The Philippine Health Insurance Corporation (PhilHealth) has increased the hemodialysis coverage from PHP 4,000 to PHP 6,350 per session.
As outlined in PhilHealth Circular No. 2024-0023, the new hemodialysis package rate offers increased support to members and their qualified dependents diagnosed with chronic kidney disease stage 5 (CKD5). Eligible patients can now access the updated rate of PHP6,350 per session at any accredited dialysis facility nationwide.
This enhanced benefit offers CKD5 patients up to PHP990,600 in annual financial assistance. Essential services included for CKD5 patients are anti-coagulation medications, anemia management drugs, laboratory tests, and necessary supplies like dialyzers and hemodialysis solutions, along with a dialysis kit for each session.
Additionally, CKD5 patients are entitled to coverage for administrative fees related to the use of dialysis machines, facility fees, utilities, and staff time at all accredited facilities.
Despite the reimbursement rate increase to PHP4,000 per session on July 1, PhilHealth acknowledged receiving reports of patients still shouldering significant out-of-pocket costs for their dialysis sessions.
PhilHealth president and chief executive officer Emmanuel Ledesma said: “Our aim is to ensure that patients will no longer have co-payment when availing of the minimum set of services for dialysis.”
Patients who need additional and premium services beyond the minimum standard of care specified will have to be subject to co-payment. Moreover, there is a cap of PHP 450 for professional fees if patients need additional services, like telemedicine or immediate interventions to manage complications arising during sessions.
If a co-payment is needed, PhilHealth will require the dialysis facility to provide an explanation for it.
