News
PhilHealth-7 Extends Dialysis Coverage to 90 Days
Philippine Health Insurance Corporation (PhilHealth) has expanded the health insurance coverage for hemodialysis from 45 days to 90 days per year.
Hemodialysis is the most common way to treat advanced kidney failure.
The procedure can help a patient carry on an active lifestyle despite failing kidneys.
Hemodialysis requires patients to follow a strict treatment schedule, take medications regularly, and usually make changes in their diet.
The health insurance coverage is extended to qualified dependents (if any) at no added premium, also up to a maximum of 45 days per year but these additional 45 days to be shared by all qualified dependents, according to a press release from PhilHealth.
It was also explained that the reduction in the package amount will extend the members’ accessibility to the treatment of up to 90 sessions per year instead of the current maximum allowable sessions of 45 per year.
Members are covered by the health insurance company for a maximum of 45 days of admission or confinement per year.
Each admission (outpatient) or each day of confinement (inpatient) will be deducted from this 45 day limit.
This applies to all cases covered by PhilHealth, including hemodialysis.
Members and dependents who have already used up their respective 45 day allowances are no longer entitled to PhilHealth coverage for the year, except when the reason for admission is outpatient hemodialysis.
PhilHealth allows members to use the 45 day allowance intended for dependents (or what is left of it, if any) as additional health insurance coverage exclusively for outpatient hemodialysis.
In the same way, dependents can use the 45-day allowance of the member (or what is left of it, if any) for outpatient hemodialysis.
Members and dependents can only do so once their first 45 days of coverage has been used up.
The same policy applies to members without qualified dependents. PhilHealth covers their admissions or hospitalizations for a maximum of 45 days per year.
If 45 days have been exhausted, the member is no longer entitled to insurance coverage except when the reason for admission is outpatient hemodialysis for another 45 days.
Hemodialysis patients can avail of a maximum of P234,000 per year as health insurance coverage from PhilHealth at a case rate of P2,600 per session for a total of 90 days if the dialysis patients use their 45 day allowance solely for outpatient hemodialysis meaning no other hospitalization. (rmn/hfg/PIA-7/PhilHealth)
