PhilHealth: Contribution hike needed to expand benefits

MANILA, Philippines — The Philippine Health Insurance Corporation (Philhealth) on Tuesday justified the increase in members’ contributions, saying that it is necessary for the implementation of its improved benefit packages.

According to PhilHealth chief Emmanuel Ledesma Jr., the state health insurance provider has already implemented many enhancements in its health benefits packages in 2023 and will continue to improve its coverage in 2024.

“We have implemented many enhancements that members will surely feel due to lower hospital fees, if not completely free,” Ledesma was quoted as saying in a statement.

Ledesma said that this year, PhilHealth will rationalize case rates for bronchial asthma and bacterial sepsis in newborns and COVID-19 inpatient benefits.

Guidelines for outpatient therapeutic care benefits package for severe acute malnutrition in children aged 5 years old and below and services for physical medicine and rehabilitation will also be expected this year, the PhilHealth chief added.

“Another benefit to look forward to is the enhancement of peritoneal dialysis under the Z Benefits Package.”

But to make these improvements in its health packages, the state health insurance noted that members’ contribution increase is necessary.

“This is where the importance of adjusting our contribution rates comes into play. It will generate funds necessary for us to complete our benefit plans, and more importantly to sustain the reforms in the benefit packages,” Ledesma stressed.

Philhealth’s increase in members’ contribution from 4 to 5 percent is currently under review by President Ferdinand “Bongbong” Marcos Jr. amid Health Secretary Teodoro Herbosa’s call for the hike’s suspension.

Herbosa said that the insurance provider has enough money to improve its benefits sans a hike.

The state health provider also noted that in 2023, it was able to expand its coverage of hemodialysis from 90 to 156 sessions per year and has increased the annual benefit coverage of patients with Chronic Kidney Disease Stage 5 to P405,600 from P234,000.

Also increased last year were benefit packages for acute ischemic stroke from P28,000 to P76,000; and acute hemorrhagic stroke from P38,000 to P80,000. Ledesma said these two packages alone have increased by 200 percent.

Recently, Philhealth likewise increased the benefit package for the treatment of breast cancer from P100,000 to P1.4 million, up by 1,300 percent.

Ledesma previously said that the state health provider has implemented a 30 percent increase in most of its case rate packages which he said will “restore substantial coverage affected by health inflation.”