PhilHealth pays for leptospirosis

Manila (21 October) — Confinements due to leptospirosis are compensable.

This was emphasized recently by Dr. Rey B. Aquino, PhilHealth President and CEO in support of President Gloria Macapagal-Arroyo’s and Health Secretary Francisco T. Duque III’s call for all-out efforts to address the increasing number of leptospirosis cases noted in hospitals, particularly in the National Capital Region, in the aftermath of typhoon Ondoy.

Noting that leptospirosis icterohemorrhagica may be classified as Case type C, Aquino said that 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 P800.00 per day and allowances for drugs and medicines of up to P28,000 per single period of confinement.

“They 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 said.

The PhilHealth Chief added that members may also avail of allowances for the professional fees of attending physicians at P700.00 per day, for a maximum of P5,600.00 for daily visits of specialists.

Patients requiring dialysis are similarly entitled to additional allowance of P560.00 for the professional fees of nephrologists, and about P1,200.00 per session for the use of the hemodialysis room.

Aquino stressed that availment of these benefits is subject to medical evaluation and existing policies on claims payment.

He advised employed and individually paying members (IPMs) to have at least three (3) months premium contributions within a six-month period prior to the month of availment to be able to avail of these benefits.

On the other hand, sponsored and overseas worker-members may avail themselves of the special package within the validity period of their PhilHealth coverage as reflected in their PhilHealth cards and enhanced Member Data Records (MDRs) respectively.

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

Noting that the cases of leptospirosis were mostly in areas heavily affected by typhoon Ondoy, Aquino added that the government agency has made benefits availment easier by temporarily doing away with the Affidavit of Loss usually required from members requesting for replacement of their Member Data Records or Number Cards.

From January to June this year, PhilHealth has paid about P2.3 million in benefits for the confinement of members and their dependents due to leptospirosis. The amount represents payment for about 324 claims, with each claim averaging P7,377.00. (PhilHealth)