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Philhealth: Additional rates effective Feb. 14

by Kiko Cueto

THE increase in the coverage rates of most of the benefit packages of the Philippine Health Insurance Corporation (PhilHealth) takes effect on February 14, 2024.

It will be recalled that in November last year, PhilHealth said that the rates of their benefit packages will increase by 30% so as to lessen the out-of-pocket expenses for Filipinos who are availing of the health care services using PhilHealth.

PhilHealth spokesperson Rey Baleña noted that the state health insurer had already issued Circular No. 2024-001 that contains the case rates or benefit packages subject to increase or adjustment.

Under the said circular, it takes effect on February 14, PhilHealth said that they had adopted an inflation adjustment factor of 30%, for existing case rates to account for price changes over the past decade.

“‘Yan ang layunin ng ating adjustment sa benefit packages, ang mapababa o mabura na ang balanseng binabayaran sa pagpapaospital,” Baleña said.

However not all case rate packages would increase since these were already adjusted in the last five years.

“Pangunahin diyan ‘yung dialysis… Kung matatandaan, last year ang ginawa natin sa dialysis ay hindi lang 30% adjustment… Ang ginawa ng PhilHealth Board, ‘yung pangangailangan ng isang pasyente for dialysis sessions sa buong isang taon ay sinagot na ng PhilHealth,” Baleña said.

“Ang ginawa natin sa dialysis, lahat ay kinover na natin… Hindi na maaantala ang pagpapa-dialysis ng pasyente sa buong taon,” he said.

Meanwhile, Baleña noted that the high-risk pneumonia was exempted from the 30% adjustment.

“Iba ang naging approach natin sa high-risk pneumonia dahil isa ‘yan sa mga condition na talagang high burden sa patients. From P32,000, naging P90,100 ‘yan effective last year. Hindi lang 30% ang naging increase diyan,” he said.

For stroke cases, Baleña said the benefit coverage was increased by more than 150% last year.

“Dati ‘yung [coverage] for ischemic stroke ay nasa P28,000, naging P76,000. ‘Yung hemorrhagic, dating P38,000 naging P80,000,” Baleña said.



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