‘Tsekap’: Philhealth has new benefits for indigents

MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) expanded its primary care package to benefit more than 15 million indigents and sponsored members.

The expanded package called Tamang Serbisyo sa Kalusugan ng Pamilya or Tsekap will be available in identified government and private health care facilities that will serve the following PhilHealth members:

• Indigent – as identified by the Department of Social Welfare and Development (DSWD), these are people who have “no visible means of income,” or whose income is not enough to sustain his/her family.
• Sponsored – persons whose contributions are being paid for by government agencies, private entities, or another individual.

About 15,068,028 families can now avail themselves of the following services:

• Medical consultations
• Regular blood pressure and body measurement
• Periodic clinical breast examination
• Cervical cancer screening
• Digital rectal examination
• Risk profiling for hypertension and diabetes
• Counseling for smoking cessation and lifestyle modification
• Oral check-up and prophylaxis for children 12 years old and below

Medicines and drugs may also be provided by PhilHealth-accredited drug outlets for the following medical conditions: 

• Asthma
• Acute gastroenteritis
• Upper respiratory tract infection
• Pneumonia
• Urinary tract infection
• Diabetes mellitus
• Hypertension
• Dyslipidemia
• Deworming
• Ischemic heart disease

Other diagnostic exams may also be availed of “when clinically necessary”:

• Complete blood count
• Blood typing
• Urinalysis
• Stool exam
• Chest x-ray
• Sputum microscopy
• Lipid profile
• Fasting blood sugar
• Creatinine
• Electrocardiogram
• Peak expiratory flow meter testing
• Blood glucose monitoring through blood glucose meters

Regardless whether it’s a public or private Tsekap provider, the “No Balance Billing” policy will apply. This means indigents and sponsored members do not have to pay any amount beyond what PhilHealth pays for during hospital admission. 

The health facility must enlist the family and establish their individual health profiles for the Electronic Medical Records.

This way, medical records are digitized, and the physician’s prescription will be sent to partner-pharmacies, where members can get their medicines packs. 

“Tsekap shall be initially rolled out to the indigent and sponsored members, but eventually it will be offered to all other sectors,” PhilHealth President Alexander Padilla said in a statement Friday, March 13. – Jee Y. Geronimo/Rappler.com