PhilHealth benefits enhancement on track, more to expect this year
STATE Health Insurance Chief Emmanuel Ledesma Jr. assures President Ferdinand Marcos Jr. that members and their beneficiaries can expect better and more responsive health benefits packages that they can avail of at any accredited health facility nationwide.
“We’ve started to offer better benefits last year and will continue this year. We have several enhancements for all members as packages offer lower hospital rates or no fees at all,” he declared.
The PhilHealth chief’s pronouncement came on the heels of the President’s recent call that “any increase in premium will substantially be much more in value in terms of benefits and coverage to PhilHealth members.”
Ledesma recently announced that the 30-percent increase in most of its case rate packages already took effect for all admissions starting Feb. 14, 2024, the first time that an across-the-board increase was implemented since the all-case rate scheme was launched in 2013.
“The 30-percent increase in case rates will restore substantial coverage affected by health inflation,” Ledesma said.
Coverage for breast cancer under its Z Benefits Package also jumped from P100,000 to P1.4 million or an increase of 1,300 percent.
In 2023, the PhilHealth Board approved the expansion of its coverage of hemodialysis from 90 to 156 sessions per year, increasing the annual benefit coverage of patients with chronic kidney disease stage 5 to P405,600 from P234,000.
In 2023, PhilHealth paid a total amount of P17.43 billion for hemodialysis claims alone.
Coverage for high burden disease in terms of finances and effect on the quality of life of patients also increased. Benefits packages for acute ischemic stroke and acute hemorrhagic stroke increased by 200 percent.
“We are [also] set to expand access points for medicines by engaging pharmaceutical service entities to make essential medicines within reach by our countrymen needing them,” Ledesma vowed.