PhilHealth now covers cartridge-based PCR tests

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To further boost the country’s targeted testing capacity, the Philippine Health Insurance Corporation (PhilHealth) is now paying for SARS-CoV-2 testing using cartridge-based polymerase chain reaction or PCR tests.

According to its PhilHealth Circular No. 2021-0003, the benefit can be availed of by all PhilHealth members as prescribed by the Department of Health.

The new benefit package ranges from Php 1,059 to Php 2,287 and will be paid directly to the accredited testing laboratories following these conditions:

Condition for paymentAmount
PCR cartridges are donated to the testing laboratory; the cost of running the cartridge-based PCR test is subsidized by the governmentPhp 1,059
PCR cartridges are donated to the testing laboratoryPhp 1,099
All services and supplies for the testing are procured and provided by the testing laboratoryPhp 2,287

Members eligible to the said benefit is determined through the DOH Memorandum No. 2020-0258-A which enumerates the priority sub-groups of “at-risk” population needing SARS-CoV-2 testing which include individuals with symptoms and relevant history of travel and/or contact; those with no symptoms but with relevant history of travel or contact or high risk of exposure; contact-traced individuals; healthcare workers; other vulnerable patients like pregnant women, immunocompromised and dialysis patients; returning Overseas Filipino Workers who shall immediately be tested at the port of entry; frontline and economic priority workers; including mass media. 

Eligible members should not be charged co-payment/additional payment beyond the set rates, except when availing of extra services such as online appointments, drive thru and home services, among others.

For more details on this package, members and accredited testing laboratories are encouraged to read the full guidelines at https://www.philhealth.gov.ph/circulars/2021/circ2021-0003.pdf or visit the nearest regional or local health insurance office for direct assistance. ###  

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