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?
- What Other Procedures Are Covered by PhilHealth?
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:
|Case||Case Rate||Facility Level|
|Cesarean Section||₱19,000||2 to 4|
|Hysterectomy||₱30,000||2 to 4|
|Mastectomy||₱22,000||2 to 4|
|Appendectomy||₱24,000||2 to 4|
|Cholecystectomy||₱31,000||2 to 4, if laparoscopic, may also be in ambulatory surgical clinics|
|Herniorrhaphy||₱21,000||2 to 4, may also be in ambulatory surgical clinics|
|Thyroidectomy||₱31,000||2 to 4|
|Radiotherapy||₱3,000||3 to 4|
|Hemodialysis||₱4,000||Freestanding dialysis clinics, 2 to 4|
|Cataract||₱16,000||Ambulatory 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
- 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