MANILA: The Philippine Health Insurance Corporation (PhilHealth) announced a significant increase in its hemodialysis coverage, raising the per session reimbursement rate from PHP4,000 to PHP6,350, effective October 7, as per PhilHealth Circular No. 2024-0023. This adjustment elevates the annual financial protection for each patient with chronic kidney disease stage 5 (CKD5) to PHP990,600.
According to Philippines News Agency, the adjustment aims to fulfill PhilHealth’s commitment to the Universal Health Care law by ensuring that its benefit packages adequately meet the needs of patients. PhilHealth President and CEO Emmanuel Ledesma emphasized the organization’s dedication to reducing the financial burden on patients. “We make good on our promise to take concrete steps to ensure that our benefit packages respond adequately to the needs of patients,” Ledesma stated.
Members and their qualified dependents diagnosed with CKD5 can now access the enhanced benefits at any accredited dialysis facility. The revise
d package includes essential services such as anti-coagulation medications, drugs for anemia management, laboratory tests, and necessary dialysis supplies. Additionally, the coverage encompasses administrative and facility fees, utilities, and staff time at both public and private hemodialysis centers.
Despite the previous increase to PHP4,000 per session implemented last July, reports indicated that patients continued to incur significant out-of-pocket expenses. With the latest policy update, PhilHealth aims to eliminate co-payments for the minimum set of dialysis services, although additional premium services will still require co-payments. A cap of PHP450 has been set for professional fees if patients require services beyond the standard care, such as telemedicine or interventions during complications.
PhilHealth also mandates that dialysis facilities provide a detailed explanation for any co-payment charges, ensuring transparency and adherence to the new guidelines.