List of PCSO Medical Assistance Requirements for Application Process
PCSO MEDICAL ASSISTANCE REQUIREMENTS – Here are the documents required in seeking for a Medical Cash Aid to the Philippine Charity Sweepstakes Office.
In seeking for a Medical Assistance from the Philippine Charity Sweepstakes Office or more popularly called PCSO, there are documents that you need to prepare and submit to the lotto-operating body.
The PCSO Medical Assistance requirements depend on the medical case of the patient. The IMAP or the Medical Assistance Program is open to help the patient and his/her family in the payment of the hospital bill, chemotherapy, transplant, laboratory, radiotherapy, dialysis, and medicine expenses.
Here is a guide on the PCSO Medical Assistance requirements for application based on the medical condition of the patient:
Hospital Bill
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- original copy of the Statement of Account or Hospital Bill duly-signed by the Billing Officer or Credit Supervisor
- Endorsement from the Medical Social Services of the health facility
- Endorsement or the Certificate of Acceptance of PCSO Guarantee Letter
- official quotation from the service provider
- official quotation with the breakdown of expenses
- official sealed quotations from three (3) suppliers
- relevant laboratory result
- photocopy of Histopath or Biopsy report
- Audiological Evaluation Report signed by a licensed Audiologist
- cross-matching results
- original prescription duly-signed by physicial with license number
- copy of the physician’s order with implant specification
- laboratory request duly-signed by physician with license number
- one (1) whole body picture
- certification from Dialysis Center
- certification of patient’s inclusion in transplant program from authorized representative of NKTI
- relevant PhilHealth tracking number certification
- Police Report – for medico-legal cases
Chemotherapy
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- relevant laboratory result
- photocopy of Histopath or Biopsy report
- original prescription duly-signed by physicial with license number
Transplant
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- relevant laboratory result
- cross-matching results
- certification of patient’s inclusion in transplant program from authorized representative of NKTI
- relevant PhilHealth tracking number certification
Laboratory
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- laboratory request duly-signed by physician with license number
Radiotherapy
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- official quotation from the service provider
Dialysis
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- Endorsement or the Certificate of Acceptance of PCSO Guarantee Letter
- official quotation from the service provider
- official quotation with the breakdown of expenses
- official sealed quotations from three (3) suppliers
- relevant laboratory result
- certification from Dialysis Center
Medicines
- duly-accomplished and signed Philippine Charity Sweepstakes Office (PCSO) Individual Medical Assistance Program (IMAP) Application Form
- original or Certified True Copy of the Updated Clinical Abstract duly-signed by the attending physician with license number
- one (1) valid ID of patient and representative (any of the following):
- Driver’s License
- Professional Regulations Commission (PRC) ID
- passport
- PhilHealth ID
- Government Service Insurance System (GSIS) eCard
- Voter’s ID
- Senior Citizen’s ID
- DSWD 4Ps ID
- Authorization Letter from patient in cases where there is no immediate relative available for interview
- relevant laboratory result
- photocopy of Histopath or Biopsy report
- original prescription duly-signed by physicial with license number
To apply for the Medical Aid offered by the Philippine Charity Sweepstakes Office, go to a branch of the PCSO nearest to you and submit your duly-accomplished IMAP Application Form and the other documentary requirements.
