At any point in anyone's life, there is a place for a physical therapist - when a newborn struggles to move due to delayed movement patterns such as walking, a student who fractured her elbow while playing during recess, a teenager developing knee pain due to excessive football, a college student with a very sore neck from all the studying, the yuppie whose back is in constant pain as he proves himself at his first job, the middle-aged mother whose knee has to be replaced and the lolo of the family who had an unprecedented heart attack. Physical therapy (PT) is for everyone, across the life span, from minor to life-altering injuries. Health is wealth but in the Philippines, wealth is health! Let's talk about a taboo topic in our culture: money.
Is PT covered in Philhealth?
Local Philippine insurance, Philhealth covers some PT services
Amputation: 17,500 to 135,000 PHP
Due to Diabetes, vehicular accidents, congenital and other causes of partial or complete removal of one's limb, amputations can be covered by Philhealth. Limb prosthesis, limb orthosis, and spinal orthosis with integrated rehabilitation service are included in this coverage. The patient must consume 6 physical therapy or occupational therapy sessions by PRC-licensed physical therapist (PT) or occupational therapist (OT). Prior to any sessions with a PT or OT, a prescription by a Physiatrist or Rehab Doctor. Coverage rates range from 17,500 to 135,000 depending on area and laterality of prosthesis/orthosis provision. All eligible Philhealth members and qualified dependents may avail, with specific criteria depending on prosthesis or orthosis prescribed.
Children with Developmental Disabilities: 3,626 to 5,276 PHP
Eligible children with developmental disabilities such as Cerebral Palsy, Down syndrome and Global Developmental Delays can only avail of a maximum of nine sets of therapies costing 5,000 PHP per set. Each set of therapies has a maximum of 10 sessions.
Will my health card cover PT?
Maxicare: PT and OT procedures are covered at 100% actual cost for up to 12 sessions per member per year. Therapy of 1 body area shall be considered as 1 session. This does not cover specialized program like cardiac and pulmonary rehab.
Intellicare: PT for a maximum of 12 sessions per year
PhilCare: 16 sessions per member per year for the principal member and up to 10 for dependents. This does not cover specialized program like cardiac and pulmonary rehab.
What is a Health card vs. Health Insurance?
Health cards or Health Maintenance Organization (HMO) Cards only covers costs availed from healthcare providers within their network, hence is more restrictive. In cases of hospitalization, the room type is dependent on HMO policies. Premiums are lower than that of health insurance. HMOs charge hospital bills yearly, with a maximum amount. Patients are only covered until age 65 and the card is renewed annually. Progressive employers usually provide their employees with health cards or HMO (Health Maintenance Organization) cards as part of the employment process geared towards ensuring proper healthcare services to their members. HMO is a network of accredited healthcare providers such as hospitals, doctors, and clinics from which a member can avail services. It typically covers emergency services, laboratory procedures, prescription drugs, inpatient expenses and outpatient expenses.
Health Insurances require higher premiums, higher deductibles and higher co-pays than HMOs. These may also cover cost availed from providers out of their network. After being diagnosed, the health insurance provider issues a lump sum money for managing the condition. Patients have the discretion to chose their preferred healthcare provider including those outside of the health insurance network. Insurances usually cover until 100 years of age. Hospitalization entails daily cash provision to offset income loss d/t hospitalization. Premiums are already fixed throughout life.
You can get reimbursed with us!
Doctors' online consultations, online PT sessions and sessions at the comfort of your home could all be covered as outpatient expenses! Kakayanan Digital Rehab Inc is a SEC registered corporation that is able to provide you a guarantee on quality and accountability. Our group is made up of committed Filipino PTs who aim to elevate the quality of rehabilitation locally. Through collaborations with each other, cohesive coordination with our doctors and putting our patients' and their families' needs at the center of our care, you are assured of high quality health care with us.
If you have availed of our services in the past or considering to, then let us help you reimburse those out-of-pocket costs from your HMO. Here’s the six steps you need to know:
1. Secure your Medical Certificate
Just as important as your prescription for medicines, your medical certificate and/or referral to PT is the first document that you will need for reimbursements. By Philippine law, this must be issued by a Physiatrist or a Doctor of Physical Medicine and Rehabilitation (Rehab Med). Kakayanan has a roster of Rehab Medicine Doctors such as the ones below, who could easily accommodate any schedule through our virtual clinic which you may access through the button below. Need to inquire? Reach Aira at 0905 333 0709.
2. Choose a PT service that works for you