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PhilHealth: Severe pertussis patients may claim up to P90,000 coverage

April 8 ------ Pertussis or whooping cough patients who require hospitalization may claim up to P90,000 from the Philippine Health Insurance Corp. (PhilHealth).

PhilHealth president and CEO Emmanuel Ledesma Jr. said in a statement over the weekend that the current case rate for pertussis patients who need to be confined ranges from P13,780 to P19,500, which includes both the hospital and professional fees. But should a patient develop severe pneumonia, a common complication of the disease, the PhilHealth benefit package can go up to P90,100. “We understand the concerns surrounding pertussis treatment and want to reassure the public that PhilHealth is fully committed to supporting individuals needing inpatient care for this illness,” Ledesma said.

Under Republic Act No. 11223, or the Universal Health Care Act, all Filipinos—whether or not they pay contributions—are automatically enrolled in the National Health Insurance Program implemented by PhilHealth.

Those experiencing symptoms of pertussis like mild fever, cough or cold can consult a doctor under PhilHealth’s Konsultasyong Sulit at Tama (Konsulta) package, Ledesma added. “If our kababayans need medical consultation, I encourage them to avail themselves of the free consultation and the medicines they need to treat the disease as recommended by the health-care provider under PhilHealth Konsulta. All they have to do is register,” he said.

Konsulta package inclusions

The package includes free consultation, targeted health risk screening and assessment, selected laboratory and diagnostic tests, on top of drugs and medicines recommended by the health-care provider. To avail of the package, one should register first with an accredited PhilHealth Konsulta provider among the 2,161 available nationwide. While pertussis is treatable with antibiotics, the Department of Health (DOH) and medical societies have urged parents to have their children vaccinated against the disease. Newborns may get the three-dose primary pentavalent shots at barangay health centers free of charge. The shots must be administered when they reach six weeks, 10 weeks and 14 weeks. Aside from pertussis, the pentavalent (5-in-1) vaccine also protects against diphtheria, tetanus, hepatitis B, and Haemophilus influenzae type B.

Significant threat

For older children, adults and pregnant women, the Philippine College of Physicians, the country’s umbrella organization of internists, has recommended that they get booster shots. However, these are not offered for free in health centers. The shots, which cost P2,000 each, are also not covered by any PhilHealth benefit package.

Based on DOH latest data, a total of 862 cases of pertussis have been recorded since the start of the year—a 30-fold increase compared to the same period last year. There have been 49 deaths so far. Outbreaks have also been reported in Quezon City, Iloilo City and Cavite province due to the surge in pertussis and measles cases, mostly among unvaccinated children. Pertussis is an acute respiratory infection caused by the bacteria Bordetella pertussis. The infection poses a significant threat particularly to infants and young children who are at risk of severe symptoms and life-threatening complications and outcome. While teens and adults may experience milder symptoms, there is a risk of severe illness, especially among those with preexisting health conditions and the unvaccinated elderly.

For patients who already contracted pertussis, a doctor will prescribe antibiotics treatment that should start as early as possible. Depending on the antibiotic used and the age and condition of the patient, treatment may run from four to 14 days. The DOH, however, reminded the public to consult a doctor first and use antibiotics only as prescribed. Patients were also warned against self-medication and to always complete the number of days for treatment. Pertussis is spread through coughing or sneezing but transmission may be prevented by practicing proper hygiene. This includes covering the mouth when coughing or sneezing and washing hands often.



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