I.

PHILHEALTH

BENEFIT COVERAGE

Inpatient Coverage
Subsidies for hospital room and board fees, drugs and medicines, x-ray and other
laboratory exams, operating room and professional fees for confinements of not
less than 24 hours.

Outpatient Coverage
Day surgeries, dialysis and cancer treatment procedures such as chemotherapy
and radiotherapy.

SPECIAL BENEFIT PACKAGES

1. CASE RATES
MEDICAL CASES
1. Dengue I (Dengue fever, DHF
grades I&II)
2. Dengue II (DHF grades III&IV)
3. Pneumonia I (moderate risk)
4. Pneumonia II (high risk)
5. Essential Hypertension
6. Cerebral Infarction (CVA-I)
7. Cerebral Hemorrhage (CVAII)
8. Acute Gastroenteritis (AGE)
9. Asthma
10.
Typhoid Fever
11.
Newborn Care Package
in Hospitals and Lying In
Clinics
SURGICAL CASES
1. Radiotherapy
2. Hemodialysis
3. Maternity Care Package
(MCP)
4. NSD Package in Level I
Hospitals
5. NSD Package in Levels 2 to 4
Hospitals
6. Caesarean Section

8,000
16,000
15,000
32,000
9,000
28,000
38,000
6,000
9,000
14,000
1,750

3,000
4,000
8,000
8,000
6,500
19,000

7. Appendectomy
8. Cholecystectomy
9. Dilatation and Curettage
10.
Thyroidectomy
11.
Herniorrhaphy
12.
Mastectomy
13.
Hysterectomy
14.
Cataract Surgery

24,000
31,000
11,000
31,000
21,000
22,000
30,000
16,000

2. TB Treatment through DOTS Package

Treatment of new cases of pulmonary and extra-pulmonary tuberculosis in
children and adults are covered through the Directly Observed Treatment
Shortcourse or DOTS, the shortest and most effective internationally
accepted treatment protocol for tuberculosis (TB).
INCLUSIONS
Amount of Coverage

4,000

Services

Diagnostic work-up, consultation

services and anti-TB drugs required
in an outpatient setup

Providers

Duly accredited TB-DOT Centers

Eligibility

New cases only i.e. patient has

never had treatment for TB or who
has taken anti-TB drugs for less
than one month.
Enrolment with TB-DOTS Center
falls within the validity period as
statedin the Member Data Record

3. SARS and Avian Influenza Package

Amount of
Coverage

For members and their qualified dependents - Php 50,000 per

case
For health care workers(forefront and high risk) - Php 100,000
per case

Services

Professional fees (Php 2,500 - pay to doctor)

Hospital charges (Php 42,500 - pay to hospital)
Official receipts amounting to Php 12,000 (Php 5,000 - pay to
member)

Providers

Patients must be admitted only in accredited DOH-designated

SARS or AI/IP hospitals.

Confinements abroad shall be paid compensated provided a
certification from the attending physician is submitted
Eligibility

Must be certified by the DOH as SARS or avian

influenza/influenza pandemic patient
Confinement within the validity period as stated in the Member
Data Record

4. Novel Influenza (AH1N1) Package

To mitigate the direct medical cost for the treatment of complicated

human cases of novel Influenza A (H1N1) with complication or comorbidities requiring hospitalization. The following shall be effective in all
local and overseas confinements with admission dates starting May 1,
2009.

INCLUSIONS
Amount of
Coverage

Maximum of Php 75,000 for non-health worker-members

Maximum of Php 150,000 for health worker-members

Services

For Members/Dependents:
- Room and board allowance of 1,500/day but up to 10,000 only
- Drugs and medicines; X-ray, lab and others (including
supplies and personal protective equipment and transfer
services) and operating room fees 50,000
- Professional fees of 1,000/day but up to 15,000 only
For Health Care Workers:
- Room and board allowance of 1,500/day but up to 20,000 only
- Drugs and medicines; X-ray, lab and others (including
supplies and personal protective equipment and transfer
services); operating room and other medically necessary care
100,000
- Professional fees of 1,000/day but up to 30,000 only

Providers

Hospitals designated by DOH as referral centers (national, subnational and satellite) for Influenza A (H1N1) and other
emerging and re-emerging diseases with the exception of
confinements abroad.
Admissions in private hospitals may be covered if confirmatory
tests were coordinated with or confirmed by the RITM, DOH-

CHD or other DOH certified laboratories.

Eligibility

Limited to members and health qualified workers with novel

swine-origin influenza A (H1N1) virus infection confirmed by
the Department of Health (DOH)
Confinement within the validity period as stated in the Member
Data Record
For qualified health care workers (HCWs):
- Rendered service in a DOH-designated hospital for Influenza A
(H1N1) and contracted the disease while performing their
duties and or caring for an influenza A (H1N1) patient as
certified or attested by DOH.
- Qualified dependents of HCWs who also contracted the
disease shall be provided a maximum coverage of Php 75,000.

II.

FUNERAL SERVICES TO BE PROVIDED BY ST. MARKS FUNERAL HOMES

Breakdown
Body Preparation
Burial Vault
Burial Shroud
Casket
Clergy/Officiant
Death Certificates
Embalming
Direct Burial at a Cemetery
Cremation
Flowers
Grave Marker
Grave Opening and Closing
Grave Plot
Gravesite
Hearse
Obituary
Printed Materials
Urn
Procession

III.

Cost

COMMON SICKNESS ACQUIRED BY EMPLOYEES WORKING IN FUNERAL

SERVICES

DISEASES
1. Tuberculosis
2. Cancer
3. HIV

Due to percutaneous exposure to infected

blood

4. Hepatitis B
5. Myeloid Leukaemia

Three types of hazard are always associated with the handling of deceased
humans: microbial, psychological and ergonomic (Hindi ko sinali itong dalawa
kasi hindi talaga death-causing yung diseases). A fourth type of hazard chemical exposure - is introduced when embalming is performed.

Microbial Hazards
Death is often caused by disease. After death the germs that caused the disease
may continue to live in the deceased person and can infect the people handling
the dead body.

Chemical Hazards
Embalming procedures introduce a number of potent chemicals into the
workspace of funeral workers. Perhaps the most widely used and toxic of these is
formaldehyde. Formaldehyde is irritating to the mucous membranes, the eyes,
the nasal lining and the respiratory system, and has been associated with
mutagenic cell changes and the development of cancer, as well as occupational
asthma. During the past several decades the occupational exposure level
associated with no adverse effects has been consistently lowered.

SOURCE:
http://cancerres.aacrjournals.org/content/44/10/4638.full.pdf