THE Philippine Health Insurance Corp. (PhilHealth) has increased its financial coverage for dialysis treatments, raising it to nearly P1 million per patient per year.
This development, implemented through PhilHealth Circular 2024-0023, took effect on Oct. 7, 2024, benefiting members and dependents diagnosed with chronic kidney disease stage 5 (CKD5).
In a press statement on Monday, Oct.14, 2024, the latest adjustment raises the reimbursement for hemodialysis sessions to P6,350, from the P4,000 rate introduced in July.
Patients now have access to a total annual package of P990,600, covering 156 sessions, compared to the previous maximum of P624,000.
The move aims to ease the financial burden on patients undergoing life-sustaining dialysis treatments at accredited facilities.
PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. said the increase addresses feedback from patients who reported paying significant out-of-pocket expenses despite the
July 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.
The updated benefit package also aligns with the objectives of the Universal Health Care Law, according to Ledesma.
He credited the PhilHealth Board, led by Health Secretary Ted Herbosa, for approving the adjustments swiftly to ensure accessible care without additional costs to patients.
The revised package includes essential services, such as anticoagulation medications, anemia management drugs, dialyzers, hemodialysis solutions, and other supplies necessary per session.
Laboratory tests, dialysis kit expenses, facility fees, and utilities are also covered, ensuring that patients can access these services at accredited public and private facilities.
However, the circular allows co-payments for additional or premium services beyond the standard care.
A P450 cap has been set for professional fees if patients require services such as telemedicine consultations or interventions for complications during dialysis.
Dialysis centers are required to provide full disclosure to patients regarding any co-payments to prevent billing confusion.
As of June 2024, PhilHealth has a total of 6,353,703 beneficiaries all over Central Visayas.
Of the 6.3 million beneficiaries, 3,677,834 are registered as members, while 2,675,869 are declared dependents. / CAV with PR