PhilHealth increases yearly dialysis coverage to 156 sessions
THE Philippine Health Insurance Corp. (PhilHealth) announced that its coverage for hemodialysis has been expanded from 90 to 156 sessions starting this year, as provided for in PhilHealth Circular 2023-0009 titled “Institutionalization of 156 hemodialysis sessions” which took effect on June 22, 2023.
PhilHealth members and their qualified dependents diagnosed with chronic kidney disease stage 5 (CKD5) needing hemodialysis as prescribed by their nephrologists may avail themselves of this benefit package. The patient should also be registered in the PhilHealth Dialysis Database prior to availment.
The state-run health insurer explained that the total of 156 sessions is in accordance with the current standards for adequate hemodialysis of three sessions per week for 52 weeks, which is equivalent to one year. With this benefit expansion, CKD5 patients on hemodialysis can avail of as much as P405,600 per year at P2,600 per session.
“We are confident that this will adequately support our kababayans who need this lifesaving treatment,” PhilHealth President and CEO Emmanuel Ledesma Jr. said.
However, PhilHealth strongly advocates for peritoneal dialysis (PD) first, as it encourages accredited health care providers to recommend PD as the initial line of treatment for CKD5 patients.
On the other hand, kidney transplantation remains the gold standard treatment for patients with kidney failure. The state agency said it is set to increase financial coverage for its peritoneal dialysis and kidney transplantation packages in the next two years. As such, all health facilities should register their newly diagnosed CKD Stage 5 patients needing renal replacement therapy in the PhilHealth Dialysis Database.
Ledesma also emphasized that the expansion in hemodialysis coverage as well as its institutionalization is made possible with the help of the Philippine Amusement and Gaming Corp. (Pagcor) and Philippine Charity Sweepstakes Office (PCSO).
A total of P21 billion from the said partner agencies have already been approved for transfer to PhilHealth under the 2023 General Appropriations Act.