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Health & Wellness Philhealth for an expat?

Discussion in 'Businesses - Services - Products' started by AlwaysRt, Dec 2, 2016.

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  1. DavyL200

    DavyL200 DI Forum Luminary ★ Global Mod ★ ★ Moderator ★ Highly Rated Poster Showcase Reviewer

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    A lot of the Drs in there don't agree with how the admin runs things,the Drs mostly are ok but the admin are just! I'm sure you know what I mean.
     
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  2. OP
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    AlwaysRt

    AlwaysRt DI Forum Patron Highly Rated Poster Blood Donor Veteran Air Force Marines

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    Being from Mampas Valencia my wife has Valhealth for free. She has a Valhealth card and I saw the Valhealth desk at the hospital here when we had to do our marriage seminar. She isn't sure how or where (thinks maybe Valencia only?) it works. I added her for free to my Philhealth so she might be double covered in Valencia.
     
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  3. PatO

    PatO DI Forum Luminary Highly Rated Poster Showcase Reviewer Veteran Marines

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    I think I recall my wife being told pregnancy is not covered the first nine months of membership but that was six years ago so not sure.
     
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  4. DavyL200

    DavyL200 DI Forum Luminary ★ Global Mod ★ ★ Moderator ★ Highly Rated Poster Showcase Reviewer

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    April 16, 2016 03:59 AM

    THE PHILIPPINE Health Insurance Corp. (PhilHealth) recommended a minimum number of days of confinement for members and dependents who are admitted for Acute Gastroenteritis (AGE) or Diarrhea, Community Acquired Pneumonia (CAP) and Urinary Tract Infection (UTI), three of the leading illnesses in claims reimbursement.

    “We (PhilHealth) shall deny claims of less than the recommended minimum length of hospital stay set by PhilHealth,” said Lourdes F. Diocson, regional vice-president for PhilHealth VI.

    PhilHealth translated the Clinical Practice Guidelines (CPG) into policy statements in defining, diagnosing and managing the treatment of PhilHealth members who are confined for AGE Pneumonia and UTI.

    These policy statements shall serve as guidance to hospitals, medical professionals and members as to what tests and medicines shall be given to PhilHealth members and their dependents who are suffering from the said illnesses.

    According to the recent circulars released by PhilHealth, patients suffering from moderate to severe diarrhea should at least have 3 days (72 hours) of hospital stay and those suffering from pneumonia should at least have 4 days (96 hours) confinement with at least three (3) days of IV antibiotics.

    Meanwhile, only patients suffering from moderate and high-risk pneumonia can be reimbursed by PhilHealth and hospital stay may be extended for patients suffering from high-risk pneumonia.

    UTI cases, on the other hand, are admissible when patient is unable to accept oral medication and that the condition requires need for IV treatment and close observation due to potential complications.

    “The required hospital stay for UTI is at least four (4) days or 96 hours to provide sufficient time for our members/dependents to respond to the recommended therapy,” Diocson said.

    Under the All Case Rate payment scheme of PhilHealth, the package rate for AGE is P6,000; UTI ranges from P6,900 to P12,700; and a benefit package of P15,000 for Moderate Risk Pneumonia and P32,000 for High Risk Pneumonia.


    “It is of vital importance for our members to be aware of these policies, otherwise, PhilHealth will not reimburse them,” Diocson said. (PRO-6/Public Affairs Unit) PHILHEALTH LIMIT: Minimum confinement days for members with common illnesses set
     
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  5. cabb

    cabb DI Forum Patron Highly Rated Poster ✤Forum Sponsor✤

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    Does the rate PhilHealth pays cover entire stay or is it just a partial payment? I'm wondering if it doesn't create a situation where you might leave early and forgo insurance because the reimbursement is significantly less than the daily hospital rate.
     
  6. Dave & Imp

    Dave & Imp DI Forum Patron Highly Rated Poster Showcase Reviewer

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    I am a little confused. Is Phil Health a plan to help pay hospitals costs or a plan tohelp keep Hospital beds full with extended stays? :o o:
     
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  7. ChMacQueen

    ChMacQueen DI Forum Patron Highly Rated Poster Showcase Reviewer Veteran Army

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    #2 Best Answer
    You hit the nail on the head. Its surely a way to keep hospital beds full. If it was to help cover hospital costs they wouldn't have such silly rules and simply require the attending doctors to agree with the release and home treatment which would be far cheaper. Many of these cases someone could go home in 24-48 hours and do at home medications and get better just as quick if not quicker as people are more comfortable and happier at home then in a hospital.

    It doesn't pay the whole thing. Its a a partial payment with a fixed amount paid depending on the issue. You could get out with just 24 hours in and have a bill of 3-4k or stay the 4 days to get PhilHealth coverage and still pay 3-4k or a LOT more. Many of the things they do at the hospital they consider mandatory aren't needed such as IV's for everyone under the sun yet when have you seen an admitted patient not have an IV? Most issues someone can drink water just fine and often do. Add in the doctors fee's which change drastically if they consider you poor or not which could be 500p a day or 2500p a day depending on what the doctor feels like and IF you end up having a 2nd doctor specialist take a look their fee adds in as well and they love bringing in a specialist if they can find the silliest reason to.

    In the end many a time going home early and forgoing Philhealth coverage can save sanity and money. It all depends on the issue and how much longer one would have to wait to qualify.
     
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  8. DavyL200

    DavyL200 DI Forum Luminary ★ Global Mod ★ ★ Moderator ★ Highly Rated Poster Showcase Reviewer

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    So the days of cheap philhealth for the expat maybe over,as long as the law goes through around june of 2017 foreigners who have philhealth will be paying around p6000 a year instead of p2,400 a year.
     
  9. Princeton

    Princeton DI Member

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    imo still one of the best deals in the phils,,i have been in hospital here twice and philhealth covered a good portion of bill both times...WAY more than the total premiums i have paid
     
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  10. DavyL200

    DavyL200 DI Forum Luminary ★ Global Mod ★ ★ Moderator ★ Highly Rated Poster Showcase Reviewer

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    Sorry i made a mistake on the amount! Its p15,000 year if youre on an ssrv and p17,000 on any other visa!
    Screenshots of the new terms attached. If youre now under your wifes name or on a tourist visa you will need to reapply after july 1st 2017
     

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