PCSO Medical Assistance Requirements, Procedures, and FAQs

FAQs about PCSO Medical Assistance

Q: Is it true that patients who are confined in charity wards and in public hospitals may get higher amount of PCSO Medical Assistance than those who are confined in private rooms and in private hospitals? 

• If the patient is confined in a government hospital, the percentage of PCSO medical assistance may be higher because it is the mandate of PCSO to give priority or assistance to the marginalized and indigent patients who could not afford hospitalization.

Q: If both patients are confined in a government hospital, but one patient is in the service ward, and the other is in pay ward, who gets higher medical assistance from PCSO? 

• Both patients can get medical assistance from PCSO, but those who are in the Service Ward may get higher medical assistance than those in the pay ward. But again, the case rate is also part of the factors in giving the amount of medical assistance.

Q: We wanted our patient to be confined in the Service Ward, however, the service ward is full and there’s no vacant bed for the patient, so we have no choice but to go to the pay ward. 

• The PCSO cannot guarantee the availability of Service Wards in hospitals. Yes, bigger assistance will be given to those in the service ward. More often, patients at the service ward get 100% medical assistance because it is the policy of the PCSO.

But you should not worry because you can still avail of PCSO medical assistance even if you’re in the pay ward. It may not be as big as that in the service ward, but what’s important is that PCSO still extends help.

Room classification includes the following: Service Ward, Pay Ward, Semi-Private, Private, and Suite Room. The Service Wards are occupied by patients who opted for charity service while the other room classifications are for Pay patients.

Q: Why are there no PCSO ASAP Helpdesks anymore in private hospitals? 

• Because PCSO wants to prioritize patients in government hospitals.

Q: Who are qualified to avail of PCSO Medical Assistance in Private Hospitals? 

• Patients confined in a private hospital with a room rate of more than P2,200 are not qualified for PCSO Assistance.

Q: Can we still avail of PCSO Medical Assistance even if the patient has already been discharged from the hospital? 

Our patient already wanted to go out of the hospital and could not wait until the PCSO medical assistance application is processed. So, we loaned money from a friend and promised them that we will pay them back when we receive medical assistance from PCSO. Is this possible?

• NO. PCSO does not reimburse hospitalization bills.  Even if you only loaned the money to pay for your hospitalization bills, PCSO will never give reimbursement.

According to PCSO, the fact that you were able to come up with the amount needed to pay for your hospitalization bills only goes to show that you have the means to pay for it, whether it’s your personal money or somebody else’s money.

Therefore, if you want to avail of PCSO medical assistance, you have to wait until your application is processed before you discharge your patient.

PCSO does not give cash assistance to the patient. PCSO only deals with the medical institution or hospital.

Q: What if the hospital approved or signed a promisory note that the patient’s hospitalization bills will be settled once his/her PCSO medical assistance application is approved? 

• That is possible depending on the agreement between the patient and the hospital. But PCSO does not encourage this process. What PCSO advices is that the patients should wait for his PCSO medical application to be processed before he gets discharged from the hospital. Only then will you know how much assistance will the PCSO can provide for you.

 

Sa panahon ngayon, napakamahal magkasakit…

With the high inflation rate that our country is experiencing right now, many Filipinos who are sick and suffering could not afford to pay their medical expenses.

Good thing there’s the Philippine Charity Sweepstakes Office that offers PCSO Medical Assistance.

Any citizen from the Philippines who is either hospitalized or is in need of due treatment is eligible for PCSO’s Individual Medical Assistance Program (IMAP).

You don’t need to have a friend or relative working in a government agency to avail of this program because IMAP is available to all.

Who can avail of PCSO Medical Assistance

PCSO can give financial assistance to those who request for it, provided you meet the following criteria:

• You are confined in any health facility;
• You are receiving health care management as outpatient; and
• You are seeking management in foreign countries, if no health facility within the Philippines can provide such procedure.

Requirements to avail of PCSO Medical Assistance

Once you met the above criteria, you need to submit the required documents to the Philippine Charity Sweepstakes Office to apply for PCSO medical assistance.

Any request must be submitted with the following three documents:

1. Duly accomplished PCSO IMAP Application Form

• You can get this from a PCSO desk in the hospital, or from any PCSO office near you.
• You may also download the PCSO IMAP Application Form here.

2. Original / Certified True Copy of the Updated Clinical Abstract duly signed by the attending physician with License Numer

• For wheelchair requests, you may submit a Medical Certification.

3. Valid ID of both Patient and your Representative. If you do not have a Government ID, a Student or Company ID will do.

• Government ID
  • Passport
  • Driver’s License
  • GSIS eCard
  • PRC ID
  • Voter’s ID
  • Phil Health ID
  • Senior Citizen’s ID
  • DSWD – 4P’s ID
• Company ID
• Student ID

Once you’ve submitted the necessary requirements and get an approval from PCSO, they will issue a guarantee letter to your hospital or health facility, stating that they (PCSO) will assume the obligation to pay a specific amount due of the patient to the health provider.

Please note that PCSO will not be able to bear all the expenses for the beneficiary for the treatment received because IMAP deals with thousands of patients everyday and as much as they want to provide financial assistance, they have an allocated budget.

Aside from the three documents needed, there are other additional requirements for specific requests.

1. For Confinement

• Original copy of the Statement of Account / Hospital Bill duly signed by the Billing Officer / Credit Supervisor”
• Endorsement from the Medical Social Services of the health facility (for charity / service patients).

2. For Dialysis

• Endorsement / Certificate of Acceptance of PCSO Guarantee Letter

• • Not required if health facility has PCSO desk.

• Official quotation from service provider
• Relevant laboratory results

3. For Medicines including Chemotherapy:

• Relevant laboratory results
• Photocopy of Histopath / Biopsy Report
• Original prescription duly signed by physician with license number
• Progress Notes from the doctor / oncologist.

• • For chemotherapy requests

4. For Radiotherapy

• Endorsement / Certificate of Acceptance of PCSO Guarantee Letter

• • Not required if health facility has PCSO desk.

• Official quotation from service provider

5. Surgical Supplies

• Official quotation with breakdown of expenses.

6. Implant

• Official sealed quotation from 3 suppliers
• Copy of physician’s order with implant specification
• Police Report – for medico-legal cases

7. Laboratory / Diagnostic Procedures

• Official quotation from service provider
• Laboratory request duly signed by physician

8. Medical Devices (Pacemaker, Septal occluder, Percutaneous Coronary Intervention (PCI), and more)

• Official sealed quotation from 3 suppliers

9. Assistive Devices – Hearing Aid (Bone Anchored Hearing Aid (BAHA))

• Official sealed quotation from 3 suppliers
• Audiological Evaluation Report signed by a License Audiologist

10. Assistive Devices – Wheelchair

• Official sealed quotation from 3 suppliers
• Progress note from the doctor / oncologist

• • For chemotherapy requests

11. Assistive Devices – Prosthesis (Arm, Leg, Eye)

• Official sealed quotation from 3 suppliers

12. Assistive Devices – Pulmonary Apparatus (rental of ventilator /respirator)

• Official quotation from service provider

13. Non and Minimally Invasive Procedures (Laparoscopic Surgery, Endoscopic procedure, ESWL, etc)

• Endorsement / Certificate of Acceptance of PCSO Guarantee Letter

• • Not required if health facility has PCSO desk.

• Relevant laboratory result

14. Transplant (Kidney, Liver, etc)

• Relevant laboratory result
• Cross – matching result
• Certification of patient’s inclusion in transplant program from authorized representative of NKTI, if applicable.
• Relevant PhilHealth tracking number certification

15. Rehabilitative Therapy (Physical, Occupational, Speech)

• Official quotation from service provider

Things to Remember

Please note that you will not be given cash or money for your medical expenses.

Once your request or application for medical assistance from PCSO has been approved, PCSO will issue a guarantee letter to your hospital or health facility.

It states in the guarantee letter that PCSO will assume the obligation to pay a specific amount due of the patient to the health provider.

Also, don’t expect that all your medical expenses will be shouldered by PCSO. Only a portion of your medical needs will be given by PCSO as medical assistance.

This is because there are also a lot of applicants and patients like you who need medical assistance from PCSO. They have to allocate their budget to cover all the patients in need.

If you have any more inquiries, you may contact the PCSO and their respective departments if your requests are not listed above.

How much can you expect from PCSO? 

According to Dr. Larry Cedro, charity sector assistance manager of the PCSO, they provide assistance to almost all but they always tell the public that the role of the PCSO is to augment their funds. So they check the condition of the patient, especially if the patient is the breadwinner.

The question on how to provide an equitable distribution of funds is almost like deciding who lives and dies.

That’s why the PCSO has IMAP or Individual Medical Assistance Program which uses the patient classification system being adopted by all hospitals and prescribed by the Department of Health.

“There’s an appropriate amount to be given,” said Cedro.

One of the factors that they consider is whether the patient is confined in a public or private hospital.

Patient Classification

• If you are admitted in the charity ward of a government hospital and you are classified as F, then you are entitled to receive 100 percent (of your medical expense).
• If you’re admitted to the pay section of a government hospital, you are entitled to receive 90 percent.
• In a private charity ward, you can receive a maximum of 70 percent, and
• In a private hospital, your (subsidy is not) going to exceed 60 percent

PCSO Assistance for Dialysis Patients

When it comes to dialysis, the PCSO has developed its own package to complement PhilHealth’s 90-day dialysis package.

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

PCSO Assistance for Chemotherapy Patients

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

• If there are six cycles of chemo, we cover three.
• There are other assistance programs like Roche’s Access program that covers 50 percent of the remaining treatment.
• So, if a patient needs 18 cycles, Roche will cover half, the PCSO will shoulder five and the patient will shoulder the remaining four treatments.

(Source)

Watch this video on how to Apply for PCSO Financial Assistance by Jing Castaneda.

PCSO Medical Assistance Sample Letter

Here is a sample letter that you can use to ask assistance from PCSO IMAP.

Dear Sir/Madam:

I’m Maria Cruz. I am a single mom to my three young children. Last month, I was diagnosed with cancer. I would like to ask for your assistance because I could not afford to pay for my hospitalization and medical bills. I am the breadwinner of the family and I have no one to help me financially. I was advised by my doctor to seek your assistance in the hopes that through your help, I could get treated as soon as possible and to fully recover so that I can continue to support myself and my family.

I am hoping for your favorable response. 

Thank you so much.

Sincerely,

Maria Cruz

How to Contact PCSO for Medical Assistance Inquiries

• Visit PCSO Website
• Visit PCSO Head Office Address at Sun Plaza Building, 1507 Princeton Street corner Shaw Boulevard, Mandaluyong City 1552
• Charity Assistance Department
  • Mr. Rubin Z. Magno
    OIC-Department Manager
    Address: 3/F Radiotherapy Bldg. LCP Complex, Quezon Avenue, Quezon City
    Telephone Number: 426-3735, 921-7608
    Email Address: rmagno@pcso.gov.ph
• Medical Services Department
  • Jose Bernardo H. Gochoco, Jr., MD
    OIC-Department Manager
    Address: 3/F Radiotherapy Bldg. LCP Complex, Quezon Avenue, Quezon City
    Telephone Numbers: 441-2612; 441-2076; 441-2065; 441-2081
    Email Address: jgochoco@pcso.gov.ph

PCSO Medical Assistance Program is just one of the many programs that the government offers to Filipinos.

Aside from this, you may also seek assistance from other agencies including PhilHealth, DSWD, Office of the Mayor, Congressman, Senators, and other Government Officials.