PhilHealth expands hemodialysis package to 156 annual sessions

By Ma. Teresa Montemayor

June 22, 2023, 3:41 pm

MANILA – The Philippine Health Insurance Corporation has expanded its hemodialysis package for patients with chronic kidney disease (CKD) stage 5 to 156 sessions from 90 sessions annually.

“Ito po ay alinsunod sa standard dialysis requirement ng isang pasyente na mayroon siyang at least tatlong sessions kada linggo at kung ‘yan ay imu-multiply natin sa 52 weeks for buong taon, iyan po ay 156 (This follows the standard dialysis requirement for each patient who must have at least three sessions every week which when multiplied by 52 weeks for a year, that is 156),” Philhealth Corporate Affairs Group acting Vice President Rey Baleña said in a televised public briefing Thursday.

Under PhilHealth Circular 2023-009, the agency would be paying PHP2,600 every session or PHP405,600 per year for CKD stage 5 patients.

The expanded package has been institutionalized with funds coming from the Philippine Amusement and Gaming Corporation (PAGCOR) and the Philippine Charity Sweepstakes Office (PCSO).

The General Appropriations Act for 2023 mandates that PHP21 billion from the earnings of the PAGCOR and the PCSO must be transferred to the PhilHealth. 

Baleña said the package aims to provide financial protection for CKD stage 5 patients needing hemodialysis.

To avail of the package, patients must be recommended by a licensed doctor to have hemodialysis and must be listed in the PhilHealth dialysis database.

The number of sessions availed by the patient will be monitored by the facility administering the hemodialysis.

If the patient is unable to meet the total number of sessions for the year, the unused number of sessions cannot be carried over to the following year.

Last year, PhilHealth paid PHP17.3 billion for 3.6 million claims filed by hemodialysis patients.

As for the first quarter of this year, the agency paid PHP4.5 billion for 926,000 hemodialysis claims. (PNA) 

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