In response to the passage of Republic Act 11228 which provides for the mandatory PhilHealth coverage for all Persons with Disabilities (PWDs), state agency Philippine Health Insurance Corporation (PhilHealth) said preparations for the law's implementation is underway starting with the crafting of its implementing rules and regulations (IRR).
The new law which amends the Magna Carta for PWDs was signed into law by President Rodrigo R. Duterte on February 22, 2019 and took effect on March 19, 2019. It also mandates PhilHealth to develop exclusive packages that will address PWDs' specific health and developmental needs.
"Long before the passage of RA 11228, PhilHealth has introduced in 2013 its special benefits for Mobility, Orthosis, Rehabilitation, Prosthesis Help or ZMORPH to assist our PWDs for the needed lower limb prostheses, expanding it in 2014 to include selected orthopedic implants such as total and partial hip prostheses, and implants for hip fixation, among others," PhilHealth Acting President and CEO Dr. Roy B. Ferrer declared, adding that "in 2014 we further upped the ante for our PWDs with the inclusion of upper limb prostheses, orthoses and orthoprostheses, among others in 2014."
The PhilHealth Chief said that in the latter part of 2018, they introduced Z benefits for children with mobility impairment, developmental disabilities, and visual and hearing impairments to start investing for the health of affected children who will be tomorrow's leaders. He further said they intend to build on these existing benefits to expand their portfolio to all PWDs based on their unique health care needs.
The required premium contributions for PWDs shall be paid for by the national government from the proceeds of the restructured excise taxes on alcohol and tobacco; while employers of employed PWDs are responsible for half of their monthly premiums.
Ferrer clarified that full implementation of the law will follow as soon as the IRR is completed and the required premium contributions for PWDs are released by the National Government. "Since the enactment of the law came at a time when the 2019 national budget has long been completed for submission to the President for approval, the necessary funds for its implementation will require a supplemental budget to be approved by Congress," he explained.
PhilHealth is actively consulting with concerned stakeholders in crafting the IRR. The public can expect the introduction of special benefits for PWDs in due time as provided for in the law.
On another note, PhilHealth maintained that aside from inpatient care, its outpatient benefit (OPB) package also covers free consultations and diagnostics and laboratories such as chest X-ray, lipid profile, complete blood count, urinalysis, fecalysis, sputum microscopy, fasting blood sugar, among others; including medicines for asthma, acute gastroenteritis, upper respiratory tract infection, pneumonia and urinary tract infection.
This is to correct several reports that the state agency has yet to introduce free check-ups and maintenance medicines for its members.
"Free consultations, laboratories and medicines for specific conditions have been available since 2012 and are being availed of by some 40 million members such as the indigents, sponsored members, Overseas Filipino Workers, Organized Group, DepEd teaching and non-teaching employees and their dependents through their local health centers. It is clearly not accurate for some quarters to claim that PhilHealth is not offering these services," the CEO asserted.
"In 2018, we expanded the Primary Care Benefits (PCB) to include essential services and outpatient medicines for diabetes and hypertension for employed members, senior citizens and lifetime members and their qualified dependents whose combined numbers total to 42.6 million beneficiaries," Dr. Ferrer ended.