PhilHealth: Dialysis coverage now nearly P1-M per year
Inquirer file photo
MANILA – The Philippine Health Insurance Corporation (PhilHealth) has implemented an increase in the hemodialysis package from P4,000 to P6,350 per session.
With the increase to P6,350 per session, every Chronic Kidney Disease Stage 5 (CKD5) patient is now entitled to a maximum of P990,600 in financial protection per year.
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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 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 P4,000 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 minimum set of services for dialysis,” Ledesma said.
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 P450 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 provide explanation for it. (PNA)
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