Question & AnswerQ&A (PHIC PHILHEALTH CIRCULAR NO. 20, S. 2009)
The purpose is to ensure financial protection for marginalized sectors by expanding PhilHealth coverage to include take-home medications under the P100 Program for eligible sponsored members, promoting access to cheaper quality medicines.
Coverage is based on the IRR of Republic Act No. 9502, the Universally Accessible Cheaper Medicines Act of 2008, and PhilHealth Board Resolution 1214 s-2009 which approves coverage of P100 drugs for eligible sponsored members.
Eligible sponsored members of PhilHealth and their qualified dependents with valid membership during the date(s) of confinement.
Drugs include a full course treatment of antimicrobial drugs for infections (up to two weeks), maintenance dose for chronic illnesses (two weeks), and one extra pack for other acute illnesses post-discharge.
Members may purchase P100 drugs from DOH-authorized outlets such as Botika ng Bayan, with official receipts attached for reimbursement subject to benefit ceilings and claims filed within 60 days post-discharge.
No separate claim form is needed; claims for P100 drugs are included in the Claim Form 2 part III as part of inpatient services.
PhilHealth reimburses the whole treatment pack on a per pack basis even if some doses were not consumed during confinement, subject to drug benefit limits.
They must comply with rational drug use, established Clinical Practice Guidelines, other acceptable medical standards, and ethics.
It took effect starting June 1, 2009 for benefit claims with admission dates from that day forward.
Up to two weeks for infections, two weeks maintenance dose for chronic illnesses, and one extra pack for other acute illnesses beyond confinement.