PhilHealth eyes doubling dialysis package to P5,200 per session

The state-run Philippine Health Insurance Corporation (PhilHealth) plans to double its subsidy for dialysis patients from P2,600 to P5,200 per session, PhilHealth Executive Vice President Eli Santos said Tuesday.

Santos made the announcement at a press conference with House Deputy Majority Leader and ACT-CIS party-list lawmaker Erwin Tulfo, who has been clamoring for increased PhilHealth benefits.

“Pag-aaralan po ng PhilHealth ang pag-increase nito to P5,200. Binigyan po kami ng one month [para rito]. Ang goal po natin is wala ng out-of-pocket itong dialysis patients,” Santos told reporters.

(PhilHealth will study the proposal to increase the coverage to P5,200, and we were given a month for it. The goal is for our dialysis patients not to have out-of-pocket expenses.)

“Manggaling po ito sa pondo ng PhilHealth,” he said.

 (This will come from PhilHealth funds.)

Asked if a larger dialysis subsidy would result in a higher PhilHealth premium rate, Santos replied, “Hindi po.” (No.)

Santos said that PhilHealth’s assets are worth P589.5 billion, of which P463.7 billion accounts for reserve funds, as of the end of 2023.

Under the Universal Health Care Law, PhilHealth should set aside part of its revenues that are not needed to meet the cost of the current year’s expenditures as reserve funds, provided that the total amount of reserves does not exceed a ceiling equivalent to the amount actuarially estimated for two years' projected program expenditures.

The law further states that “whenever actual reserves exceed the required ceiling at the end of the fiscal year, the excess of the PhilHealth reserve fund should be used to increase the program's benefits and to decrease the amount of members' contribution.”

Tulfo said the current subsidy hardly covers the vials needed to be injected into dialysis patients.

The current PhilHealth dialysis package covers 156 sessions each year.

“These shots (vials) are not always available in dialysis centers, so the patients seek help from a lot of people [to pay for them]. They go to the congressmen, mayors, and senators. These vials are covered by the P2,600, but since there are dialysis centers that do not have these vials, patients look elsewhere,” the lawmaker said.

“To solve this problem, PhilHealth will double the [subsidy] amount from P2,600 to P5,200 for the dialysis package, so patients won’t have to pay a cash-out amount, especially those who undergo dialysis three times a week. PhilHealth said we could give them one month to fix the mechanics. Kakayanin naman raw (they said it can be done),” he added.

In addition, Tulfo said that Speaker Martin Romualdez appealed to PhilHealth to further increase its benefits to its members by granting a 10% in-patient hospital bill discount for all members.

“Maybe we can implement, on the final bill, whether you are confined in a private or public hospital, a 10% discount for all members. If your bill is P100,000, you will only raise P90,000. That is a big help already,” Tulfo said.

“Mr. Santos said this is doable. It is just that they have to study where the funds will come.'' —VBL, GMA Integrated News