Enhanced Hospitalization Program (eHOPE) 

[AMENDED GUIDELINES FOR THE ENHANCED HOSPITALIZATION PROGRAM (EHOPE) FOR THE FACULTY, REPS, AND ADMINISTRATIVE STAFF (Effective 27 April 2023) ]

Following the approval of the UP Board of Regents (BOR) at its 1380th meeting on 27 April 2023 regarding the amendments on eHOPE, the amended guidelines are as follows:

Amount of eHOPE Benefits

The eHOPE provides financial assistance for hospitalization expenses incurred during confinement up to an accumulated maximum amount of Php 100,00.00 per year. The eHOPE shall also provide financial assistance for medicine related to the covered confinement and prescribed upon discharge of the employee in the maximum aggregate amount Php10,000.00 per year.

Covered hospitalization expenses:

The following hospitalization expenses incurred during confinement shall be covered under eHOPE:

  • Medical/diagnostic procedures such as ultrasound, MRI, X-ray, CT scan, biopsy, mammography, echocardiography, angiogram, blood chemistry, and other laboratory examinations.
  • Prescribed drugs and medicines in accordance with the Generics Act of 1988 (RA 6675).
  • Professional fees of PhilHealth-accredited physicians and specialists up to a maximum of twice the amounts based on the Relative Value Unit (RVU) set by PhilHealth for specific medical cases.
  • Expenses for room and board for the duration of the confinement.

 

Excluded from coverage under eHOPE are: 

(a) hospitalization expenses for confinement related to cosmetic surgery; (b) self-inflicted injury and illness; and (c) annual medical/ physical examination which are covered by specific CU policies.

 

Who are eligible for eHOPE?

Eligible employees for financial assistance under eHOPE shall be the following:

  • Regular permanent faculty members, full-time or part-time
  • Full-time faculty members who are not tenured provided they have rendered at least one ( 1) year of continuous service in the University
  • Permanent REPS and administrative staff
  • UP contractual and casuals (including faculty, REPS and administrative staff) who have rendered at least one year of continuous service to the University, have an employer-employee relation with the University, and whose salaries are paid out of the Personnel Services (PS) allocations to UP in the General Appropriations Act (GAA)
  • UP contractual and casuals (including faculty, REPS and administrative staff) who have rendered at least one year of continuous service to the University, have an employer employee relations with the University, and whose salaries are charged against the Revolving Fund (RF)/ Trust Fund (TF).

To be eligible, all claimants must be in active service in UP at the time of the claim. Part-time faculty members shall be entitles to reduced benefits in proportion to the extent of their service to the University.

 

What are the covered hospitalization expenses?

  • Medical/diagnostic procedures such as ultrasound, MRl, X-ray, CT scan, biopsy, mammography, echocardiography, angiogram, blood chemistry, and other laboratory examinations.
  • Prescribed drugs and medicines in accordance with the Generics Act of 1988.
  • Professional fees of Philhealth-accredited physicians and specialists up to amounts based on the Relative Value Unit (RVU) set by Philhealth for specific medical cases.
  • Expenses for room and board for the duration of the confinement.

Note: excluded from coverage are: a) hospitalization expenses fr confinement related to cosmetic surgery; b) self-inflicted injury and illness; and c) annual medical/physical examination which are covered by specific CU policies.

 

Implementation of eHOPE

"No cash out" through partnerships. Partnerships through agreements with the nearest government and private hospitals shall be initiated by each of the Constituents Universities (CUs) to include a "no cash-out" arrangement for the patient.

The financial assistance under eHOPE shall be granted net of the medical expenses covered by PhilHealth and other private medical health card benefits. PhilHealth and private medical health card benefits shall be exhausted first before claims are accepted under eHOPE.

 

What is the procedure for availing eHOPE?

  1. Eligible employee requests for financial assistance not exceeding PhP 100,000.00 per year for hospitalization expense.
  2. Eligible employee files an application form for reimbursement form at HRDO. HRDO checks the completeness and accuracy of data and attachments. HRDO shall certify if the employee is qualified for the claim and maintain a record of the employee’s hospitalization.
  3. eHOPE Committee evaluates and signs the application for eHOPE and Referendum Sheet.
  4. Budget Office provides budget clearance.
  5. Office of the Vice Chancellor for Administration recommends and signs on the Referendum Sheet and eHOPE form.
  6. Office of the Chancellor signs and approves the eHOPE application.
  7. HRDO secures copy of the approval and forwards documents to College/Unit for voucher preparation.

Note: Each claim for financial assistance must be supported by an official itemized breakdown of medical expenses for laboratory examination, surgery, or any other medical expenses for laboratory examination incurred during the employee’s hospitalization.

 

What are the requirements needed for filing of eHOPE?

  1.  Accomplished application for eHOPE Form.
  2.  Accomplished Itemized Breakdown of Expense
  3. Medical Certificate
  4. Clinical Abstract
  5. Billing Statement
  6. Original Official Receipt