PhilHealth expands hemodialysis coverage

CEBU, Philippines — The Philippine Health Insurance Corporation (PhilHealth) will now cover a maximum of 144 from 90 hemodialysis sessions for 2022.

The government health insurer has issued Circular No. 2022-0017 allowing PhilHealth members registered in the PhilHealth Dialysis Database with Chronic Kidney Disease (CKD) Stage 5 to avail of a maximum of 144 hemodialysis sessions until December 31, 2022.

The Department of Health announced yesterday the good news to all PhilHealth members undergoing hemodialysis sessions.

According to DOH, these dialysis sessions must be prescribed by their attending physicians, and the 91st to 144th sessions shall be exclusively used for outpatient dialysis only.  It said that any unused sessions will not be carried over to the next calendar year. 

It added that qualified CKD patients who already used their 91st to 144th dialysis sessions, but were not able to avail of the automatic deductions of the benefits from their medical bills can still directly file their claims with any PhilHealth Regional/Branch Office or Local Health Insurance Offices per existing guidelines. 

 Also reiterated in the PhilHealth Circular is the application of the No Balance Billing (NBB) policy, wherein no other fees or expenses shall be charged or be paid for by qualified patients above and beyond the package rates as per PhilHealth Circular No. 2017-0017.

 Further, in case of delay of filing of claims due to natural calamities or other fortuitous events, PhilHealth shall likewise extend the filing period of claims from 60 to 120 days provided that the area where the patient is located or being treated is under a state of calamity.

“We thank PhilHealth for expanding its benefits for dialysis patients through this issuance. It  will improve the access of our kababayans to life saving services and help in our implementation of universal health care," said DOH Officer-in-Charge Maria Rosario Singh-Vergeire. — Caecent No-ot Magsumbol, FPL (FREEMAN)