How to Apply for Health Assistance at PCSO (and Other Offices)

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Sickness is like a thief in the night. You will never know when it will strike. Unfortunately for many Filipinos who do not have enough economic safety nets to endure sudden medical expense shocks, getting fund for treatment might be quite difficult.

Lucky you if you have  a health plan or HMO coverage from your company, covering the cost is easier – unless your illness happens to be excluded from coverage or you’ve maxed out your plan’s limit.

If you don’t have any, there are government agencies you can rely on for those extraordinary circumstances – like accidents, chronic illnesses and cancer, for example.

 

A few of these are Philhealth, the Department of Health (DOH), Department of Social Welfare and Development (DSWD) and Philippine Charity Sweepstakes Office (PCSO).

However, before going to them for help, make sure your requirements are complete.

Requirements usually start with having a formal diagnosis and a course of treatment for your condition. Unfortunately, laboratory tests and consultations are usually not covered by aid from these institutions.

They may cover part of the procedure if you need to use the operating room to get biopsy samples but these bills are not fully covered all.

However, when the situation calls for enlisting every help you could get, these tips may come in handy. The diagnosis is just the start of a long and costly treatment and recovery ahead.

 

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PCSO

All Filipinos who are hospitalized or receiving medical treatment can apply for the PCSO Individual Medical Assistance Program (IMAP). You don’t have to be an

indigent patient to get approval; you don’t have to personally know anyone serving a government position to become a PCSO medical financial assistance beneficiary.

Any Filipino can apply to become a recipient of PCSO Medical Charity program as long as the patient fulfills any of the following criteria:

 

  1. You are confined in any health facility.
  2. You are receiving health care management as outpatient.
  3. You are seeking health care management in another country, because there is no existing health facility within the Philippines that can provide the procedure that your illness demands.

 

Apply to Become a Beneficiary of PCSO Medical Financial Requirements to Apply PCSO Medical Assistance

If you meet the criteria above, you now need to prepare all the needed requirements, the documents and papers that you need to submit to the Philippine Charity Sweepstake Office to avail the Medical Assistance.

Once you get approval like for hospital confinement there will be a PCSO guarantee letter that is issued to the hospital or partner health facility, detailing that PCSO will assume the obligation to pay a specific amount due of the patient to the health provider.

Unfortunately, PCSO usually will not be able to shoulder the full amount due of the patient-beneficiary for the treatment received. This is because the Individual Medical Assistance Program deals with thousands of patients every day all over the Philippines. All these patients need financial assistance and PCSO gives as much help as they can to everyone who applies for medical financial assistance within the budget allocation for the program. But still, financial help is a welcome thing no matter the amount. But of course we pray and hope that you will be granted and approved for a big amount from PCSO.

Here are the list of documentary requirements when you apply for PCSO medical assistance:

 

Prepare all the necessary documents before going to the PCSO to avoid inconvenience:

 

  1. Duly accomplish PCSO IMAP Application Form – if the hospital has its own PCSO desk you can get it from there. If none, you need to go to the nearest office of PCSO.
  2. Original / Certified True Copy of the Updated Clinical Abstract duly signed by the attending physician with License Number. If you are requesting for free wheelchair, you only need to present medical certification.
  3. Valid ID of patient and representative – bring any government issued identification card like Passport, UMID, Driver’s License, GSIS eCard, Senior Citizen’s ID, DSWD – 4P’s ID, Voter’s ID, Postal ID, PRC ID. If you do not have any government issued ID, you can also present company ID or student ID.
  4. Additional (as applicable) – *Authorization Letter from patient is needed in cases where there is no immediate relative available for interview.

 

All cases applied for in PCSO requires the documents listed 1,2,3 above. Then aside from the above, there are additional requirements which are case specific.

 

Additional Requirements for Special Cases

 

A. For Confinement

  1. Original copy of the Statement of Account / Hospital Bill duly signed by the Billing Officer / Credit Supervisor”
  2. Endorsement from the Medical Social Services of the health facility (for charity / service patients).

 

B. For Dialysis

  1. Endorsement / Certificate of Acceptance of PCSO Guarantee Letter
  2. Note: This is not required in the cases of health facilities where there is a PCSO desk.
  3. Official quotation from service provider
  4. Relevant laboratory results
  5. Certification from Dialysis Center
  6. Beginning 2016 – There is a NEW PROCEDURE for those seeking Dialysis assistance from PCSO. Please read this separate post – How to Apply for PCSO
  7. Assistance for Dialysis Patients – Hemo and Peritoneal Dialysis.

 

C. For Medicines including Chemotherapy:

  1. Relevant laboratory results
  2. Photocopy of Histopath / Biopsy Report
  3. Original prescription duly signed by physician with license number
  4. Progress Notes from the doctor / oncologist.

 

D. For Radiotherapy

  1. Endorsement / Certificate of Acceptance of PCSO Guarantee Letter
  2. Note: This is not required in the cases of health facilities where there is a PCSO desk.
  3. Official quotation from service provider

 

  1. Surgical Supplies
  1. Official quotation with breakdown of expenses.

F. Implant

  1. Official sealed quotation from 3 suppliers
  2. Copy of physician’s order with implant specification
  3. Police Report – for medico-legal cases

G. Laboratory / Diagnostic Procedures

  1. Official quotation from service provider
  2. Laboratory request duly signed by physician

 

The medical and assistive devices examples are listed below. If you need a medical device not specified below, do not lose hope immediately. Visit a PCSO office to ask about your particular case as you may be granted assistance for what you need.

H. Medical Devices (Pacemaker, Septal occluder, Percutaneous Coronary Intervention (PCI), and more)

  1. Official sealed quotation from 3 suppliers

I. Assistive Devices – Hearing Aid (Bone Anchored Hearing Aid (BAHA))

  1. Official sealed quotation from 3 suppliers
  2. Audiological Evaluation Report signed by a Licensed Audiologist

J. Assistive Devices – Wheelchair

  1. Official sealed quotation from 3 suppliers
  2. Progress note from the doctor

K. Assistive Devices – Prosthesis (Arm, Leg, Eye)

  1. Official sealed quotation from 3 suppliers

L. Assistive Devices – Pulmonary Apparatus (rental of ventilator /respirator)

  1. Official quotation from service provider

M. Non and Minimally Invasive Procedures (Laparoscopic Surgery, Endoscopic procedure, ESWL, etc)

  1. Endorsement / Certificate of Acceptance of PCSO Guarantee Letter

 

Note: This is not required in the cases of health facilities where there is a PCSO desk.

  1. Relevant laboratory result

N. Transplant (Kidney, Liver, etc)

  1. Relevant laboratory result
  2. Cross – matching result
  3. Certification of patient’s inclusion in transplant program from authorized representative of NKTI, if applicable.
  4. Relevant PhilHealth tracking number certification

O. Rehabilitative Therapy (Physical, Occupational, Speech)

  1. Official quotation from service provider
  2. You can also apply at PCSO for Cardiac procedures like Pacemaker surgery, Congenital Heart Surgery, Coronary Artery Bypass, Aneurysm Surgery, Peripheral bypass surgery, Angioplasty, also included are cardio diagnostic procedures like Coronary Angiogram and Cardiac Cauterization.

Bring all the needed documents when you apply at PCSO office for medical financial assistance.

Please take note that every applicant must submit requirements number 1, 2, and 3 above, plus the case-specific requirement(s).

Also, if the patient doesn’t have any immediate relative that can be interviewed by the PCSO, the patient must also sign an authorization letter indicating the name of the non-relative who will be

interviewed for the patient’s case.

Reminder: With the abolition of the PDAF/Pork Barrel funds, many of those who used to go to their congressmen for help now go to PCSO for assistance. The lines are long and they are strict with the documentation so you need to make sure your papers are in order before going.

 

Other Institutions That Might Help

 

Here are a few institutions you can approach to ease your burden:

 

PhilHealth

To avail of your Philhealth coverage, you need to have your ID, your filled-out CD1 form signed by your HR department or company representative and your MDR or record of payment (unless you are a permanently covered member like senior, indigent and retired citizens). If you are a paying member, you need to have at least paid the last six months of fees. The same goes for dependents.

Senior citizens now have automatic coverage but please visit their website to understand and maximize your benefits.

Philhealth has now increased their coverage for cases they consider “as economically and medically catastrophic”, which are serious illnesses like certain cancers, kidney transplantation, heart bypass surgery among others.

 

DSWD

Did you know that DSWD offers aid to indigents and those referred by their local congressman? The latter is due to the scrapping of PDAF but you may still want to ask you local social worker or your congressman’s office for referral. It doesn’t make the process faster but they can help you understand the process better.

To apply for aid, you need patience (because of the long lines) and the following documents:

  • Case study by the social worker
  • Barangay Certification (that you are a resident in the area)
  • Medical abstract and course of treatment from the doctor and/or
  • Relevant receipts.

Please take note that they take around three weeks to a month to process your request and they do not cover everything. I believe the maximum coverage is PhP 75,000 but please visit their website for clarification.

Sources

Pcso.gov.ph. (2017). [online] Available at: http://www.pcso.gov.ph/wp-content/uploads/2016/05/Charity-Assistance-Department.pdf [Accessed 2 Apr. 2017].

Onlinefilipinoworkers.com. (2017). How to Get Philippine Charity Sweepstakes Office (PCSO) Medical Assistance Must Know – Steps and Requirements. [online] Available at: http://www.onlinefilipinoworkers.com/2015/02/loans-how-to-get-philippine-charity-sweepstakes-office-pcso-medical-assistance-requirements.html [Accessed 2 Apr. 2017].

Pcso.gov.ph. (2017). Philippine Charity Sweepstakes Office. [online] Available at: http://www.pcso.gov.ph/charity/individual-medical-assistance-programs/ [Accessed 2 Apr. 2017].