THE Philippine Health Insurance Corp. (PhilHealth) is set to implement another 30% increase in the coverage rates of its benefit packages in November 2024.
“Our commitment for this is November 2024. Final guidelines and mechanics in the form of a circular will be released for this,” said PhilHealth corporate affairs vice president Rey Baleña.
This follows a 30% increase in coverage rates for most benefit packages implemented in February of this year.
Baleña clarified that high-risk illnesses will be exempt from this upcoming increase.
“These packages (not covered) are for conditions that are high-burden diseases and in the top claims. Packages for stroke, high-risk pneumonia, etc. will be increased by more than 100 or even 200 percent,” he said.
The adjustments in benefit packages aim to minimize out-of-pocket expenses for patients, PhilHealth stated.
“The 30% increase in case rates will restore substantial coverage affected by health inflation,” said PhilHealth president and chief executive officer Emmanuel Ledesma Jr.
Meanwhile, the Benefits Committee of the PhilHealth board of directors recommended a new policy that would eliminate the single period of confinement rule. This rule, outlined in PhilHealth Circular No. 0035, s. 2013, states that “admissions and re-admissions due to the same illness or procedure within a 90-calendar day period shall only be compensated with one case rate benefit.”
Approximately 26,750 claims were denied in 2023 due to this rule.
