Is Raspa Covered by PhilHealth?

PhilHealth implements a case rate payment system where the amount that PhilHealth will reimburse the patient depends on the specific illness/case. This coverage includes healthcare professional fees and facility charges. 

In this short guide, we’ll find out whether raspa is covered by PhilHealth, as well as other medical procedures that PhilHealth typically covers. 

Disclaimer: This article has been published for educational purposes only. Neither the author nor FilipiKnow is affiliated with PhilHealth, so specific queries about your membership and insurance benefits must be forwarded to the proper authority.

Table of Contents

Is Raspa or Dilatation and Curettage (D&C) Covered by PhilHealth?

Yes. PhilHealth Circular 011-12-20111, “Selected Surgical Case Rates-Additional Implementing Guidelines,” has set the case rate for Dilatation and Curettage (D&C) at ₱11,000. 

The entire case rate amount is directly paid to the facility and includes professional fees. D&C procedure is covered in Level 1 to 4 hospitals. 

Excluded in the benefits package is the performance of uterine evacuation and curettage for hydatidiform mole. 

What Other Procedures Are Covered by PhilHealth?

Additionally, PhilHealth also covers the following procedures: 

CaseCase RateFacility Level
Cesarean Section₱19,0002 to 4
Hysterectomy₱30,0002 to 4
Mastectomy₱22,0002 to 4
Appendectomy₱24,0002 to 4
Cholecystectomy₱31,0002 to 4, if laparoscopic, may also be in ambulatory surgical clinics
Herniorrhaphy₱21,0002 to 4, may also be in ambulatory surgical clinics
Thyroidectomy₱31,0002 to 4
Radiotherapy₱3,0003 to 4
Hemodialysis₱4,000Freestanding dialysis clinics, 2 to 4
Cataract₱16,000Ambulatory surgical clinics, 2  to 4

If there are multiple procedures done in one session, PhilHealth will cover the highest package. However, if there are multiple procedures done in separate sessions but in one admission period, PhilHealth will cover all packages. 

Return to the main article: How To Register in PhilHealth Online: A Complete Guide for New Members

Reference

  1. Philippine Health Insurance Corporation (PhilHealth). (2011, November 13). PhilHealth Circular No. 011-13-2011: Selected Surgical Case Rates-Additional Implementing Guidelines [Press release]. Retrieved September 20, 2022, from https://www.philhealth.gov.ph/circulars/2011/circ11-B_2011.pdf

Camille Lamera, MD

Camille Lamera is a medical doctor with clinical and government work experience. She has always been passionate about health education and public service, having worked in two government offices and as a part-time educator in Preventive and Community Medicine. She is currently working as a doctor in public health while also doing freelance academic and scientific writing.

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