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PhilHealth No Balance Billing (NBB) Policy for Sponsored Program Members Admitted in Government Hospitals
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PhilHealth recently announces that the No Balance Billing (NBB) policy pertaining to the availment of benefits under the new case rates is applicable to Sponsored Program members and / or their dependents admitted in accredited government hospitals due to any of the following medical conditions and surgical procedures:


MEDICAL CASES
Dengue I
P8,000.00
Dengue II
P16,000.00
Pneumonia I
P15,000.00
Pneumonia II
P32,000.00
Essential Hypertension
P9,000.00
Cerebral Infraction
P28,000.00
Cerebro-vascular accident with hemorrhage
P38,000.00
Acute Gastroenteritis
P6,000.00
Typhoid Fever
P14,000.00
Asthma
P9,000.00
Newborn Care Package
P1,750.00


SURGICAL CASES
Radiotherapy
P3,000.00
Hemodialysis
P4,000.00
Maternity Care Package
P8,000.00
NSD, Level 1
P8,000.00
NSD, Levels 2-4
P6,500.00
Caesarean Section
P19,000.00
Appendectomy
P24,000.00
Cholecystectomy
P31,000.00
Dilatation and curettage
P11,000.00
Throidectomy
P31,000.00
Herniorrhaphy
P21,000.00
Mastectomy
P22,000.00
Hysterectomy
P30,000.00
Cataract Surgery
P16,000.00



Sponsored Program members refer to indigent families whose enrolment into the National Health Insurance Program (NHIP) is made possible through the sponsorship of the local government units, private companies and individuals. Also included under the Sponsored Program are families listed under the National Household Targetting System for Poverty Reduction of the Department of Social Welfare and Development (DSWD) whose annual premium has been paid for by the National Government.

Accredited government hospitals must refer to the validity period stated in the Sponsored Program member‘s ID card to ascertain that availment of benefits is within the said validity period.

The NBB policy also applies when the Sponsored Program members avail themselves of outpatient surgeries, hemodialysis and radiotherapy in accredited non-hospital facilities that includes free-standing dialysis centers (FSDCs) and ambulatory surgical clinics (ASCs). It also applies when they are availing themselves of our existing outpatient packages for TB-DOTS, Malaria and HIV/AIDS.

At the same time, all other member-types are entitled to the NBB policy when availing themselves of the Maternity Care Package (MCP) and the Newborn Care Package (NCP) in accredited MCP (non-hospital) providers.

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