East Visayas 4Ps beneficiaries now entitled to Philhealth benefits

By Erlinda Olivia P. Tiu

Thursday 28th of June 2012

TACLOBAN CITY, Leyte, June 28 (PIA) -- Pantawid Pamilyang Pilipino Program (4Ps) family beneficiaries and their qualified dependents may now avail of PhilHealth benefits.

Lawyer Jerry F. Ibay, PhilHealth-8 Regional vice president said PhilHealth issued Circular 24, s. 2012 on the entitlement to National Health Insurance Program of all 4Ps beneficiaries of the Department of Social Welfare and Development (DSWD).

As of May 2012, there were 313,474 indigent members under NHTS-PR, including Pantawid Pamilya beneficiaries who have been provided with PhilHealth coverage in Region 8.

4Ps beneficiaries need only to present their Pantawid Pamilya ID to any PhilHealth-accredited hospital or facility to avail themselves of the benefits, PhilHealth information officer Miramar Zabala said.

Their dependents need to present a supporting document to establish the relationship to the main beneficiary. Valid documents such as marriage certificate or contract, baptismal or birth certificate or a certification from the DSWD or punong barangay attesting to the relationship of the dependent to the supposed member may be presented, Zabala said.

Beneficiaries may avail themselves of benefits such as Primary Care Package (PCB) which includes preventive services such as consultation, visual inspection with acetic acid to detect cervical cancer, regular BP measurements, periodic clinical breast exam and digital rectal exam.

Also included in the package are some diagnostic services such as complete blood count (CBC), urinalysis, fecalysis, sputum microscopy, fasting blood sugar, lipid profile and chest X-ray. The PCB services can be availed of in registered rural and city health centers and the outpatient department of government hospitals.

Like other members, the 4Ps beneficiary is also entitled to inpatient benefits which include subsidies for room and board, drugs and medicines, X-ray and other laboratory fees, operating room fee and the professional fee of doctors.

Other than inpatient benefits, there are also services that a Pantawid Pamilya beneficiary can get in an outpatient basis. These include radiotherapy, hemodialysis, cataract extraction and minor surgical procedures.

The PhilHealth also rolled out 23 conditions and cases that are paid through package payment, Zabala said.

When a 4Ps beneficiary or his dependent is confined in a ward or PhilHealth bed of a government hospital due to a condition included in these 23 cases, the “no balance billing policy” must be applied.

No Balance Billing simply means that no additional fees should be charged to the indigent member during hospitalization, Zabala added. (EOT/PIA8)