December 3, 2023

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.

“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.

Under PhilHealth Circular 2023-009, the agency will pay P2,600 every session or P405,600 per year for CKD stage 5 patients.

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

The 2023 General Appropriations Act mandates that P21 billion from the earnings of the Pagcor and the PCSO must be transferred to the PhilHealth. 

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 P17.3B for 3.6 million claims filed by hemodialysis patients.

As for the first quarter of this year, the agency paid P4.5B for 926,000 hemodialysis claims. – PNA