PhilHealth to scrap single period confinement policy

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) has committed to scrapping its controversial single period of confinement policy by the end of the month after Sen. Bong Go underscored the policy’s negative impact, particularly for patients suffering from recurring illnesses.

During the Senate committee on health public hearing on Sept. 10, Go said the policy prevents patients from availing themselves of PhilHealth coverage for the same illness within a short timeframe, leading to unnecessary burdens on Filipino families.

The senator had repeatedly criticized the policy as illogical, noting that illnesses such as pneumonia and pregnancy complications are unpredictable and cannot be limited by arbitrary timelines.

“When we get sick with pneumonia, we are admitted, it is forbidden to cover it within three months. Can we prevent getting sick?” Go pointed out.

Two case studies were highlighted during the hearing to demonstrate the detrimental effects of the policy, including the case of a mother whose child was denied coverage for multiple pneumonia admissions within a short period.

She recalled how PhilHealth advised the hospital to change the diagnosis to secure coverage for her child.

Another case involved a patient suffering from emphysema who was informed, after being readmitted due to complications, that PhilHealth’s policy only allowed coverage once every six months.

The patient’s family said that despite paying contributions for years, they were left to shoulder hospital costs when they needed coverage the most.

The removal of this policy is expected to provide relief for patients and their families who have faced challenges due to the limitations imposed by the single period of confinement rule.