Escolar Documentos
Profissional Documentos
Cultura Documentos
2001-041
September 12, 2001
1.0 RATIONALE
Ordinary illness or disease other than those categorized under the Major
Medical Case.
Care other than for the care or alleviations of a medical condition which is
provided for reasons of a member’s physical or mental inability to tend for
himself.
A member in-good-standing is one who has complied with all his required
financial obligations with the PWA, such as payment of regular
contributions and loan amortizations.
3.0 AVAILMENT
3.1 The Medical Assistance Program (MAP) shall be available to all members
of the PWA who are "in good standing", as defined in 2.9.
3.2 A member who is suspended from the service shall not lose his benefit
under the MAP or shall it be diminished by reason of such suspension
provided that the member remains to be "in good standing".
3.3 Should a member be "not in good standing" for failure to comply with any
of his financial obligations with the PWA, his benefits under the MAP
shall be suspended until after he has complied with all his PWA financial
obligations.
4.0 GUIDELINES
4.1 FUNDING
4.1.1 The MAP Fund shall be sourced from the contributions of the
members and savings of the Commission.
4.1.2 Each member shall contribute monthly one-half of one percent (1/2
of 1%) of his basic monthly salary, through payroll deduction,
which shall be given priority after the mandatory statutory
deductions.
4.1.3 If the member’s contributions are not paid due to suspension from
the service, or leave of absence, the arrearages shall be deducted
from his first salary claim upon resumption to office, or the
member may pay directly to the PWA.
4.2.4 The maximum amount a member may avail in one year shall not
exceed sixty thousand pesos (P60,000.00), regardless of the
number of times of confinement.
4.2.7 The following cases shall not be covered by the schedule of rates
under 4.2.5 but shall not exceed the annual limit provided in 4.2.4:
4.2.8 The benefits granted under the MAP shall be net of 50% of the
member’s Medicare benefits. In no case, however, shall the net
benefit exceed the total hospitalization/medical expenses of the
member concerned.
4.2.9 The benefits under this program shall not include expenses and
charges for:
4.2.10 Cases not specifically covered by the above shall be referred to the
Board of Trustees for evaluation.
4.2.11 Members who are enrolled in other health insurance plans shall be
allowed to claim medical reimbursement from the Program.
The benefits under the MAP of the PWA member shall be terminated upon
resignation, retirement, transfer, expulsion or voluntary termination in case
the member decides to terminate such membership while still in the
service.
5.0 EFFECTIVITY
This Memorandum shall take effect 01 September 2001 in so far as those which
are inconsistent with previous issuances on the matter.
(Sgd.) GUILLERMO N.
CARAGUE
Chairman