No Balance Billing Policy Philhealth
What is no balance billing policy of Philhealth?
No balance billing policy of Philhealth simply means that no other fees or expenses shall be charged or paid for by the indigent patients above and beyond the packaged rates during their confinement period.
Members of Philhealth covered by the no balance billing policy:
- Indigent
- Sponsored
- Kasambahay
- Lifetime
- Senior Citizen
Indigent – a person who has no visible means of income or whose income is insufficient for family subsistence, as identified by the DSWD based on specific criteria.
Sponsored – a member whose contribution is being paid by another individual, government agency, or private entity.
Kasambahay (Domestic Worker) – refers to any person engaged in domestic work within an employment relationship such as but not limited to the following:
- General Househelp
- Nursemaid or Yaya
- Cook
- Gardener or
- Laundry Person
Senior Citizen – refers to any Filipino citizen who is a resident of the Philippines and aged 60 years or above.
Lifetime – a member who has reached the age of retirement under the law and has paid at least 120 monthly premium contributions.
What are the benefits covered?
- All Case Rates
- Z Benefit Packages
- Primary Care Benefit
- Other covered benefits: a. Middle East Respiratory Syndrome Corona Virus (MERS-CoV) Benefit b. Ebola Virus Disease (EVD) Benefit package
Source: Philhealth
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