MANILA, Philippines - The Department of Health (DOH) said yesterday that all leptospirosis patients from areas affected by heavy monsoon rains weeks ago are automatically considered members of the Philippine Health Insurance Corp. (Philhealth).
DOH Secretary Enrique Ona explained this means that they do not have to pay Philhealth premiums but can enjoy Philhealth benefits from Aug.1, 2012 to July 31, 2013.
The privilege shall be applicable for all admissions from Aug. 7 up to the end of the month.
Ona added the benefit is provided for under Philhealth Circular No. 39, series of 2012, which states that non-members living in flooded areas shall be accorded benefits under the Sponsored Program of the agency.
For non-members less than 21 years of age whose parents are not members, one parent shall be automatically covered.
Under PhilHealth Circular 40 series of 2012, a case rate of P11,000 shall be covered for moderate leptospirosis cases admitted in hospitals starting August 7.
Severe leptospirosis cases, on the other hand, shall be reimbursed “via fee-for-service scheme.”
This covers conditions like leptospirosis icterohaemorrhagica, leptospirosis-associated kidney injury that requires emergency dialysis, meningitis in leptospirosis and pulmonary hemorrhage.
“Deaths, as per Philhealth Circular No. 15 series of 2011, shall be reimbursed via fee-for-serve scheme,” the circular said.
Non-definitive final diagnosis such as suspected, to consider, probable or rule out leptospirosis may be denied or paid as fee-for-service, while pre or post-exposure antibiotic prophylaxis for leptospirosis are not covered by the scheme.