EXECUTIVE ORDER NO. 106, December 24, 1986

RESTRUCTURING THE MEDICAL CARE BENEFITS UNDER THE PHILIPPINE MEDICAL CARE PLAN

Executive Orders December 24, 1986
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WHEREAS, actuarial studies show that without increasing contributions, current benefits under the Philippine Medical Care Plan, otherwise known as the Medicare 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:

SECTION 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

P 30/day

P 35/day

P 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 / Laboratories / Others
75
150
350
2.2 Intensive Care Cases

2.2.1 Drugs & Medicines
375
400
500
2.2.2 X-ray / Laboratories / Others
125
200
500
2.3 Catastrophic Cases

2.3.1 Drugs & Medicines-

800
1.000
2.3.2 X-ray / Laboratories / 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

SECTION 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

P 20/day

P 24/day

P 33/day
2. Medical Expense Benefits (Per single period of confinement)

2.1 For Ordinary Cases

2.1.1 Drug & Medicines
150
175
250
2.1.2 X-ray / Laboratories / Others
50
75
100
2.2 For Intensive Care Cases

2.2.1 Drug & Medicines
250
300
350
2.2.2 X-ray / Laboratories / Others
100
125
250
2.3 Catastrophic Cases

2.3.1 Drugs & Medicines
–
400
450
2.3.2 X-ray / Laboratories / 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
225
7. Fees for surgical family planning procedures as may be determined by the Commission

SECTION 3. All laws, orders, issuances, rules and regulations or parts thereof inconsistent with this Executive Order are hereby repealed or modified accordingly.

SECTION 4. This Executive Order shall take effect immediately:

Done in the City of Manila, this 24th day of December in year of Our Lord, nineteen hundred and eighty-six.

(Sgd.) CORAZON C. AQUINO
President of the Philippines

By the President:

(Sgd.) JOKER P. ARROYO
Executive Secretary

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