Guidelines On How to Apply for PCSO Assistance for Dialysis Patients – Hemo and Peritoneal

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These are the guidelines for Hemo or Peritoneal Dialysis patients looking for PCSO assistance.

To help patient cover their expenses of the costly medicine EPOIETIN and laboratory procedures and to provide financial assistance to patients with kidney disease while undergoing dialysis is the main aims of the enrollment system of PCSO.

The Philippine Charity Sweepstakes Office (PCSO) requires enrollment for these patients to avail this type of Individual Medical Assistance Program (IMAP) specifically for dialysis medicines request from their office.

However, the dialysis session or treatment itself is not covered, what is covered is financial assistance to buy the drug Erythropoietin or Epoietin which is needed for dialysis sessions and lab procedures.

Actually, at first PCSO is giving assistance on dialysis sessions itself but this was adjourned. Then changed with existing assistance in which PCSO is giving financial aid to buy the expensive dialysis medicine Epoietin.

The PCSO stopped it and change into other financial aid after it learned that the Philippine Health Insurance Corporation (Philhealth) had increased the number of hemodialysis treatment coverage from 45 treatments to 90 sessions per year.

Meanwhile Philhealth has increase the number of dialysis treatment sessions it covers to 90 sessions annually, PCSO can offer more help by giving aid to buy the medicine needed for the dialysis treatment.

There are some groups though who prefers the old dialysis treatment assistance itself versus assistance for purchasing the medicine/lab procedures.

Good thing is both Philhealth members and non-Philhealth members may apply to PCSO provided they meet the set qualifications and documentary requirements.

Please check the details on enrollment requirements below for patients with a need for dialysis treatment as well as the amount of assistance.

FOR PHILHEALTH MEMBERS

For Philhealth members undergoing Hemodialysis – The maximum amount of yearly assistance that PCSO can give to this group of patient is P84,000 for the drug epoietin at P14,000 per claim. There will only be a total of 6 claims in one year.

For Philhealth members undergoing Peritoneal dialsysis and who availed of the Z Package – PCSO yearly assistance is set at P84,000 per year for medicines epoietin at P14,000 per claim. This will be a total of 6 claims per year.

For Philhealth members undergoing Peritoneal dialysis under the case rate, the maximum yearly assistance is P120,000 for dialysis solutions at P20,000 per claim. A total of 6 claims per year.

**PCSO assistance may be processed and released in six (6) equal tranches one after the other at any time upon presentation of certification of ongoing treatment from the attending physician.

FOR NON-PHILHEALTH MEMBERS

All Non-Philhealth members who wishes to enroll and avail the dialysis assistance program of PCSO are required to also submit a certification of PHIC non-membership from the attendant dialysis center. Which means you need to file a request in the dialysis center where you are undergoing treatment for a certification document that states you are not a member of Philhealth.

This is on top of all the other documentary requirements that patients need to submit for inclusion in the program.

HOW TO APPLY FOR ENROLLMENT to PCSO DIALYSIS ASSISTANCE PROGRAM

Patients who are undergoing Hemodialysis or Peritoneal Dialysis that want to become a beneficiary of PCSO financial assistance for. Here’s what you need to apply for enrollment.

UPON ENROLLMENT / FIRST CLAIM

You must go to PCSO personally to apply for inclusion in the program. You must also bring the following documents:

Duly accomplished Application Form from PCSO.
Original Medical Abstract duly signed by the attending physician/ Nephrologist with license number.
Prescriptions

Prescription if Philhealth member
*Hemodialysis & Peritoneal Dialysis Z – medicines (EPO)
*Peritoneal Dialysis case rate – PD solutions

Prescription if Non-Philhealth member
*Peritoneal Dialysis – PD solutions
Official quotation from the dialysis centers / hospitals.
Updated laboratory results.
Certification of acceptance of Guarantee Letter (GL) from the dialysis center / hospital.
Certification of PhilHealth membership status including type of package for Peritoneal Dialysis (Z or case rate).

Valid ID (patient valid ID and designated representative valid ID if a representative will process succeeding releases of claims)

Your case will be evaluated by the PCSO personnel in charge together with all the required documents you’ve submitted. However, you may need to go to PCSO office more than one time in order for you to get the application form, Guarantee Letter (GL), then you have to present the GL to the dialysis center so they can issue the certificate of acceptance, then bring the acceptance certificate back to PCSO, etc.

Once you are approved, you will also be given an index card / client-social worker agreement, keep this document safe since you need it when filing the next claims.

SUCCEEDING CLAIMS

For dialysis patients who are already enrolled and filing for succeeding claims – you or your official designated representative can file for assistance claim in your behalf in PCSO. You or your representative needs to bring the following documents on your 2nd claim, 3rd claim, until 6th claim for the year:

The index card/client-social worker agreement issued upon enrollment must be presented to claim the Guarantee Letter (GL)*.

Certification of ongoing treatment including the last date of treatment from the Nephrologist or attending physician.

Original prescriptions

For Philhealth members
*Hemodialysis & Peritoneal Dialysis Z – medicines (EPO
*Peritoneal Dialysis case rate – PD solutions

For Non-Philhealth members
*Peritoneal Dialysis – PD solutions

For more information and inquiries about dialysis assistance feel free to visit their the Philippine Charity Sweepstakes Office. There will be staff that can be answer all your concerns. Spread and share the good news!

Source: Isensey