PhilHealth eyes 100 percent hike in coverage for dialysis patients
Inquirer file photo/Grig C. Montegrande
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) is studying a 100 percent increase in the coverage for dialysis sessions, from P2,600 to P5,200, as it hopes to expand medical benefits for members.
In a joint press conference on Tuesday, PhilHealth executive vice president Eli Dino Santos and ACT-CIS Rep. Erwin Tulfo said they hoped to implement the hike within 30 days “to completely remove the need for more out-of-pocket expenditures of dialysis patients.”
READ: PhilHealth: Contribution hike needed to expand benefits
Santos, however, clarified that the proposal would still need to be discussed with the PhilHealth board and added that it appeared to be “doable” without raising premiums for members.
Currently, the state health insurance agency covers 156 hemodialysis sessions—or three sessions weekly for 52 weeks—as part of a benefit package worth P2,600 per session for PhilHealth members and their qualified dependents diagnosed with chronic kidney disease stage 5.
Tulfo, however, pointed out the package did not sufficiently cover erythropoietin injections, which often cost around P900 to P1,500.
This meant many patients often had to solicit aid from other government agencies. According to the Mayo Clinic’s website, erythropoietin treats anemia or low red blood cell count and is given to patients after dialysis.
No more cash-out
“To solve this problem, PhilHealth will just double the P2,600 package to P5,200 so that it’s all-in. Diabetic and dialysis patients don’t have to cash out anything,” Tulfo said.
If enacted, the new benefit package would cover both paying and nonpaying members, according to Santos.
The state health insurer currently has around P463 million in reserve funds. The amount includes gross margins of P173.4 million from its social health insurance program, double the P79.1 billion it generated in 2022.
The excess money prompted lawmakers like Marikina Rep. Stella Quimbo to suggest that PhilHealth suspend the collection contributions from minimum wage earners pending a review of its charter to expand benefits and reduce contributions.
