PhilHealth increasing benefit package rates

CEBU, Philippines — As Philippine Health Insurance Corp. (PhilHealth) increased the premium or member’s contribution to 5% this year in accordance with the Universal Health Care law, they said they will increase the rate of its benefit packages before the year ends.

PhilHealth-7 Regional Vice President Marjorie Cabrieto highlighted this initiative to expand benefits for critical medical conditions to ease the financial burden on Filipino patients.

In the first half of 2024, PhilHealth paid out ?74.95 billion in claims, a 16% increase from the previous year.

Particularly, Region 7 reported paying out a total of ?5.3 billion, with an average processing time of just 25 days, much quicker than the required 60 days.

This year 2024 has raised over 9,000 case rate packages by 30% in 2024, offering more financial support for various medical conditions.

“The adjustment in the premium will also help our indigent members, the senior citizens that are not paying. While you are still actively engaging with the respective professions, we shoulder the expenses,” said Cabrieto.

With that, PhilHealth now offers a hemodialysis package from 90 to 156 sessions per year for Chronic Kidney Disease Stage 5 patients, increasing annual support from ?405,600 to ?624,000.

Stroke coverage also saw a boost, with hemorrhagic stroke coverage doubling from ?38,000 to ?80,000 and ischemic stroke rising from ?28,000 to ?76,000.

Meanwhile, coverage for high-risk pneumonia was increased to ?90,100.

These benefits fall under the “No Balance Billing” which means patients no longer have to pay on top of the increased package rate.

“No balance billing can be availed by our senior citizens, our indigent members, to any government (health care) facilities…Mandated by our policy that these government facilities should not allow the members to pay or to purchase medicine outside,” Cabrieto added.

On mental health appropriation, PhilHealth extended its services by providing outpatient benefits for general and specialty mental healthcare.

In Cebu, the lone PhilHealth-accredited Outpatient Mental Health Package provider in Central Visayas is Borbon. With that, residents of Borbon and nearby towns will have improved access to mental health services and medical assistance with an allocation of ?9,000 for the entire session.

On the other hand, the Z Benefit Package, particularly for breast cancer, saw a remarkable 1,300% increase, from ?100,000 to up to ?1.4 million, alongside increased coverage for neonatal sepsis and bronchial asthma.

The accredited institutions in Cebu to provide the package for breast cancer patients are the Perpetual Succour Hospital and the Vicente Sotto Memorial Medical Center. — (FREEMAN)