PhilHealth expands hemodialysis package

MANILA, Philippines — Philippine Health Insurance Corp. (PhilHealth) members with chronic kidney disease (CKD) Stage 5 can now avail themselves of the expanded hemodialysis benefit package consisting of 156 sessions per year.

“Beginning this year and effective today (June 22), we have already expanded the PhilHealth coverage for those undergoing hemodialysis and this consists of 156 sessions,” Rey Baleña, acting vice president of PhilHealth’s corporate affairs group said at the Laging Handa public briefing yesterday.

“This extension from 90 to 156 sessions won’t be just for this year. This has been institutionalized,” he added.

The benefit package also covers qualified dependents of PhilHealth’s members.

He said, “They (patients) normally require three sessions per week, multiply that to 52 weeks, that will be 156 sessions. This means that their requirement per week for the whole year shall be covered by PhilHealth.”

With an amount of P2,600 per session, Baleña said PhilHealth shouldered P234,000 for the 90 sessions of each member in the previous years.

He pointed out that with the sessions expanded to 156, PhilHealth members can avail themselves of as much as P405,600 per year.

Baleña said the agency was able to expand the benefit for hemodialysis due to the additional funding from the Philippine Charity Sweepstakes Office (PCSO) and the Philippine Amusement and Gaming Corp. (PAGCOR).

“Under the Universal Health Care Law, portions of the PAGCOR and PCSO funds will be allocated to PhilHealth for the enhancement of benefits, first of which is the improvement of our hemodialysis coverage,” the PhilHealth official explained.

Last year, PhilHealth data showed that it paid a total of P17.3 billion for the 3.6 million hemodialysis claims.

“And for the first quarter of 2023, PhilHealth already paid P4.5 billion for the 926,000 hemodialysis claims,” Baleña added.