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New Set of Primary Care Benefits Now Available --- PhilHealth July 3, 2012

TRUE to its earlier pronouncement of taking bolder moves towards Universal Health Care (UHC), the Philippine Health Insurance Corporation (PhilHealth) introduces a new set of enhanced benefits designed to improve the financial risk protection for its members.

Dubbed Primary Care Benefits I (PCB I) Package, the new set of benefits entitles members to basic, quality health care services through accredited public health care providers nationwide. It allows primary health care providers greater flexibility in the range of services they can offer to their enlisted PhilHealth clients.

Included in the PCB I Package are primary benefits such as consultations, regular blood pressure monitoring and health promotion like education on breastfeeding, counseling on lifestyle modification and smoking cessation. Medicines for common diseases like asthma and acute gastroenteritis (AGE) with no or mild dehydration, upper respiratory tract infection/pneumonia and urinary tract infection are also included and expected to be provided by the providers of this package. "Also available are diagnostic services such as complete blood count, urinalysis, sputum microscopy, fasting blood sugar; lipid profile and chest x-ray," said PhilHealth President and CEO Dr. Eduardo P. Banzon.

Initially, these new benefits will be available to members under the Sponsored, Organized Groups and Overseas Workers Program and to their qualified dependents. However, Banzon said that "eventually, all other members in the different categories will have access to these benefits."

Availment of the PCB I benefits entails the assignment of SP members to designated Rural Health Units (RHUs), Health Centers (HCs) or outpatient departments (OPDs) of government hospitals nearest them, while OG and OWP members may choose their PCB I providers from the list of government hospitals that provides PCB I services. Since April 1, PhilHealth has been assigning the SP members to designated PCB providers --- RHUs, HCs and OPDs of government hospitals nationwide.

"The accredited provider shall actively seek out the SP members in their localities and once these members sign the master list, then they will be entitled to the benefits by presenting their valid PhilHealth ID cards," Banzon stressed. These members need not pay any amount to avail of these benefits.

He also reminded SP members that availment of the outpatient benefits must be made within the validity period specified in their PhilHealth ID cards. Members under the OG must have made at least three (3) months contributions within the immediate six (6) months prior to the month of availment, while OWP members can avail of the benefits as soon as they have paid their annual premium.

"We re-affirm our commitment to ensure better financial protection for our members in times they need it most and PCB I is a step towards this direction. This new benefit will also allow existing health centers/rural health units to improve and expand vital primary health care services, and continue to meet the increased demand for these services," the PhilHealth Chief said. (END)

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