DOH MAIP Program Guidelines in the Department of Health - Philippines

MAIP Program Beneficiary refers to an indigent and financially incapacitated patient who demonstrates clear inability to pay or spend for necessary expenditures for one's medical treatment, such as patients with catastrophic illness or any illness, which is life or limb-threatening and requires prolonged hospitalization, extremely expensive therapies or other special but essential care that would deplete one's financial resources, as assessed and certified by the Medical Social Worker (MSW).

SPECIFIC GUIDELINES

1. Eligibility and Documentary Requirements

• All MAIP Program beneficiaries defined as an indigent and financially incapacitated shall be eligible for medical assistance under the Program subject to the terms and conditions specified in DOH Administrative Order No. 2020 - 0060.
• All patients availing of medical assistance under the MAIP Program shall go to the Medical Social Service or the Designated Officer of the health facility for presentation documents, proper assessment and evaluation. In addition, a referral may be issued to the patient by the Central Office and CHD.
• The following documentary requirements shall be submitted as applicable:
• In-patient - Total charges and assessment of the MSW of the Hospital or Municipal/ City Social Welfare Officer for those in LGU Hospitals.
• Out-patient - Physician's prescription/request and assessment of the MSW.
• Referred Patient - Inter-agency referral form with attached physician's prescription or request or protocol, and either Medical Certificate or Clinical Abstract. Patients who are requesting drugs and medicines shall be examined by the physician of the recipient hospital. For non-ambulatory patients, a physician's certificate attesting to the veracity of the physical condition of the patient is required.

2. Availment Procedures

• Eligibility Assessment - The Medical Social Worker (MSW) of the health facility shall assess patients applying for medical assistance under the Program using the standard psychosocial assessment form.
• Processing of Medical Assistance - The MSW shall then process the needed medical assistance based on their assessment and recommendation.
• Provision of Service - Health facilities shall provide the necessary health/medical services based on patient needs and document provision of the same.

TERMS AND CONDITIONS

Access and utilization of the MAIP Program funds shall be subject to the following terms and conditions:

• MAIP Program Beneficiaries shall be admitted to basic or non-private ward accommodation and may be admitted to the next available private accommodation on the following conditions:
1. Non-availability of basic or non-private ward accommodation as certified by the hospital;
2. Emergency cases;
3. Communicable diseases requiring isolation including Public Health Emergencies of International Concern (PHEIC);
4. Cases requiring intensive care; and
5. Chronic and catastrophic cases requiring prolonged admission.