PhilHealth Issues Advisory on Outpatient Dialysis Coverage

Statement of PhilHealth on Outpatient Dialysis Coverage

PHILHEALTH – The Philippine Health Insurance Corp. issued an advisory on the member’s coverage of the outpatient dialysis.

In the Philippines, the state-run health insurance firm is the Philippine Health Insurance Corporation or more commonly called as PhilHealth. A huge part of the Filipino populace is a member of the said state-run government insurance institution.

The said firm was created in 1995 and is under the Department of Health (DOH). The Philippine Health Insurance Corp. and Asset Management Arm are its subsidiaries.

Currently, the institution is led by Alexander Padilla. It was hooked by corruption controversies in 2020 and several officials of the health insurance institution were removed or resigned from their positions.

PhilHealth

Members of PhilHealth are entitled to several benefits depending on their account or contribution to the state-run health institution. There are inpatient and outpatient benefits.

Among the outpatient benefits are dialysis sessions. Recently, PhilHealth spoke on the member coverage for outpatient dialysis sessions as it will implement a change. From 90 sessions, the coverage is extended to 144 this year.

Based on a report on ABS-CBN News, PhilHealth Circular No. 2021-0009 stated that the 91st to 144th session are exclusive for outpatient hemodialysis. The patient must be registered in the Dialysis Database of the state-run health institution.

According to the agency, the patient may avail up to P374,400.00 for their treatment. It also said that patients who have already consumed their 90 sessions and are currently funding the next sessions after the 90th session may file for a refund to the state-run health insurance institution.

Patients of all chronic kidney disease stage 5 may avail the offer. The qualified dependent of a member may also avail it.

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