# PHILHEALTH COVERAGE and REIMBURSEMENTS



## Ataneojr1 (Jun 2, 2013)

My father was recently admitted to Riverside Dr Pablo Torre Hospital in Bacolod City,****** after suffering a stroke.He is in a comatose/vegetative state.he is 75 years old.My dad and my mom are US Citizens of Filipino Birth and they do have PhilHealth for insurance.my question is so far they owe almost $4000 USD in bills and he has only been there since May22.They are living off their SSI and my mother has tried to pay as much as she can but she has no money left and we have to send her money via Western Union just so she can eat and pay for transportation.We are trying to get there Asap but tickets are very expensive so one of us wont be there till next week or even the next.I know the medical cost there is not that expensive compared to the US but they are charging her $700 A DAY!!!! We cant get an answer from billing about how she will be reimbursed by PhilHealth, what is the Max Charge for Procedures, Max Out of Pocket.We cant get a straight answer from her or the hospital.We dont know what do since we arent there yet.She has help from distant relatives but it is mostly emotional and companionship.
Does anyone know how PhilHealth works? Do they cover 50/30/20 percent only?Do they cover Catastrophic Illness like this? How can we contact anyone from PhilHealth direct?
We also have heard Horror Stories of Hospitals in the Philippines not Releasing Patients Until they pay the Whole Bill.Who can do that unless you are a millionare?
My family and I welcome any information or suggestions from you guys.Thanks


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## Not Sure (Jun 3, 2013)

You might want to figure out if that is a private hospital or a public one.

I know that provincial hospitals can be dicey. Poor ones require you to come up with cash for your own medicine and everything as you go. Private ones are expensive by local standards. $700 is 30,000 pesos which is like a month salary for a professional in the province. It sounds like you might be dealing with a private, "expensive" hospital.

At 75, you and or your parents would hopefully have considered their likely need for advanced care and would have discussed a plan in advance. I hope that others who read this will consider what it might mean for their children to have to deal with a situation like this without a plan or guidance. Continuing to reside in a province far from top tier care and far from relatives with means to assist is a choice with implications for situations like this. It sounds like a nightmare and I am sorry to hear about it.

As far as Philhealth goes I have no idea about care for elderly and what is covered. They likely do not normally go to the extremes that the US system does to extend life by a year or even months or weeks. A poor hospital may look at a US citizen in this situation and realize there is a good chance that someone will show up and pay a bill that locals normally would not or could not pay.

I do know that my wife filled out some paperwork and received a small reimbursement from Philhealth that covered around 20% of the cost of delivering our baby via CS. We were at St. Lukes Global though so consider that is one of the most expensive/best hospitals. It was nice but no where near enough to cover top tier private care. It might have covered a good portion of the bill at a cheaper public hospital.

You might also reach out the US Embassy in Manila for advice. Look on their website for information. Philippine government documents and forms are in English so you might find material on Philhealth's website.


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## Phil_expat (Jan 3, 2011)

Ataneojr1 said:


> My father was recently admitted to Riverside Dr Pablo Torre Hospital in Bacolod City,****** after suffering a stroke.He is in a comatose/vegetative state.he is 75 years old.My dad and my mom are US Citizens of Filipino Birth and they do have PhilHealth for insurance.my question is so far they owe almost $4000 USD in bills and he has only been there since May22.They are living off their SSI and my mother has tried to pay as much as she can but she has no money left and we have to send her money via Western Union just so she can eat and pay for transportation.We are trying to get there Asap but tickets are very expensive so one of us wont be there till next week or even the next.I know the medical cost there is not that expensive compared to the US but they are charging her $700 A DAY!!!! We cant get an answer from billing about how she will be reimbursed by PhilHealth, what is the Max Charge for Procedures, Max Out of Pocket.We cant get a straight answer from her or the hospital.We dont know what do since we arent there yet.She has help from distant relatives but it is mostly emotional and companionship.
> Does anyone know how PhilHealth works? Do they cover 50/30/20 percent only?Do they cover Catastrophic Illness like this? How can we contact anyone from PhilHealth direct?
> We also have heard Horror Stories of Hospitals in the Philippines not Releasing Patients Until they pay the Whole Bill.Who can do that unless you are a millionare?
> My family and I welcome any information or suggestions from you guys.Thanks


I suffered a stroke myself and spent 3 days and 2 nights in Angeles University hospital in Angeles. I paid about 40,000 pesos bill. $4,000 (170,000 pesos) does seem high! I know others that spent about the same time in a hospital as I did and paid 20,000 pesos. I do not have Phil Health but my understanding is they pay 20%. I have heard if the hospital is not a government hospital they want full payment before discharging the patient. 
Things do get confusing here and the rules changes fast and not applied the same. I know of a man that signed a promissory document to pay his bill and was release. Another an arm guard keeps him in the hospital till paid. 
Living in the Philippines requires one to know a good doctor and the best hospital before disaster strikes.


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