Healthcare costs of people with HIV now covered by HMOs

Isay Reyes, ABS-CBN News

Posted at Jul 05 2019 08:43 PM | Updated as of Jul 06 2019 01:08 AM

Sam Hytham, was diagnosed with HIV in 2015.

MANILA – Apart from facing stigma, people living with human immunodeficiency viruses (HIV) often worry about costly healthcare.

But things are about to change, following the enactment of Republic Act 11166 or The Philippine HIV and AIDS Policy Act, which mandates health maintenance organizations (HMOs) to provide medical benefits, without discrimination, to employed people living with HIV (PLHIV).

This is a breakthrough for people like Sam Hytham, who was diagnosed with HIV in 2015 and faced discrimination not only in the workplace but while getting treatments.

Hytham, who was a phone banker for a telephone company, said he was asked to resign when his employer found out he had HIV.
 
“At that time, I was being humiliated, na-discriminate ako, yung stigma na naranasan ko. Hindi sumama ang loob ko pero na-miss ko lang kasi yung opportunity na even i have this condition, mayroon pa akong skill, mayroon pa akong ability na maipapakita and kaya ng health ko, ng sarili ko,” he said.

(I was discriminated, I felt the stigma. I felt bad because I missed the opportunity to work, to show my skill and ability, and that I can still do my job despite getting diagnosed.)

Hytham needed to undergo laboratory examinations, amounting to P20,000 to P25,000 at least twice a year, to check if his body was reacting well to the antiretroviral treatment. Applying for medical insurance was not an option then.

But under Article 5, PLHIV will now get health and support services including medication and treatment "for opportunistic infections."

The law also emphasizes "equal employment opportunities," by mandating that "PLHIV shall not be deprived of any employment, livelihood, micro-finance, self-help, and cooperative programs by reason of their HIV status.”

Director Luisa Orezca of the Philippine National AIDS Council of the DOH said, the HMOs should not deny or deprive any PLHIV of enrolling in their life insurance companies, life insurance services. Though when a PLHIV decides to disclose his or her status, it must be highly confidential.

“Nobody can disclose the status of that person (HIV status) without the consent of the person himself or herself,” Orezca said.

“They should be dealt with confidentiality, hindi pwede ibuyangyang doon sa company na ito may different package. Depende doon sa company. For a private individual who [wants insurance], itataas ang premium,” she added.

ABS-CBN News tried to get the response of AHMOPI or the Association of Health Maintenance Organizations of the Philippines but has yet to receive their response on the matter. But on Sunday, the Insurance Commission already instructed the HMOs to give medical coverage to PLHIV.

Under the new law, the Philippine National AIDS Council is reconstituted and streamlined to ensure effective implementation of the country’s response to the spread of HIV and AIDS among the population.

The law also penalizes people who will discriminate against HIV-positive individuals.

KNOW YOUR STATUS

Based on Department of Health data, there was a total of 945 new HIV cases in November 2018, bringing the total number of HIV infections to 10,550 in the first 11 months of 2018.

A total of 61,152 HIV cases have been recorded in the Philippines since government started keeping track of the spread of the viral infection in 1984.

But experts and advocates believe that more cases have yet to be reported as some PLHIV may not be aware of their status due to the refusal to undergo screenings or they are simply unaware of the process.

HIV can be transmitted through bodily fluids such as blood, semen, vaginal fluid, and breast milk.

In the Philippines, most cases in the past years were reported among men who have sex with men. DOH records show that of the 61,152 HIV positive individuals recorded since 1984, a staggering 57,235 were male.

The Project Red Ribbon does HIV tests in their office in Pasig City 24/7

But early intervention is the key to survive the virus, DOH said. A person infected with HIV can have a normal life for as long as medications are given early.

“For all of us, walang hindi kasali, know our status because there are conditions na hindi natin alam na nagkaroon tayo. Be tested and be treated, libre naman po yun, walang gagastusin,” Orezca said.

It only takes less than 30 minutes to take the HIV test. Those who would like to know their status can try The Project Red Ribbon in Lumiere Suites in Pasig City, which is open 24 hours to make sure that they can cater to all who wish to be tested. The test may only take about 15 minutes and in case the patient tested positive, he or she will be referred to treatment hubs to get medications.