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PhilHealth: Dialysis coverage now P1-M per year

Manila: The Philippine Health Insurance Corporation (PhilHealth) has implemented an increase in the hemodialysis package from PHP4,000 to PHP6,350 per session.

In a news release Monday, the state insurer said the increase took effect on Oct. 7 under PhilHealth Circular No. 2024-0023.

Members and their qualified dependents with chronic kidney disease stage 5 (CKD5) can avail of the adjusted package rate from any of the accredited dialysis facilities near them.

“We make good on our promise to take concrete steps to ensure that our benefit packages respond adequately to the needs of patients which is a core objective of the Universal Health Care law,” PhilHealth president and chief executive officer Emmanuel Ledesma said.

Despite the increase in reimbursement rate of PHP4,000 per session last July 1, the PhilHealth continues to receive reports that patients still pay a significant amount for their dialysis sessions.

“Our aim is to ensure that patients will no longer have co-payment when availing of the mini
mum set of services for dialysis,” Ledesma said.

With the increase to PHP6,350 per session, every CKD5 patient is now entitled to a maximum of PHP990,600 in financial protection per year.

The essential services for CKD5 patients include anti-coagulation medications and drugs and medicines for the management of anemia; laboratory tests; supplies such as dialyzers, hemodialysis solutions; and a dialysis kit per session.

Other benefits for patients include administrative fees for the use of dialysis machines, facility fee, utilities, and staff time in all accredited public and private hemodialysis facilities.

Patients who will require additional and premium services beyond the minimum standard of care specified will be subject to co-payment.

A cap of PHP450 for professional fees is also set should patients require additional services such as telemedicine and/or immediate interventions to manage complications arising during session.

In cases of co-payment, the PhilHealth requires the dialysis facility to pr
ovide explanation for it.

Source: Philippines News Agency