PhilHealth Bicol cites health insurance privileges for 4Ps beneficiaries

By Sally A.Atento

LEGAZPI CITY, Dec. 15 (PIA) -- The Philippine Health Insurance Corp (PhilHealth) regional office in Bicol assures access to health insurance benefits and privileges for all beneficiaries and qualified dependents of Pantawid Pamilyang Pilipino Program (4Ps) in the region.

Philhealth 5 director Orlando Iñigo Jr said that with PhilHealth Circular No 24 on June 22 this year, all 4Ps benefits and their qualified dependents are automatically eligible to avail of PhilHealth benefits in all accredited facilities.

“Through the said circular, the 4Ps ID card of a beneficiary is already acceptable to establish eligibility to claim National Health Insurance Policy (NHIP) benefits, in lieu of a PhilHealth ID or member data record,” Iñigo said.

Health cards issued to 4Ps beneficiaries are valid for three years.

Iñigo also clarified the additional guideline which applies only to a 4Ps beneficiary and at the same time a qualified dependent of an enrolled PhilHealth-sponsored program under the NHTS.

“Under the supplemental policy, a 4Ps beneficiary may be registered as a PhilHealth primary member provided that the patient-dependent is a qualified dependent of the said beneficiary but not a qualified dependent of the sponsored program or an existing member of the PhilHealth," Iñigo explained.

Among the PhilHealth benefits that 4Ps beneficiaries and dependents can avail of are preventive and diagnostic services under the Primary Care Package and all inpatient and outpatient care services at PhilHealth accredited facilities.

Qualified beneficiaries can also be free from paying other fees or expenses above and beyond the packaged rates as specified in the No Balance Billing (NBB) policy of all PhilHealth-sponsored program.

However, such policy will only apply to members and/or dependents who are diagnosed with any of the 23 cases under Case payment and admitted to non-private accommodation beds of government hospital, availed outpatient surgeries, hemodialysis and radio theraphy in accredited hospital facilities including free-standing dialysis centers (FSDCs) and ambulatory surgical clinics (ASCs) or those who utilized existing outpatient packages for TB-DOTS, malaria and HIV.

Members who availed services under the Maternity Care Package (MCP) and the Newborn Care Package (NCP) in accredited non-hospital providers are also qualified. (MAL/SAA-PIA5, ALbay)