LEGAZPI, Albay (PIA) – Around 5.5 million Bicolanos will have access to improved health benefits through the government’s National Health Insurance Program in 2024, according to PhilHealth Bicol Regional Vice-President Alberto Maduriao.
Speaking at a forum on Tuesday (September 10), Maduriao reported 3,102,295 beneficiaries from indirect contributors and 2,417,687 from direct contributors, out of a total eligible population of 6,298,715 Bicolanos.
“In our aim to rationalize benefit packages that will truly matter to our kababayans, we have focused on certain conditions that are particularly burdensome and could lead to catastrophic spending for Filipino patients and their families,” said Maduriao.
One of these individuals is Joel Bejerano from Burabod, Castilla, Sorsogon. He is currently undergoing a hemodialysis session at Bicol Regional Hospital and Medical Center.
“Malaking tulong ang mga benepisyo sa ilalim ng program ni Pangulong BBM at ng PhilHealth dahil nagamit ni papa sa kaniyang hemodialysis. Lahat na mahirap, natutulungan nto. Ako ay nagpapasalamat at umaasa na ang benpisyong ito ay magpapagaling sa aking ama,” Bejerano’s daughter Jocel said.
(The benefits under the President’s BBM program and PhilHealth are a big help because Papa was able to use it for his hemodialysis. Everyone poor can be helped. I am grateful and hope that this benefit will heal my father.)
The Enhanced Benefits of PhilHealth now cover up to 156 sessions of hemodialysis, providing treatment for patients with Chronic Kidney Disease Stage 5 for a year.
Additionally, the coverage for hemorrhagic stroke has been increased from P38,000 to P80,000, ischemic stroke from P28,000 to P76,000, and high-risk pneumonia from P32,000 to P90,100.
“Malaki ang pasasalamat ko na may ganitong programa si PBBM para sa Bicol region na nakakatulong sa napakaraming mahihirap at isa kami sa napakaraming nakatanggap ng tulong,” Bejerano’s wife, Myrna, said.
(I am very grateful that PBBM has this program for the Bicol region that helps so many poor people and we are one of the many who have received help.)
Both of them encouraged other Bicolanos to get PhilHealth membership.
“Sa lahat ng manganganak, sa lahat ng may sakit, o anuman ang karamdaman, kailangan niyo ng PhilHealth. Kaya magregister na kayo (To all those who give birth, to all those who are sick, or whatever the illness is, you need PhilHealth. So register now),” Myrna said.
Enhanced benefits
In addition to upgraded hemodialysis benefits, mental health services have also been expanded to provide general and specialty mental health services for the people of Bicol.
Specifically, an outpatient benefit package for mental health is now available, and providers are making it more accessible for those seeking treatment.
The health insurer also encouraged the public to take advantage of the “Konsultasyong Sulit at Tama” or “Konsulta,” which offers free primary care check-ups and maintenance medications for conditions such as asthma, diabetes, and hypertension. Filipinos are urged to register with the nearest and most convenient Konsultaprovider.
The budget per patient for Konsulta has increased from P500 to P1,700, now including mammograms and ultrasounds for early breast cancer detection,” as mentioned by Manduriao.
Manduriao also mentioned that PhilHealth Bicol has paid P4.23 billion in claimed payments with an average turn-around time of 16 days, faster than the required 60-day processing duration. In the first half of 2024, PhilHealth Bicol achieved payment of P74.95 billion in claims, a 16-percent increase from P64.36 billion the previous year.
“As the people’s health insurer, the reconciliation of accounts is carried out in strict compliance with the law and is part of our responsibility as stewards of public funds,” Manduriao said.
He stated that certain claims need to be either returned or denied due to non-compliance. For PhilHealth, such claims cease to be considered payable, while for the hospitals, these claims should no longer be treated as receivables.
Ease of transactions
As per President Ferdinand Marcos Jr.’s directive to digitalize, PhilHealth was among the first agencies to integrate with the eGovPH app.
Members can now conveniently access their profiles, check contributions, and register for Konsulta using their mobile phones.
In addition to the app, PhilHealth is also upgrading its website and implementing other digital payment schemes.
Toward the yearend, PhilHealth implemented a 30 percent across-the-board increase in over 9,000 case rate packages, with another increase planned before the year ends.
As ways forward, PhilHealth will expand more benefit packages for Filipinos such as physical rehabilitation, emergency care, severe dengue, chemotherapy, cataract extraction, and open-heart surgeries for children.
PhilHealth will also use artificial intelligence to further reduce claims processing times and improve reimbursements. (PIA5)
