PhilHealth revising coverage policies for COVID-19, other cases

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MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) assured the public that policies in line with the COVID-19 pandemic are being reviewed, after complaints that patients’ stay in emergency rooms and makeshift tents are not being covered.

“Be it COVID-19 or not, patients should be afforded with all the financial help as guaranteed by the Universal Health Care Law. Pursuant to this, PhilHealth has been reviewing existing policies to better respond to the extraordinary demands brought about by this pandemic, with the best interest of the patients in mind,” PhilHealth said in a statement on Friday.

“Enhanced guidelines will be issued the soonest to ensure that adequate financial protection is duly provided to the patients without compromising quality of care,” it added.

Last Tuesday, Bayan Muna party-list Rep. Ferdinand Gaite revealed that some hospitals are charging patients at emergency rooms or temporary tents — which were set-up due to the high influx of patients amid a COVID-19 surge — at P1,000 per hour.

Under existing rules, emergency room (ER) services are not shouldered by PhilHealth.

Gaite and Sen. Joel Villanueva said that it is not the fault of the patients that they are staying inside ERs and tents because hospitals are already at full capacity.

Villanueva said in a tweet on Thursday that expenses in ER and makeshift tents should be covered by PhilHealth because overcrowding in the emergency rooms are not a sufficient reason to exclude patients from PhilHealth assistance.

PhilHealth reiterated that patients receiving in-patient care even in ERs or the tents outside hospitals should already be included in the state insurer’s coverage.

“PhilHealth fully acknowledges the current situation where patients are temporarily placed in tents because hospitals can no longer admit them in regular hospital beds,” PhilHealth said.

“PhilHealth guarantees that COVID-19 patients are entitled to health insurance coverage for RT-PCR tests, isolation in accredited community isolation units, and hospitalization for mild to critical cases of COVID-19,” it added.

PhilHealth likewise assured that it would probe the reports that hospitals are charging P1,000 per hour for ER services.

The country is currently dealing with a surge in COVID-19 cases.

As of Friday, there are over 153,000 active infections after the Department of Health recorded 15,310 new cases, of which 3,790 are from a previous backlog.

 This has left a lot of hospitals in Metro Manila and other areas in the enhanced community quarantine (ECQ) bubble on full capacity for COVID-19 cases.

 The situation has prompted hospitals to set-up tents to accommodate more patients.

Former Senator JV Ejercito recently said that his father, former President Joseph Estrada, who tested positive for COVID-19, spent the night in the emergency room of a hospital.