EXECUTIVE ORDER NO. 106 December 24, 1986
RESTRUCTURING THE MEDICAL CARE BENEFITS UNDER THE PHILIPPINE MEDICAL CARE PLAN
WHEREAS, actuarial studies show that without increasing contributions, current benefits under the Philippine Medical Care Plan, otherwise known as the Medical Program can be increased for certain items only and at different rates for the two sectors of beneficiaries covered:
NOW, THEREFORE, I, CORAZON C. AQUINO, President of the Philippines, do hereby order:
Sec. 1. The medical care benefits to Medicare beneficiaries covered by the Social Security System (SSS) shall not exceed the rates indicated below:
|
HOSPITAL CATEGORY |
|
BENEFIT |
PRIMARY |
SECONDARY |
TERTIARY |
|
1. Room and Board |
P30/day |
P35/day |
45/day |
|
2. Medical Expense(per single period of confinement) |
|
|
|
|
2.1 Ordinary Cases
|
|
|
|
|
2.1.1 Drugs & Medicines
|
175 |
200 |
300 |
|
2.1.2 X-ray/ Laboratory/ Others
|
75 |
150 |
350 |
|
2.2. Intensive Care Cases
|
|
|
|
|
2.2.1 Drugs & Medicines
|
375 |
400 |
500 |
|
2.2.2 X-ray/Laboratory/Others
|
125 |
200 |
500 |
|
2.3 Catastrophic Cases
|
|
|
|
|
2.3.1 Drugs & Medicines-
|
|
800 |
1,000 |
|
2.3.2 X-ray/Laboratory/Others
|
|
400 |
1,000 |
|
3. Medical/Dental Practitioner's Fee shall be P15.00 per day not to exceed: |
|
|
|
|
3.1 For Ordinary Cases (per single period of confinement)
|
200 |
200 |
200 |
|
3.2 For intensive Care/Catastrophic Cases (Per single period of confinement)
|
300 |
300 |
300 |
|
4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P650.00 |
|
|
|
|
5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's fee. |
|
|
|
|
6. Operating Room Fee for Surgical Procedures with Relative Unit Value of: |
|
|
|
|
0 - 5
|
30 |
35 |
65 |
|
5.1 - 10
|
|
120 |
165 |
|
10.1 - above
|
|
170 |
225 |
|
7. Fees for surgical family planning procedures as may be determined by the Commission |
|
|
|
Sec. 2. The medical care benefits of Medicare beneficiaries covered by the Government Service Insurance System (GSIS) shall not exceed the rates indicated below:
|
HOSPITAL CATEGORY |
|
BENEFIT |
PRIMARY |
SECONDARY |
TERTIARY |
|
1. Room and Board |
P20/day |
P24/day |
P33/day |
|
2. Medical Expense(per single period of confinement)
|
|
|
|
|
2.1 Ordinary Cases
|
|
|
|
|
2.1.1 Drugs & Medicines
|
150 |
175 |
250 |
|
2.1.2 X-ray/ Laboratory/ Others
|
50 |
75 |
100 |
|
2.2. Intensive Care Cases
|
|
|
|
|
2.2.1 Drugs & Medicines
|
250 |
300 |
350 |
|
2.2.2 X-ray/Laboratory/Others
|
|
150 |
300 |
|
2.3 Catastrophic Cases
|
|
|
|
|
2.3.1 Drugs & Medicines-
|
|
400 |
450 |
|
2.3.2 X-ray/Laboratory/Others
|
|
150 |
300 |
|
3. Medical/Dental Practitioner's Fee shall be P15.00 per day not to exceed: |
|
|
|
|
3.1 For Ordinary Cases (per single period of confinement)
|
200 |
200 |
200 |
|
3.2 For intensive Care/Catastrophic Cases (Per single period of confinement)
|
300 |
300 |
300 |
|
4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P650.00 |
|
|
|
|
5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's fee. |
|
|
|
|
6. Operating Room Fee for Surgical Procedures with Relative Unit Value of: |
|
|
|
|
0 - 5
|
30 |
35 |
65 |
|
5.1 - 10
|
|
120 |
165 |
|
10.1 - above
|
|
170 |
265 |
|
7. Fees for surgical family planning procedures as may be determined by the Commission |
|
|
|
Sec. 3. All laws, orders, issuances, rules and regulations or parts thereof inconsistent with this Executive Order are hereby repealed or modified accordingly.
Sec. 4. This Executive Order shall take effect immediately. lawphi1.net
Done in the City of Manila, this 24th day of December, in the year of Our Lord, nineteen hundred and eighty-six.
The Lawphil Project - Arellano Law Foundation
