Lack of PhilHealth rules on coronavirus expenses leaves patient’s family in limbo

MANILA, Philippines – For 28-year-old Joseph Mercado and his family, their father’s fight against the coronavirus disease is just half the battle. They are also battling with hospital expenses.

Lito Mercado, 60, is a coronavirus patient confined at the Asian Hospital and Medical Center in Alabang, Muntinlupa. He is in stable condition, but aside from his recovery, his family is exhausting all means to pay the running hospital bill amounting to P1.4 million, so far.

On March 24, Joseph told Rappler that they were left with no choice but to admit his father to a high-end private hospital as he needed to be intubated immediately.  All the nearby hospitals were in full capacity and did not accept him.

“Naghanap na kami ng mga ospital. Naikot na namin Laguna, Batangas, at lahat ng ospital dito sa Muntinlupa kaso wala na talaga mag-accept. Nag walk-in kami sa Asian Hospital tapos na-admit agad ang father ko,” Joseph said.  

(We looked for hospitals. We looked around Laguna, Batangas, and all hospitals here in Muntinlupa but none of them accepted him. We went to Asian Hospital and Medical Center and they immediately admitted my father.)

Joseph said that his father started experiencing COVID-19 symptoms on March 16.

“Normal na ubo lang until March 17. And then March 18, nagdecide sila ng brother ko na magpatest na sa Asian hospital. Doon sila nagpa-swab test (He had normal cough on March 17, and then on March 18, he and my brother had themselves tested at the Asian Hospital. They had swab tests there),” he added. 

Joseph said they did not know how his father got infected since he has no travel history to countries with COVID-19 cases and no known exposure to a COVID-19 patient.

“Hindi talaga namin alam kung paano. Kasi ang activity niya lang naman araw-araw ay ihatid ang nanay ko na nagtatrabaho sa BuCor dito sa Muntinlupa. Ten minutes travel lang 'yun pag mula dito sa bahay namin, Joseph explained. 

(We really don't know how he got infected. His only activity every day is to bring my mother to work at the Bureau of Corrections here in Muntinlupa. It's just a 10 minute-travel from our house.)

Joseph also told Rappler that aside from his father, his eldest brother was also diagnosed with COVID-19. Their results came back on March 25. 

“He is recovering now and in stable condition. Malakas pa kasi siya kasi 32 years old (He is strong because he's only 32 years old),” Joseph said. 

He suspected that his brother got infected in Makati since his brother was working there. However, it remained unclear if his father was infected by his brother.

Joseph said that he had travel history to Japan. He arrived in the Philippines on March 11. As he feared that he might have contracted the virus uduring his trip, he immediately got tested for coronavirus, but the result came back negative on March 13.

Confusion

As they worried about the running hospital bill, Joseph coordinated with the Philippine Health Insurance Corporation (PhilHealth) for coverage of the expenses. 

“Ang alam ko talaga covered nila kasi nakita ko sa news 'yung sinabi ng PhilHealth president (From what I know expenses are covered by the PhilHealth since it's all over the news),” he said. 

In their communication with PhilHealth and the Asian Hospital and Medical Center, they were told that the state insurer will only cover P42,000 of the bill as of now – P32,000 for pneumonia-related disease and P14,000  for the isolation room. 

On March 26, PhilHealth president and CEO Ricardo Morales said that the state insurer will shoulder the hospital expenses of Filipinos should they be diagnosed with COVID-19.

Morales, however, said that he could not identify a definite set of benefits yet but gave assurances that PhilHealth will pay for “whatever it takes.”

“Hindi pa natin na fo-focus lahat 'yun kung ano ang gagastusin kasi iba-iba naman yung protocol na ginagamit sa ospital. May sarili silang procedures diyan (We haven’t ironed out yet the coverage of expenses since every hospital has different protocols. They have their own procedures),” Morales added.

Under the Universal Health Care Law, PhilHealth is tasked with implementing the National Health Insurance Program, which covers all Filipino citizens.

PhilHealth earlier announced that it was releasing a P30-billion budget to its accredited hospitals during the coronavirus outbreak. The state insurer said this was to cover all hospital expenses of coronavirus patients.

"Yes. It's like a cash advance which hospitals can draw from for any COVID-19-related expenses including testing," Morales said in a text message sent to Rappler on March 26.

But one week into his pronouncement, there was no definite coverage yet for coronavirus patients. 

Rappler has reached out to Morales for comment on the issue, but he has yet to reply as of posting.

As of Monday, March 30, the Philippines had 1,546 confirmed cases of coronavirus, with 78 deaths and 42 recoveries. – Rappler.com

Bonz Magsambol

Bonz Magsambol is a multimedia reporter for Rappler, covering health, education, and social welfare. He first joined Rappler as a social media producer in 2016.

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