BAGUIO CITY (PIA) — The Philippine Health Insurance Corporation (PhilHealth)- Cordillera Regional Office through its Local Health Insurance Office (LHIO) in Baguio, oriented cancer patients and caregivers on PhilHealth’s Konsultasyong Sulit at Tama (KonSulTa) benefit package on August 2, 2024 at the Baguio General Hospital and Medical Center (BGHMC) Cancer Center Training Hall.
Janet Palaez, Baguio Local Health Insurance Office head, introduced the KonSulTa as a comprehensive outpatient benefits program mandated under Republic Act No. 11223 or the Universal Health Care (UHC) Law. Its goal is to boost members’ access to primary care services such as free initial and follow-up consultations, health risk screening and assessment, laboratory tests, and maintenance drugs and medicines as needed by patients and as recommended by their physicians.
She said in order to avail of the KonSulTa package, one must be a PhilHealth member, and he or she must register to a KonSulTa facility of his/her choice. Once registered with a KonSulTa provider, a patient may now avail of the First Patient Encounter (FPE) and the services as may be required or prescribed by an attending physician.
For Baguio City, the KonSulTa program is being implemented in the city’s 16 district health centers and a private facility, the Olympian Medical and Diagnostic Center, Inc., which are issued licenses to operate as primary care facilities by the Department of Health. They are accredited as KonSulTa package provider by the PhilHealth enabling them to provide individual-based health services including initial follow-up primary care consultations, health screening and assessment and access to selected diagnostic services and medicines, Palaez said.
The PhilHealth board approved the inclusion of mammography and ultrasound screening services in the KonSulTa Package. These vital screenings aim to facilitate early detection of breast cancer.
Meanwhile, Palaez shared the enhanced package rates for different illnesses. As of July this year, the number of hemodialysis sessions covered for patients with Chronic Kidney Disease Stage 5 has increased to 156 per year, with the benefit amount rising from P2,600 to P4,000 per session.
Benefits for high-risk pneumonia patients also increased from P32,000 to P90,100, while the Z Benefit package for breast cancer was enhanced from P100,000 to a high of P1.4 million.
Moreover, case rates for surgical procedures including cholecystectomy increased from P31,000 to P40,300, caesarean section from P19,000 to P24,000, appendectomy from P24,000 to P31,200, and thyroidectomy from P31,000 to P40,300.
A 30 percent increase in case rates is also be applied to various medical conditions and procedures including essential hypertension from P9,000 to P11,700, and dengue 1 from P10,000 to P13,000.
Palaez informed that in response to growing concerns over mental health issues especially among the youth, PhilHealth has introduced a new outpatient benefit package for mental health services.
“This package includes a general mental health service offering up to P9,000 per person per year, and a specialty mental health service package providing up to P16,000 per person annually for those diagnosed and confined in accredited hospitals,” she said.
Palaez said they continue to encourage all Filipinos to enroll in PhilHealth to take advantage of these benefits which help ensure financial relief during medical emergencies and other difficult medical situations.
She reminded senior citizens and Persons with Disabilities (PWDs) to always demand for the 32 percent discount from medical bills prior to hospital discharge. The application of the deductions shall be 12% VAT exemption, and 20% senior citizens or PWD discount.
The said discounts are mandated under RA 9994 or the Expanded Senior Citizens Act, and 10754 or the Expanded Benefits and Privileges of Persons with Disability Act. The application of these discounts is also provided in the health facilities’ Performance Commitment with PhilHealth, Palaez said. (MAWC-PIA CAR)
