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PhilHealth: No Reimbursement for Repeat CS Procedure

Read on about PhilHealth’s conditions when it comes to reimbursing childbirth expenses.

deliveryLast November, PhilHealth released a clarificatory circular regarding its Circular No. 011 (New PhilHealth Case Rates for Selected Medical Cases and Surgical Procedures).

In the original circular, PhilHealth indicated the new amounts for different medical cases, including caesarean section, under surgical cases. In the addendum circular, PhilHealth mentioned that “Elective cesarean sections (e.g., CS per patient request) including repeat cesarean sections performed without indication shall not be reimbursed by the Corporation.”

According to netdoctor.co.uk, an elective caesarean section is when a woman or an obstetrician-gynecologist opts to undergo a CS procedure.

Normal childbirth, or vaginal deliveries are always the better option as these pose significantly less health risks to the mother and the infant. Nonetheless, moms who have already given birth by caesarean procedure may still opt for VBAC (vaginal birth after casesarean). However, there have been fears that this might tear the mother’s C-section scar from her previous delivery/ies, and also of babies dying during the procedure.

PhilHealth later clarified that the non-reimbursement of expenses incurred from repeat CS procedures will be treated on a case-to-case basis; only when the need for another CS procedure can be justified by the patient’s obstetrician will PhilHealth reimburse the expenses.

You may also want to read:
Is Normal Delivery Possible after a C-section?
Pregnancy FAQs: Top Questions on Labor Answered

Sources:
• Philhealth Circular No. 011-2011. “New PhilHealth Case Rates for Selected Medical Cases and Surgical Procedures and the No Balance Billing Policy” philhealth.gov.ph < http://www.philhealth.gov.ph/circulars/2011/circ11_2011.pdf >
• PhilHealth Circular No. 011-13-2011. “Selected Surgical Case Rates – Additional Implementing Guidelines” philhealth.gov.ph < http://www.philhealth.gov.ph/circulars/2011/circ11-B_2011.pdf >

Photo from flickr creativecommons

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