PhilHealth releases benefit for children with dev’tal disabilities

AS PhilHealth continues to put measures in place in ensuring sustainability of the social health insurance fund, initially by making slight adjustment in the premium rate of employed members, the state-run health insurance firm is also on its pursuit in expanding benefit packages for its members.

The Z Benefit Package for children with developmental disabilities, with guidelines released February this year, is intended for children below 18 years of age having manifestation of delays, regressions, or deviations in any developmental domains, such as cognitive-adaptive, sensorimotor, communication, social, emotional, or behavioral.

Under this benefit package, eligible patients may avail of assessment services ranging from P3,626 to P5,276 and rehabilitation therapy sessions at P5,000 per set.

“There is an increasing number of people with developmental disabilities and a large chunk of these cannot afford assessment services and rehabilitation therapy sessions. We hope that this benefit package will help ease the financial strain on families of children with developmental disabilities,” said William O. Chavez, PhilHealth Regional Vice President.

“The sooner we get people with developmental disabilities into a therapy program, the better chance of there being a successful outcome,” Chavez added.

To qualify for the Z benefit, a child shall be assessed by appropriate physicians or health care providers at the contracted hospital. Pre-authorization from PhilHealth based on approved selection criteria shall also be required.

With the implementation of the Z benefit for children with disabilities, PhilHealth envisions persons with disabilities to be active participants and contributors in their respective economies through education, inclusion and participation in their community based on the multidisciplinary assessment of individual needs.

However, since the release of the PhilHealth circular on this benefit package, hospitals have yet to be contracted by PhilHealth to provide the necessary services to eligible patients.

PhilHealth invites hospitals in the Central Visayas to apply for contracting services for the delivery of this benefit in the region.

Interested hospitals may apply for contracting by submitting a letter of intent, signed by the medical director or chief of hospital, indicating the capability of their institution to provide for the mandatory services of the package.

The Z Benefit was launched by PhilHealth in 2012 to address health conditions that are considered catastrophic due to the very expensive and prolonged course of treatment.

To date, there are only two contracted hospitals in Central Visayas providing Z benefit package — the Vicente Sotto Memorial Medical Center for kidney transplantation, early stage breast cancer, acute lymphocytic leukemia (ALL) in children, coronary artery bypass graft (CABG), ventricular septal defect (VD), Tetralogy of Fallot (TOF), and selected orthopaedic implants; and Perpetual Succour Hospital for ALL in children, early stage breast cancer, CABG, VSD, TOF, colon and rectum cancer.