHealth pays P17.5B in health insurance benefits - February 24, 2006
THE Philippine Health Insurance Corporation (PhilHealth) today
announced that it has paid P17.5 billion in health insurance
benefits to its members in 2005.
Lorna O. Fajardo, Officer-in-charge of the Office of the PhilHealth
President and CEO said that the P17.5B in payments is 25 percent
more than what the government agency paid to its members in
2004.
Fajardo attributed the increase to the significant number of
claims for medical reimbursements that the agency received over
the 12-month period. "We have noted an upsurge in the
number of claims being filed for reimbursements, both by the
hospitals and by the members themselves, particularly from the
indigent sector," she said.
Another factor, Fajardo said, is the increasing support value
of the PhilHealth benefit package. She told media that over
the last five years, the support value of the PhilHealth benefit
package has greatly improved and that it now ranges from 30
to 70 percent per confinement, depending on the category of
the hospital where the patient was admitted and on the disease
classification for which the patient was hospitalized. "Where
before the support value was a low five percent, today, the
PhilHealth package contributes significantly in bringing down
the out-of-pocket expenses of our members," she said.
Of the P17.5B payments, P10.4B or 59.4 percent was paid to the
private sector which includes the individually paying members
while P4.4 B or 25.1 percent was paid to employees in the government
sector. Some P2.7B representing 15.4 percent of the total amount
was paid to members from the indigent sector which includes
the less privileged families enrolled by various local government
units, private individuals and companies into the National Health
Insurance Program (NHIP).
The PhilHealth package provides for in-patient hospitalization
benefits such as allowances for hospital room and board fees
of up to 45 days in one year, allowances for drugs and medicines
of up to P16,000.00 per single period of confinement, allowances
for x-ray and other laboratory exams of up to P14,000.00, also
per single period of confinement and allowances for the professioanl
fees of the attending physician. These benefits may be availed
of by members in any of the 1,564 accredited hospitals nationwide.