THE Philippine Health Insurance Corp. (PhilHealth) has significantly increased its financial support for dialysis treatments, now offering nearly P1 million per patient per year. This new policy, outlined in PhilHealth Circular 2024-0023, took effect on October 7, 2024, and specifically benefits members and dependents diagnosed with chronic kidney disease stage 5 (CKD5).
What’s new?
In a press statement released on October 14, 2024, PhilHealth announced that the reimbursement for hemodialysis sessions has increased to P6,350, a substantial rise from the previous P4,000 rate set in July 2024.
Annual coverage details
The updated policy now provides a total annual package of P990,600, which covers 156 dialysis sessions. This marks a significant increase from the earlier maximum of P624,000.
Purpose of the increase
PhilHealth's adjustments aim to alleviate the financial strain on patients undergoing life-sustaining dialysis treatments.
PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. emphasized that this increase responds to patient feedback, highlighting that many reported high out-of-pocket expenses despite the earlier adjustment.
“Our aim is to ensure that patients will no longer have co-payment when availing of the minimum set of services for dialysis,” said Ledesma.
Alignment with Universal Health Care
The new benefit package also supports the goals of the Universal Health Care Law.
Ledesma credited the PhilHealth Board, led by Health Secretary Ted Herbosa, for their quick approval of these adjustments, ensuring that care remains accessible without additional costs to patients.
What’s included in the revised package?
The revised dialysis benefit package includes essential services such as:
Anticoagulation medications
Anemia management drugs
Dialyzers
Hemodialysis solutions
Other necessary supplies per session
Additionally, the package covers laboratory tests, dialysis kit expenses, facility fees, and utilities, allowing patients to receive these services at both accredited public and private facilities.
Co-payments and additional services
It is important to note that the circular permits co-payments for any additional or premium services that exceed standard care. For example, a P450 cap has been established for professional fees if patients require telemedicine consultations or interventions for complications during dialysis.
To prevent confusion regarding billing, dialysis centers are required to fully disclose any potential co-payments to patients.
Beneficiary statistics
As of June 2024, PhilHealth serves a total of 6,353,703 beneficiaries across Central Visayas. Of this number, 3,677,834 are registered members, while 2,675,869 are classified as dependents. (SunStar Cebu)
*** This article was made with the help of an automated editorial system.