Title
PhilHealth Coverage for Influenza A
Law
Phic Philhealth Circular No. 33, S. 2009
Decision Date
Sep 1, 2009
Effective September 1, 2009, PhilHealth Circular No. 33 revises reimbursement rules for Influenza A (H1N1) treatment, limiting benefit payments to Level 3 and 4 hospitals while establishing specific rates for Level 1 and 2 facilities.
A

Q&A (PHIC PHILHEALTH CIRCULAR NO. 33, S. 2009)

PhilHealth Circular No. 33, S. 2009 pertains to the amendment of PhilHealth Circular No. 25, S. 2009, specifically relating to PhilHealth coverage for confirmed cases of Novel Influenza A (H1N1) in humans.

The amended provisions took effect starting September 1, 2009.

Level 3 and Level 4 (Tertiary) hospitals are eligible for the full benefit payment as stated in PhilHealth Circular No. 25, S. 2009.

The maximum room and board benefit for members in Level 1 (Primary) hospitals is 500 pesos per day, up to a maximum of 10,000 pesos.

No, healthcare workers in Level 2 hospitals receive a higher benefit for room and board and professional fees, with maximums of 20,000 pesos and 30,000 pesos respectively, compared to members.

Healthcare workers in Level 1 hospitals are entitled to a professional fee benefit of 500 pesos per day with a maximum of 30,000 pesos.

Yes, these are included as benefit items, although specific amounts are not listed in the excerpts provided.

Yes, operating room fee is included with a maximum amount of 50,000 pesos for members and 100,000 pesos for healthcare workers, applicable to Level 1 and Level 2 hospitals as per the circular.

The total maximum benefit amount for members in Level 2 (Secondary) hospitals is 75,000 pesos.

All provisions of previous issuances which are not inconsistent with this circular remain in full force and effect.


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