PhilHealth increases dialysis coverage to P1m per year

The Philippine Health Insurance Corp. (PhilHealth) increased its benefit package for hemodialysis from P4,000 to P6,350 per session, effective Oct. 7, 2025, bringing the total financial package to nearly P1 million per patient per year.

Under PhilHealth Circular No. 2024-0023, members and their qualified dependents with chronic kidney disease stage 5 (CKD5) can now avail of the adjusted package at any accredited dialysis facility.

PhilHealth president and chief executive Emmanuel Ledesma Jr. said the increase is a testament to the agency’s commitment to providing adequate health care coverage to its members.

“This is clear proof that PhilHealth is not only listening to our members. We make good on our promise to take concrete steps to ensure that our benefit packages respond adequately to the needs of patients, which is a core objective of the Universal Health Care Law,” he said.

Despite the July 1 increase in reimbursement rate to P4,000 per session, Ledesma said many patients were still paying significant amounts out of pocket for their dialysis sessions. “Our aim is to ensure that patients will no longer have to pay co-payment when availing of the minimum set of services for dialysis,” he said.

With the new rate of P6,350 per session, a CKD5 patient is now entitled to a maximum of P990,600 in financial protection per year. The circular also specifies the essential services required for CKD5 patients, including anti-coagulation medications, anemia drugs, laboratory tests, supplies, and administrative fees.

Patients who require additional or premium services beyond the minimum standard of care may be subject to co-payment. A cap of P450 is set for professional fees for additional services like telemedicine or immediate interventions to manage complications.

PhilHealth made it a requirement for dialysis facilities to fully explain any co-payment to patients.

The increased dialysis coverage has brought hope to patients like Roseanne Lappay of Tabacalera, Pateros. “This is good news for us dialysis patients,” she said.