COVID-19 claims in WV reach P3B – PhilHealth

By Joseph B.A. Marzan

The Philippine Health Insurance Corporation (PHIC or PhilHealth) reported on Tuesday that claims related to the coronavirus disease 2019 (COVID-19) have so far totaled to P3.508 billion.

Data provided by PhilHealth to the media on Tuesday include the following COVID claims made by patients from the beginning of the pandemic in 2020 up to May 26, 2022:

– P1.077 billion for 1,577 claims of critical patients;

– P829 million for 2,576 claims of severe patients;

– P609 million for 4,390 claims of moderate patients;

– P31.5 million for 726 claims of mild patients; and

– P57.25 million for 277 claims of Financial Risk Protection against COVID.

The following were also included in the P3 billion sum for COVID testing and community isolation:

• P455 million for 137,904 claims of all COVID testing services;
• P316 million for 149,563 claims for free testing kits;
• P97 million for 108,874 claims for free testing kits and running of RT-PCR machines; and
• P476,000 for 34 community isolation claims.

COVID-19 Benefit Packages offered by the PhilHealth include the following sums of up to:

• P786,384 for critical COVID patients;
• P333,519 for severe COVID patients;
• P143,267 for moderate COVID patients;
• P43,997 for mild COVID patients;
• P2,800 for all COVID testing services;
• P1,200 for free COVID testing kits;
• P800 for free testing kits and running of RT-PCR machines;
• P22,449 for community isolation;
• P5,917 for home-based isolation; and
• P100,000 as vaccine injury compensation package.

Meanwhile, PhilHealth also paid out P6.08 billion for 858,052 claims lodged across the region, comprising of both COVID and non-COVID causes.

The state-run insurance provider also accredited Konsultasyong Sulit at Tama (Konsulta) providers in several Aklan, Antique, and Guimaras public health facilities to ensure access to quality health care services without high costs and unnecessary travel to denser areas.

Konsulta is the primary care benefit package of PhilHealth, paid per capita and covers a defined set of primary care health services based on their life- stage, health risks, and needs for which all Filipinos are entitled to, in accordance with the provisions of Republic Act No. 11223 (Universal Health Care Act).