Philhealth assures coverage for leptospirosis

With many dying from leptospirosis in flood-hit areas in Metro Manila and nearby provinces, the Philippine Health Insurance Corp. (PhilHealth) on Monday announced that it would pay for confinements arising from the animal feces-borne disease.

In a statement, Dr. Rey Aquino, PhilHealth president and chief executive officer, said that confinements of PhilHealth members resulting from leptospirosis icterohemorrhagica are compensable.

“PhilHealth members who might be admitted in Levels 3 and 4 hospitals may avail themselves of allowances for hospital room and board fees of up to P800 per day and allowances for drugs and medicines of up to P28,000 per single period of confinement,” Aquino said.

“Members may also avail of as much as P21, 000 for supplies, X-ray and other laboratory exams that may be administered during the entire period of confinement,” he added.

According to Aquino, PhilHealth members may also apply for allowances for the professional fees of attending physicians at P700 per day, for a maximum of P5,600, for daily visits of specialists.

Patients requiring dialysis, he said, were similarly entitled to additional allowance of P560 for the professional fees of nephrologists, and about P1,200 per session for the use of the hemodialysis room.

Aquino said that availment of these benefits was subject to medical evaluation and existing policies on claims payment. He advised employed and individually paying members to have at least three months’ premium contributions within a six-month period prior to the month when they will use the benefits.

Government effort

Earlier, President Gloria Arroyo and Health Secretary Francisco Duque 3rd called for an all-out effort to address the increasing number of leptospirosis cases noted in hospitals, particularly in Metro Manila in the aftermath of tropical storm Ondoy.

Under the availment, sponsored and overseas worker-members may apply for the special package within the validity period of their PhilHealth coverage as reflected in their PhilHealth cards and enhanced Member Data Records, or MDRs, respectively.

“They must have a copy of their MDRs attached to their claim documents,” Aquino said.

Noting that the cases of leptospirosis were mostly in areas heavily affected by Ondoy, the PhilHealth chief added that they have made benefits application process easier by temporarily doing away with the affidavit of loss that is usually required from members requesting replacement of their Member Data Records or Number Cards.

From January to June this year, PhilHealth paid about P2.3 million in benefits for the confinement of members and their dependents stricken ill with leptospirosis.

The amount represented payment for about 324 claims, with each claim averaging P7,377.

Also on Monday, the government-run San Lazaro Hospital in Manila’s Santa Cruz district admitted 221 leptospirosis patients. –James Konstantin Galvez with report from Michael Tanaotanao, Manila Times