PhilHealth extends dialysis coverage from 90 to 144 sessions this year
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MANDAUE CITY, Cebu — Philippine Health Insurance Corporation (PhilHealth) is increasing its coverage for outpatients undergoing hemodialysis from 90 to a maximum of 144 sessions this year.
Under Circular 2022-0017 that was published on August 3 and which took effect immediately, “PhilHealth members and their dependents with chronic kidney disease stage 5 (CKD) who are registered in the PhilHealth Dialysis Database are allowed to avail of the maximum 144 hemodialysis sessions until December 31, 2022, provided that the dialysis sessions are prescribed by their attending physicians,” the agency said in a statement released on Friday, August 5.
This means that hemodialysis patients could avail of coverage worth a maximum of P374, 000 for the entire year with dialysis valued at P2,600 per session. Philhealth’s previous offer was 90 free sessions worth P234,000 per year.
PhilHealth said that “the 91st to 144th sessions shall be exclusively used for outpatient dialysis only and any unused sessions will not be carried over to calendar year 2023. “
“Moreover, qualified CKD patients who already used their 91st to 144th dialysis sessions and were not able to avail of the automatic deductions of the benefits from their medical bills can still directly file their claims with any PhilHealth Regional/Branch Office or Local Health Insurance Offices per existing guidelines.” it added.
Philhealth also reiterated on the implementation of the the No Balance Billing (NBB) Policy “wherein no other fees or expenses shall be charged or be paid for by qualified patients above and beyond the packaged rates as per PhilHealth Circular No. 2017-0017.”
The NBB policy applies to indigent, sponsored, registered kasambahay, senior citizens, and lifetime members who avail of benefits in government health care institutions.
“In case of delay of filing of claims due to natural calamities or other fortuitous events, PhilHealth shall likewise extend the filing period of claims from 60 to 120 days provided that the area where the patient is located or being treated is under a state of calamity,” part of the statement read.
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