PhilHealth open to proposed expanded coverage in private hospitals

(INQUIRER FILE PHOTO / GRIG C. MONTEGRANDE)

MANILA, Philippines — The Philippine Health Insurance Corporation said it is open to Speaker Ferdinand Martin Romualdez’s proposal for a 50 percent coverage for members admitted to private hospitals, PhilHealth president Emmanuel Ledesma Jr. said on Wednesday.

During the latter part of the House committee on health’s hearing, Ledesma assured panel chairman and Batanes Rep. Ciriaco Gato that they welcome Romualdez’s suggestion.

Romualdez on Tuesday called for a hearing to assess PhilHealth’s charter, requesting that benefits coverage be increased to 50 percent from the current 30 percent.

According to Ledesma, they can even go north of 50 percent in the future.

“Mr. Chair I will reiterate, we — me and the rest of our colleagues in PhilHealth — we fully support all of the statements that were mentioned by Speaker Martin 100 percent ‘no […] And then to add to that pa, not only 50 percent ‘no as COO (Eli Dino Santos) mentioned, maybe even north of 50 percent.  We are there, we are one, we are united in that aspect,” Ledesma said.

“My follow-up question is it possible to increase it to more than 50 percent in the near future?” Gato asked.

“Without a doubt, again I think (the) COO put it very well.  Yes, yes.  Short answer is yes. Hangga’t kaya Cong, honorable committee, gagawan natin ng paraan. ‘Yan ang mandato namin Cong, ‘yan ang trabaho namin eh so it will also make us happy if we can go even more than 50 percent why not?  So yes,” Ledesma answered.

(Without a doubt, again, I think the COO put it very well.  Yes, yes.  The short answer is yes.  As long as we can, Cong, honorable committee, we will find a way.  That’s our mandate, eh, so it will also make us happy if we can go even more than 50 percent. Why not?  So yes.)

“Mr. Chairperson, honorable members of the committee, with the leadership of our President and Chief Executive Officer, Emmanuel Ledesma, Jr., Philhealth, we will be able to fulfill and comply with the directive of our Honorable Speaker Martin Romualdez,” PhilHealth Chief Operating Officer Eli Dino Santos said.

During the discussions on the PhilHealth charter, Ledesma said they have already started increasing benefits given like in the case of the annual hemodialysis limit, which has gone up from 90 to 156 sessions in a year.

Ledesma said they based the new number on three hemodialysis sessions per week, multiplied by 52 weeks in a year.

“PhilHealth expanded its hemodialysis benefits package from 90 to 156 hemodialysis sessions recognizing and empathizing with the needs of our members, who are also affected by the socio-economic challenges,” Ledesma said.

“PhilHealth increased the coverage sessions to 156 in accordance with the current standards for adequate hemodialysis sessions per week, that was actually computed sirs by the maximum of three hemodialysis sessions per week plus the maximum of 52 weeks in a year.  So we computed po 52 weeks times three sessions, that’s how we came up with the 156 figure po,” he added.

Aside from these, Ledesma mentioned several ailments of which PhilHealth have already increased coverage:

• high-risk pneumonia, P32,000 to P90,100 (182 percent increase)
• acute stroke ischemic, P28,000 to P76,000 (171 percent increase)
• acute stroke hemorrhagic, P38,000 to P80,000 (111 percent increase)