WITH the rising number of tuberculosis cases noted in the country, the Philippine Health Insurance Corporation (PhilHealth) today reminded members that treatment for pediatric and adult tuberculosis is covered through its outpatient Directly-Observed Treatment Short-course DOTS) Package.
Tuberculosis is caused by a bacterium called Mycobeacterium tuberculosis, acquired through inhalation of droplets containing tubercle bacilli. It ranks sixth among the leading causes of morbidity and mortality in the Philippines and claims 75 to 90 lives daily.
At the onset, it is characterized by cough and other symptoms such as loss of weight and energy, poor appetite, fever, and night sweats. Medical experts advise affected individuals to immediately consult a physician once these symptoms manifest.
PhilHealth President and CEO Dr. Eduardo P. Banzon said that members with confirmed TB cases may enroll in the TB-DOTS program through any of the more than 800 private and public health facilities nationwide. "PhilHealth pays P4,000.00 for the entire six-month treatment which includes diagnostic work-up, consultation services and drugs provided on or after enrolment into the DOTS," Banzon said.
The outpatient TB-DOTS Package is designed only for new cases of pulmonary and extra-pulmonary TB in children and adults and does not cover cases of patients who returned for treatment after interruption for two or more months.
The accredited DOTS center shall submit a copy of the National Tuberculosis Program (NTP) treatment card of the PhilHealth beneficiary to the PhilHealth Accreditation and Quality Assurance Division of the PhilHealth Regional Office within 60 days from initiation of treatment. Not all patients need the recommendation of the TBDC; only those with negative sputum exam but with signs and symptoms suggestive of TB shall need the TBDC recommendation during enrolment.
To be able to maximize the benefit, a member or dependent must have updated premium contributions within the duration of treatment. Employed and individually paying members must have at least three monthly contributions within a six-month period immediately before the month of availment. For Lifetime members, they must present their Lifetime Membership Program ID to avail of the benefit. On the other hand, Overseas Filipino Workers and Sponsored members may avail themselves of the treatment benefit within the date of effectivity of membership as stated in their ID card or Eligibility certificate.
After completion of treatment, members are enjoined to continue paying their premium contributions so that they can avail of their PhilHealth benefits anytime especially in times of medical emergency.
As of December 2011, PhilHealth has paid P22,875,000 for 10,822 TB-DOTS cases. (END) (by Jonathan M. Yao)