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HealthCare denying Coverage for Patients.

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1 HealthCare denying Coverage for Patients. on Wed Jun 06, 2012 3:42 am

ferdiefrancisco


Arresto Menor
Tanong ko lang po sa mga experts sa law kasi hanggang ngayon po naka confine ang twins ko sa isang premyadong ospital sa Q.C simula nang ipanganak sila (premature) noong April 2, 2012. 2 months na po sila ngayon pero mukhang mag-stay pa ang panganay sa kambal ng mga isang buwan pa ulit dahil sa mga komplikasyon, habang ang pangalawa naman po ay malapit ng umuwi. Ako po ay nagtatrabaho sa call center at may health card from "intellicare". Nai-enroll ko na po ang mga bata sa Intellicare within the 15 day period na sinabi nila sa brochure...na-grant naman po ang enrollment for the twins..dahil nga po premature sila , maraming complications na nadevelop during their stay in the hospital. Pero sa mga sakit na un, na-identify ng doctor namin ang mga sakit na hindi related sa prematurity..
Ngayon po, ang intellicare ay ayaw i-cover ang mga bata dahil sa kadahilanang ang pinirmahan daw ng kumpanya namin sa intellicare ay nagsasabi na "Any disability which may have affected a dependent prior to the 30th day after birth" ay di macocover ng intellicare.. malinaw naman pong nakasaad sa exclusion na "disability" hindi "illness" ang hindi covered ng intellicare. Meron po ba akong habol at ano po ang hakbang na pwede kong gawin?

Salamat ng marami sa makakatulong sa akin!

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2 Re: HealthCare denying Coverage for Patients. on Thu Jun 07, 2012 10:28 am

ferdiefrancisco


Arresto Menor
Any advise will be greatly appreciated!

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3 Re: HealthCare denying Coverage for Patients. on Fri Jun 08, 2012 4:27 pm

attyLLL


moderator
tough situation. medical law is not yet mature in the philippines. i can appreciate the alleged distinction.

short of filing a case, keep writing letters through your HR and to the company. perhaps they will relent.

if not, your remedy is to file a complaint n court.


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4 Re: HealthCare denying Coverage for Patients. on Sat Jun 09, 2012 2:30 am

ferdiefrancisco


Arresto Menor
Yes it's tough! I've been trying to get a hold of HR but to no avail. Well I guess I'll have to exhaust our resources in the company first to see if whether they can help or not. Otherwise, I'll do your advise! I'll keep you posted.

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