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What medical assistance can we get from PhilHealth?
PhilHealth will shoulder the cost of treatment for all patients who have COVID-19:

  • For patients who were admitted from February 1 through April 14, 2020 and who paid for their hospital bills, PhilHealth will reimburse the expenses in full amount.
  • After April 14, 2020, PhilHealth will continue to cover admission costs using a recomputed case rate.

Starting April 15, how much will PhilHealth cover for COVID-19 treatment? And how does this apply with Intellicare’s coverage?

For patients who were admitted starting April 15, PhilHealth will cover the admission cost based on a case rate package:

Mild pneumonia in the elderly or with comorbidities
Levels 1-3 hospital, private room
Moderate pneumonia
Levels 1-3 hospital, private
Sever pneumonia
Level 2-3 hospital, private rooms, ICU
Critical pneumonia
786, 384
Levels 2-3 hospital, private room, ICU (capable of ECMO, RRT)

Further, Intellicare will continue to provide coverage for COVID-19 treatment throughout the duration of the quarantine period. Intellicare will cover the remaining balance after PhilHealth benefits are deducted. Please take note that Intellicare’s coverage will be based on the final diagnosis and the member’s maximum benefit limit.

These are mandatory services included in the benefits package (inclusive of professional or readers’ fees):
  • Accommodation
  • Management and monitoring of illness
  • Laboratory, diagnostics and imaging
  • Medicine prescribed in the DOH guidelines and protocols
  • Supplies and equipment

Further, the following conditions are covered for patients with critical pneumonia:
  • Acute respiratory distress syndrome (ARDS)
  • Septic Shock
  • Requiring invasive ventilation
  • Requiring extracorporeal membrane oxygenation (ECMO)
  • Requiring renal replacement therapy (RRT)

All filing of claims and reimbursements will be handled by the hospital provider, and there shall be no direct filing by the PhilHealth member. If patient is not registered to PhilHealth, he or she will still be covered provided that patient must complete the PhilHealth member registration prior to discharge.


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