How Much Can You Expect from PCSO Medical Assistance?

As a government agency for charity, the Philippine Charity Sweepstakes Office or PCSO provides the Individual Medical Assistance Program (IMAP) to Filipinos who need financial assistance, regardless of their economic status.

Whether you’re rich or poor, you may avail of the IMAP from PCSO.

However, it is also important to know that the role of PCSO is to augment or help Filipinos who are in need of medical assistance, and that doesn’t mean that PCSO will have to shoulder all your medical expenses.

How does PCSO Classify Patients? 

Although PCSO can accept and assist applicants from all walks of life, they have certain rules on who will get how much medical assistance from PCSO.

PCSO’s Individual Medical Assistance Program (IMAP) uses the patient classification system being adopted by all hospitals and prescribed by the Department of Health.

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Patient classification can be from A (the well-to-do individuals) to F (the impoverished/poor).

  • If you are classified as F and you are admitted in the charity ward of a government hospital, you may be entitled to receive 100% of your medical expenses.
  • If you are admitted to the pay section of a government hospital, you are entitled to receive 90 percent.
  • If you are admitted in a private charity ward, you can receive a maximum of 70 percent.
  • If you are admitted in a private hospital, your subsidy is not going to exceed 60 percent.

In short, the medical assistance given by PCSO depends on the financial capacity of the patient or the relative of the patient.

If the patient falls under F category, he/she may receive 70% to 100% financial assistance from PCSO IMAP.

What is a Guarantee Letter? 

PCSO does not give its medical assistance in cash but in the form of a Guarantee Letter (GL).

If you want to avail of PCSO medical assistance and acquire a Guarantee Letter, you must submit the following requirements:

  • A medical abstract
  • A handwritten request for financial assistance addressed to PCSO General Manager Alexander Balutan, or to PCSO Chairman Anselmo Simeon Pinili
  • The final hospital bill before discharge from the said hospital

The Guarantee Letter only has a two-month effectivity.

pcso-imap

PCSO Medical Assistance based on Medical Procedure

Dialysis

The PCSO has developed its own package to complement PhilHealth’s 90-day dialysis package.

  • The PCSO covers 14 out of the 90 treatments covered by PhilHealth
  • The PCSO also provides 14 syringes of Erythropoietin since PhilHealth is limited to procedures.

Chemotherapy

For chemotherapy, there is an enrollment system where the PCSO can cover 50 percent of the total treatment cycle.

  • The PCSO may cover 3 cycles if there are 6 cycles of chemotherapy.
  • Other assistance programs like Roche’s Access program can also cover 50 percent of the remaining treatment.

If a patient needs 18 cycles of chemo, Roche will cover 9 (50%); then the PCSO will shoulder 5; and the patient will shoulder the remaining 4 treatments.

PCSO Medical Assistance Guidelines based on Room Accomodation

The hospital room accommodation expenses of the patient, such as the executive suite, are not covered in the PCSO IMAP.

If the patient avails of a private room, it is not covered by the financial assistance from PCSO.

The only time it will be covered is if the doctors require the patient to stay in a private room to prevent the spread of a contagious disease or if the reason is to aid their survival.

Can we reimburse hospital bills from PCSO? 

The answer is no. Hospital bills or any medical expenses are not reimbursable.

PCSO will not pay the bills paid by the patient for their hospitalization or reimbursement, and the doctor’s fee.

Even if the patient paid using a credit card or borrowed money to pay his bills, it cannot be reimbursed by PCSO.

To avail of PCSO Medical assistance, you must submit your requirements and application before discharge from the said hospital.

IMAP Fund Allocation in PCSO Branches 

The PCSO has 63 branch offices in the Philippines and every branch has a daily fund allocation for Imap.

Usually, the PCSO can only give P50,000 assistance for the hospitalization bills of patients who are in great need.

If the amount requested by the patient exceeds P50,000, the request is forwarded to the Office of the General Manager for augmentation of the assistance.

If the amount reaches P1 million and above, the board will have to make the decision.

Please take note that PCSO does not leniently provide financial assistance to anyone who are sick and in need of help. You must subtmit the necessary requirements to avail of the PCSO IMAP.

Even if the PCSO funds do not come from the General Appropriations Act of Congress or the people’s taxes, the agency’s fund may still be considered a public fund.

PCSO’s funds generally come from the gaming public who patronize the agency’s lottery games, such as Lotto, Keno, Digit Games, Sweepstakes and Small Town Lottery.

Sources: Inquirer, Manila Times, Business Mirror

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