MANILA — Cognizant of the needs of its members undergoing dialysis, the
Philippine Health Insurance Corp. increases its coverage for outpatient
hemodialysis from 90 to a maximum of 144 sessions for CY 2022.
In its PhilHealth Circular 2022-0017 published over the weekend and in effect
immediately, PhilHealth members and their dependents with chronic kidney
disease stage 5 (CKD) who are registered in the PhilHealth Dialysis Database are
allowed to avail themselves of the maximum 144 hemodialysis sessions until Dec.
31, 2022, provided that the dialysis sessions are prescribed by their attending
physicians.
The state insurer also emphasized that the 91 st to 144 th sessions shall be
exclusively used for outpatient dialysis only and any unused sessions will not be
carried over to calendar year 2023.
Qualified CKD patients who already used their 91 st to 144 th dialysis sessions and
were not able to avail themselves of the automatic deductions of the benefits
from their medical bills can still directly file their claims with any PhilHealth
Regional/Branch Office or Local Health Insurance Offices per existing guidelines.
Also reiterated in the guidelines is the application of the No Balance Billing Policy
wherein no other fees or expenses shall be charged or be paid for by qualified
patients above and beyond the packaged rates as per PhilHealth Circular No.
2017-0017.
In case of delay of filing of claims due to natural calamities or other fortuitous
events, PhilHealth shall likewise extend the filing period of claims from 60 to 120
days provided that the area where the patient is located or being treated is under
a state of calamity.
