THE Philippine Health Insurance Corporation (PhilHealth) said hospital confinements brought about by mental and physical conditions due to abuse of illegal substances are being paid for under the existing benefit schedule it provides.
Ramon F. Aristoza Jr., PhilHealth OIC president and CEO, said these conditions are among the components related to drug dependency that the state-run health insurer is paying for under the All Case Rate payment mechanism.
At the same time, Senior Vice President for Health Finance Policy Sector Ruben John A. Basa explained that hospitalization brought about by mental and behavioral disorders secondary to substance abuse are being paid for by PhilHealth at a package rate of P7,800, including payment for professional and hospital fees.
In 2014 and 2015, PhilHealth has paid about P25 million in benefit payments for the said related cases.
PhilHeath is now working on a medical detoxification package to safely manage the acute physical symptoms of withdrawal associated with stopping the drug use.
Amid the present administration’s drive against illegal drugs, the health insurer is presently working with the Department of Health and other stakeholders in the formulation of the guidelines for the said benefit package.
Meanwhile, PhilHealth has released a new policy covering orphans, abandoned and abused minors, out-of-school youths and children under its Sponsored Program. PhilHealth Circular No. 2016-0019 entitles them to benefit coverage such as access to inpatient, outpatient and primary care services, and to the application of the no balance billing policy.