PhilHealth hikes benefits package for kidney patients

MANILA, Philippines — After approving a 50 percent increase in almost all its benefit packages, the Philippine Health Insurance Corp. (PhilHealth) has also raised the benefit package for members suffering from stage 5 chronic kidney disease (CKD5).

Under Circular No. 2024-0035, the kidney transplant procedure under the Z Benefits Package has been hiked from P600,000 to more than P2 million.

Under Circular No. 2024-0036, on the other hand, peritoneal dialysis under the same benefits package has also been increased from P270,000 to up to P1.27 million per year. Both circulars took effect on Jan. 1.

READ: PhilHealth raises dialysis benefits, but private labs to cost more

Z Benefits Packages cover catastrophic illnesses and health conditions requiring expensive treatments and hospitalizations amounting to millions of pesos, such as different types of cancer.

PhilHealth now covers living organ donor transplants using Basiliximab (a drug to prevent organ rejection) amounting to P993,000 if the donor undergoes laparoscopic surgery or P865,000 if the donor proceeds with open surgery.

The benefits package becomes higher if the living organ transplant uses rabbit antithymocyte globulin or rATG (used to reduce rejection rates and treat tissue rejections in the kidney recipient)—P1.045 million if done with laparoscopy for the donor, and P918,000 if open surgery for both donor and recipient.

Higher rates are covered when the donor is deceased. If the transplant procedure uses Basiliximab, donor organ retrieval using machine perfusion is at P2.093 million, and organ retrieval using cold storage is at P1.583 million.

Deceased organ transplant using rATG’s rate is at P2.146 million (machine perfusion) or P1.636 million (cold storage).

This is the first time the Z benefit package for kidney transplants has been updated since its launch in 2012.

PhilHealth then covered only P600,000, or half of the average cost of a kidney transplant at P1.2 million, excluding post-operation procedures, including the lifelong medication patients must take.

For patients with end-stage renal disease, a kidney transplant is the best treatment option.