Effective May 1, 2024, the Philippine Health Insurance Corporation (PhilHealth) is implementing another round of enhancements in two of its existing benefit packages, this time for neonatal sepsis and bronchial asthma which have been increased heftily by more than 100%.
PhilHealth Circulars 2024-0008 and 0009, the implementing guidelines of these two case rate packages, prescribe that all patients admitted on May 1, 2024 onwards may avail themselves of the increased benefits in accredited health facilities.
According to PhilHealth President and CEO Emmanuel R. Ledesma Jr. “the PhilHealth Board has approved the increase in package rate for neonatal sepsis to P25,793 from P11,700 and bronchial asthma in acute exacerbation to P22,488 from P9,000. The increase translates to 120% and 150%, respectively”.
Neonatal sepsis and other infectious conditions are among as the leading causes of neonatal deaths in the Philippines. In 2023, PhilHealth paid P733.86 million for more than 57,000 cases for the said condition.
On the other hand, asthma remains to be a high-burden ailment in the Philippines despite medical advancements. The majority of Filipinos with asthma do not have adequate control over their conditions, resulting to confinements. Based on PhilHealth data for 2023, asthma ranks eight among the top medical confinements paid by the state insurer, where P717 M have been paid for, for more than 90,000 cases of asthma.
PhilHealth identified neonatal sepsis and bronchial asthma as priority conditions in rationalizing its All Case Rates packages to further improve financial coverage and lower, if not eradicate the patients out-of-pocket expenses.
Ledesma explained that “PhilHealth is continuously improving its benefit packages in line with our thrust Pinalawak at mga Bagong Benepisyo para sa Mamamayang Filipino. We are hoping that these enhancements bring positive impact in the behavior of the Filipinos in seeking medical attention. Sa mga nangangailangang magpagamot, huwag na pong magdalawang isip dahil nakaalalay ang PhilHealth sa kanilang gastusing medikal”.
PhilHealth also reminded the members that the adjusted case rates may be availed of in Levels 1 to 3 accredited public and private health facilities nationwide. Meanwhile, the previous rates of P11,700 for neonatal sepsis and P9,000 for bronchial asthma will be applied to patients admitted in accredited primary care facilities.
The state agency also emphasized the important role that primary care plays in disease prevention and early detection. It has again called on primary care facilities to be Konsulta Package Providers (KPP) to provide wider access to drugs and medicines for the control of asthma. “Since our accredited KPP provides consultations, drugs and medicines and laboratory tests, hospital admission due to worsening of asthma will be avoided”, Ledesma added.
The PhilHealth Chief also urged all members to register to their preferred to Konsulta Package Provider to avail themselves of free consultations, health screening and assessment, as well as any of the 21 essential drugs and medicines and 13 laboratory tests as will be required by their primary care physician.