PhilHealth coverage for Influenza A (H1N1)

CEBU, Philippines - Beginning this July 11, hospital confinements due to Influenza A (H1N1) virus will be paid as Case Type A based on PhilHealth’s inpatient benefit schedule instead of a benefit package.

During the outbreak of the H1N1 virus in 2009, PhilHealth produced a benefit package intended for those who were infected with the disease to alleviate the direct medical cost for its treatment.

Hospitalization benefit for PhilHealth members and qualified dependents then was set at P75,000 and at P150,000 for qualified health care workers who rendered service in a Department of Health (DOH)-retained hospital for H1N1 cases or contracted the disease while performing their duties and or caring for an H1N1 patient as certified by the DOH.

However, the World Health Organization recently announced that the H1N1 virus is now shifting toward the post-pandemic phase, which means that the virus has taken on a behavior and intensity similar to that of the regular seasonal flu viruses. This impelled PhilHealth to consider the Influenza A (H1N1) to be paid as Case Type A under the fee-for-service kind of benefit coverage.

Patients admitted in a tertiary level hospital with an illness classified as Case Type A will have a maximum coverage of P500 per day for the room and board charges; maximum of P4,200 for drugs and medicines for the whole period of confinement; P3,200 for X-ray, laboratory, and supplies; and coverage for the doctors’ professional fees.   - (THE FREEMAN)