PhilHealth for Contribution Increase and Promotes Wider Coverage in the Philippines
PhilHealth pushed for bigger contributions this year, claiming that this is necessary to expand coverage further, even as the administration evaluates the state health insurer’s proposed rate increase.
Emmanuel Ledesma Jr., CEO of PhilHealth, stated that under the organization’s proposed coverage expansion, members and their beneficiaries won’t even have to pay for the treatment of some ailments.
Ledesma noted, “Marami kaming nakalatag na enhancements na siguradong mararamdaman ng mga miyembro dahil sa mas mababang bayarin sa ospital, kung hindi man wala nang babayaran pa.”
Better packages for severe acute malnutrition in children ages 5 and below, as well as services for physical medicine and rehabilitation, can also be anticipated by beneficiaries.
President Ferdinand Marcos cited that he is still studying the PhilHealth Premium increase.
On the other hand, PhilHealth is still waiting for the administration’s decision regarding the implementation of the rate hike.
PhilHealth mentioned, “Another benefit to look forward to is the enhancement of peritoneal dialysis under the Z Benefits Package.”
However, Ledesma also cited that the premium increase ought to go into effect.
Ledesma stated “This is where the importance of adjusting our contribution rates comes into play. It will generate funds necessary for us to complete our benefit plans, and more importantly to sustain the reforms in the benefit packages.”
The contributions made by PhilHealth members were scheduled to rise from 4 percent to 5 percent of their income this year.
The President later stated that the proposed increase was still being considered, despite Ledesma’s earlier statement that he had “no objections” to the hike.
According to Ledesma, on February 14 last year, they had already increased most of their case fee packages by 30%.
Moreover, he also mentioned that the agency’s coverage for breast cancer under Z benefits also increased from ₱100,000 to ₱1.4 million.
Hemodialysis has also increased from 90 sessions to 156 sessions annually.
The state health insurer mentioned, “This has increased the annual benefit coverage of patients with Chronic Kidney Disease Stage 5 to ₱405,600 from ₱234,000. In 2023, PhilHealth paid a total amount of ₱17.43 billion for hemodialysis claims alone.”
Furthermore, the benefits package for acute ischemic stroke was also raised from ₱28,00 to ₱76,000, and acute hemorrhagic stroke from ₱38,000 to ₱80,000. Ledesma noted that these packages have increased by 200 percent.
