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PhilHealth Benefit for Mother and Child May 28, 2013

The United Nations reports that 11 Filipino mothers die everyday as a result of pregnancy or childbirth. This translates to more than half a million women dying each year due to childbirth complications such as hemorrhage, hypertension and sepsis, among others. Japan International Cooperation Agency-Department of Health (DOH) Project Maternal and Child Health Specialist Roland Eric Macanas said that mismanagement on the part of childbirth attendants such as 'manghihilots' and 'comadronas' also contribute to the rate of maternal and infant deaths.

The solution to such problem may lie not only with the government but with the many pregnant women as well who remain uninformed of the risks of childbearing. It is expected that with correct information as well as observing prenatal to postnatal care, childbirth survival rates will improve progressively.

The DOH earlier issued an order authorizing only skilled and trained midwives, doctors and nurses to help pregnant women give birth. This in turn is supported by the Local Government Units by upgrading the conditions of their health centers, not only to entice pregnant women to give birth in healthcare facilities instead at home, but also, to be able to avail of the benefits of PhilHealth for maternity cases.

Under the case rate packages of PhilHealth, all member-types admitted in any of the accredited healthcare facilities nationwide will be able to know how much PhilHealth will be paying for services provided to birthing mothers. Members are entitled to a cost benefit of P8,000 for Maternity Care Package (MCP) in non-hospital facilities (health centers, lying-in clinics, birthing homes or midwife-managed clinics), and in Level 1 hospitals.

Normal Spontaneous Delivery (NSD) in accredited Levels 2 to 4 hospitals, members are entitled to a cost benefit of P6,500; while coverage for Caesarian Section(CS) delivery in said facilities and performed by accredited health professionals is P19,000.

Babies of members are also assured of the Newborn Care Package (NCP) provided for in accredited hospitals and lying-in clinics for a cost benefit of P1,750, which would include physical examination, eye prophylaxis, Vitamin K administration, BCG vaccination, first dose of Hepatitis B immunization, newborn screening tests, and breastfeeding advice.

For Sponsored Program members admitted in government hospitals, the “No Balance Billing” (NBB) policy applies where no other fees or expenses shall be charged to or paid for by the patient-member above and beyond the package rate for maternity care.

The same policy shall also apply to any other member type such as the employed, individually paying and overseas workers, who will avail themselves of the MCP and NCP in all accredited MCP non-hospital providers such as maternity clinics and birthing homes.

Health Secretary, PhilHealth Chairman of the Board and OIC President and CEO, Dr. Enrique T. Ona urged women who are members to utilize the benefits in accredited health care facilities and for those who are not yet members to enroll themselves in PhilHealth so that they and their babies may avail of the medical attention needed for a safe and effective delivery tended by professional providers. (END)

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