TODAY, Philippine Health Insurance Corporation (PhilHealth) launches the new Case Type Z benefit package that gives substantial financial risk protection and totality of care for the treatment of catastrophic illnesses.
With the new benefit package, PhilHealth will pay for the whole treatment course of each PhilHealth patient-member/dependent who is confined of any of the four (4) conditions identified as catastrophic.
The Case Type Z benefit include early stage breast cancer and prostate cancer with low to intermediate risk, both with a package rate of P100,000; childhood acute lymphoblastic leukemia (standard risk) which will be paid at P210,000 and low risk end-stage renal disease requiring renal transplantation with P600,000 benefit package.
Availment of the package is initially through selected PhilHealth accredited Level 3 or Level 4 government hospitals that have signed a contract on the provision of specialized care. These contracted and reference hospitals throughout the country will provide the mandatory services and other necessary services to achieve high survival rates and best outcome for the patient based on the approved clinical protocols of the Corporation. The package will also cover payment for room and board, drugs and medicines, laboratory, operating room and professional fees.
In Region 6, the Corazon Locsin Montelibano Memorial Hospital (CLMMH) is the contracted facility for the treatment of breast cancer and Western Visayas Medical Center (WVMC) for acute lymphocytic leukemia and prostate cancer aside from breast cancer treatment.
Under the Z benefit package, PhilHealth members will be eased from the burden of paying for these expensive therapies. A 100 percent support value for Sponsored Program (SP) members is guaranteed as the “no balance billing” policy is made applicable. However, for non-SP members, fixed co-pay for each condition will be paid on top of the packaged amount. Only one (1) quarter or three (3) monthly payments within the immediate six months prior to confinement is required for IPP and Employed Sector members. While the Sponsored (SP) and Overseas Workers Program members and retirees or pensioners under Lifetime Member Program avail of the Z benefit package within the validity of their membership.
Upon diagnosis, PhilHealth member/dependent availing of the new benefit package will accomplish the Member Empowerment (ME) Form jointly signed by the patient or of the authorized representative and the health care provider. The ME Form contains the information of the member, agreed diagnosis and treatment options, schedule of treatment and follow-ups, list of mandatory and other services, roles and responsibilities of the member, rules and limitations of the Z benefit availment and other information vital to the patient. A tracking system is also made to monitor and ensure provision of all the medical services to PhilHealth members. (PhilHealth Public Affairs Unit)