Tarlac Health Maintenance Plan
Country of Operation
- Provincial Government of TarlacGovernment
Target income level
- Bottom 20%
SummaryThe Health Maintenance Program is THMP’s (Tarlac Health Maintenance Cooperative) provincial-level health insurance scheme which aims to fill the gaps in outpatient service coverage left by PhilHealth.
The Tarlac health plan insures outpatient consultation, diagnostic services, minor surgery, and inpatient fees (e.g. medication, room and board, diagnostic tests, physicians' fees).
Key program components
The Tarlac Health Maintenance Plan is a health insurance scheme which covers members’ outpatient consultation, hospital treatment and medicines. Membership is by household, with a standard annual lump-sum premium of P1,200 (approximately USD 28) per member (regardless of number of dependents). If a user does not or cannot make a lump-sum payment, they may choose to pay P660 (USD 15) every 6 months, make a quarterly payment of P348 (USD 8), or a monthly payment of P120 (USD 3). Indigent members are subsidized by the local government unit.
Physicians and health care facilities accredited by the plan are reimbursed for services provided to members. All private and public physicians, hospitals, and diagnostic centers based in the province of Tarlac and licensed either by the Department of Health or the Professional Regulations Committee (PRC) are eligible to apply as a service provider under plan.
Currently, the Tarlac plan includes 14 hospitals (4 primary, 6 secondary, and 4 tertiary), 1 diagnostic center, and 130 physicians (90 of them based in Tarlac City and 40 based in nine municipalities). Of these 130 physicians, 16 are general practitioners and the rest practice specialty medicine. Providers are paid on a fee-for-service basis.
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