Areas under state of calamity entitled to special privileges from PhilHealth

Areas under state of calamity entitled to special privileges from PhilHealth

In the wake of the devastation brought about by Severe Tropical Storm "Paeng" (Nalgae), President Ferdinand Marcos Jr. signed Proclamation No. 84 declaring Calabarzon, Bicol, Western Visayas, and the Bangsamoro Autonomous Region in Muslim Mindanao under a state of calamity for six months.

In response to the declaration of state of calamity, the Philippine Health Insurance Corporation is extending various special privileges to affected members, employers, and healthcare facilities to ensure the continuous provision of health care services to all Filipinos adversely affected by fortuitous events.

In PhilHealth Circular 2020-0007, special privileges are granted by ensuring "continuous access to PhilHealth benefits and substantial aid to Health Care Institutions in rebuilding their critically damaged health care system", provided that a declaration of state of calamity is issued by competent authorities.

Affected members are granted exemption from the 45-day benefit limit and single period of confinement rule, as well as coverage even for confinements under 24 hours. The deadline for the payment of contributions for self-paying members shall likewise be extended to provide greater financial flexibility.

The same will also apply to the employer in the affected areas.

On the other hand, affected health care institutions shall be entitled to extended submission of claims from 60 to 120 calendar days, reimbursement for both referring and receiving health care institutions, extension on the submission of the mandatory reports, extension of validity of accreditation and/or submission of application of health care providers, and reimbursement for destroyed claims.

Affected health care providers are requested to send a letter request to the concerned PhilHealth Regional Office for the application of the said policy.

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