EXECUTIVE ORDER NO. 106 - RESTRUCTURING THE MEDICAL CARE BENEFITS UNDER THE PHILIPPINE MEDICAL CARE PLAN

WHEREAS, actuarial studies show that without increasing contributions, current benefits under the Philippine Medical Care Plan, otherwise known as the Medical 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 P30/day     P35/day   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/
Laboratory/
Others   75     150 350
2.2. Intensive
Care Cases
2.2.1 Drugs &
Medicines 375    400    500
2.2.2 X-ray/
  Laboratory/
Others 125     200   500
2.3 Catastrophic
Cases
2.3.1 Drugs &
Medicines- 800   1,000
2.3.2 X-ray/
Laboratory/
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

Sec. 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     P20/day P24/day    P33/day

2. Medical Expense
Benefits (Per single
period of confinement)
2.1 For Ordinary Cases
2.1.1 Drugs &
   Medicines 150 175 250
2.1.2 X-ray/
  Laboratory/
Others 50   75   100
2.2 For Intensive
Care Cases
2.2.1. Drug &
Medicines     250   300 350
2.2.2 X-ray/
Laboratory/
Others     150   300
2.3 Catastrophic Cases
2.3.1 Drugs &
Medicines 400 450
2.3.2 X-ray?
  Laboratory/
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 Surgical
Procedures with relative
Unit Value of:
  0 - 5 30   35  65
   5.1 - 10 120 165
  10.1 - above  170 265

7. Fees for surgical family
planning procedures as
may be determined by the
Commission

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 All laws, orders, issuances, rules and regulations or parts thereof inconsistent with this Executive Order are hereby repealed or modified accordingly. 

Sec. 4. This Executive Order shall take effect immediately.

Done in the City of Manila, this 24th day of December, in the year of Our Lord, nineteen hundred and eighty-six.
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Since 19.07.98.