PhilHealth extends confinement for dialysis

The Philippine Health Insurance Corporation has extended members’ coverage for the confinement and dialysis session beyond their annual limit, the agency spokesperson said on Sunday.

Interviewed on Dobol B sa News TV, PhilHealth spokesperson Rey Baleña said the agency will release a policy and clarification on the matter this week.

“Mananatili po na sasagutin ng PhilHeatlh ‘yung pong pagpapa-confine ng mga miyembro kahit ito ay lagpas na sa 45-day limit sa bawat taon,” Baleña said.

“At pagdating naman po sa dialysis, ay nililinaw po natin na ‘yung mga lagpas doon sa 90-session limit kada taon, yan po ay sagot pa rin po ng PhilHealth,” he added.

Baleña noted PhilHealth still covers dialysis treatment until December 19.

Baleña said the extension was based on the Bayanihan 2 and the declaration of state of calamity in the country.

Earlier, the Dialysis Philippines Support Group Inc. lamented that some dialysis centers were rejecting PhilHealth cards of patients who have availed of over 90 dialysis sessions.

The group’s President Reynaldo Abacan Jr. said that under the Bayanihan 2, the privilege to avail of free dialysis sessions should last until December as there was still a public health emergency.

Philhealth likewise issued the policy statement in response to an appeal by Assistant Majority Leader and Quezon City Rep. Alfred Vargas, who had said that the decision to temporarily halt the program hurts the poor and members who have been affected by the Covid 19 pandemic.

The Dialysis PH Support Group Inc., meanwhile, had said that over 100 accredited dialysis centers rejected the PhilHealth cards of patients who have availed of more than the 90 dialysis sessions provided by the program. This has allegedly affected some 30 to 70 patients per center.

“It is unconscionable to have our indigent dialysis patients scrounge around for money amid record unemployment and rising poverty during this pandemic. Mga kababayan natin yan na lubhang na-apektuhan ng pandemya. Dapat silang tinutulungan, hindi pinahihirapan,” said Vargas.

The lawmaker also chided the state health insurer for hiding behind legalities whenever it draws flak for it failure to perform its functions.

“Parang nagiging default excuse na ang pag-review nila ng proseso sa kawalan ng agarang aksyon. This shows insensitivity to the needs of their members, and we cannot hide this insensitivity behind the same tired excuses,” Vargas said.

Abacan Jr. earlier said that under the Bayanihan 2 law, the free dialysis privilege should last until December due to the ongoing public health emergency.

The regular coverage of up to 90 days or 90 sessions per calendar year for dialysis patients was extended when President Rodrigo Duterte declared a state of calamity due to the Covid-19 pandemic for six months in March.

The coverage of regular members of 45 days  per calendar year was also extended by the declaration of a state of calamity.

Since the President extended the state of calamity for one year from Sept. 13, 2020 to Sept. 12, 2021, the PhilHealth is still obligated to pay for dialysis sessions even if the allotted days of insurance coverage have already been used up.

Topics: Philippine Health Insurance Corporation , Reynaldo Abacan Jr , Dialysis PH Support Group Inc , Rey Baleña , Alfred Vargas
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