PhilHealth releases new rates for COVID-19 testing

by Shiela Crisostomo – The Philippine Star, 19 Dec 2021

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) announced its new benefit package rates for COVID-19 testing, using plate-based and cartridge-based Reverse Transcription-Polymerase Chain Reaction (RT-PCR).

The new package rates are contained in PhilHealth Circular No. 2021-0021, which took effect upon its publication last Nov. 30.

According to PhilHealth, it shall provide coverage, ranging from P800 to P2,800 for plate-based – and P500 to P2,450 for cartridge-based – RT-PCR tests.

The state insurer based the new rates on the revised costing estimates and the price cap prescribed by the Department of Health (DOH) and Department of Trade and Industry (DTI).

PhilhHealth said it will “continue monitoring and reviewing the implementation of its benefit packages to ensure financial risk protection to its beneficiaries.”

“These testing benefits are available in PhilHealth-accredited testing laboratories,” it noted.

The agency added that a member is entitled to the benefit “following applicable DOH guidelines on priority sub-groups for SARS-CoV-2 testing.”

On the other hand, PhilHealth said it will still extend coverage to those who are not yet registered with the program.

Based on DOH Department Circular No. 0374 that took effect last Sept. 6, a price cap was set for RT-PCR plate-based and cartridge-based testing.

Under the circular, the price cap for plate-based is P2,800, and P2,450 for GenExpert (cartridge -based) for public facilities.

On the other hand, the price limit for plate-based is P3,360, while P2,940 for GenExpert (cartridge based) for private facilities “with 20 percent allowable markup.”