Philippine Health Insurance Corporation (PhilHealth) manually process their members’ transactions at PhilHealth National Capital Region Central Branch in Quezon City on Tuesday, September 28, 2023. Maria Tan, ABS-CBN News

MANILA - PhilHealth pushed for higher contributions this year saying this is needed for its plan to further widen coverage, even as President Ferdinand Marcos Jr. reviews the state health insurer's planned hike in premiums.

PhilHealth CEO Emmanuel Ledesma Jr. said members and their beneficiaries will not even need to pay for treatment of certain illnesses under PhilHealth's planned expansion of coverage.

“Marami kaming nakalatag na enhancements na siguradong mararamdaman ng mga miyembro dahil sa mas mababang bayarin sa ospital, kung hindi man wala nang babayaran pa,” Ledesma said.

PhilHealth will rationalize case rates for bronchial asthma and bacterial sepsis in newborns and COVID-19 inpatient benefits, said Ledesma.

Beneficiaries can also expect better packages for severe acute malnutrition in children aged 5 years old and below, and services for physical medicine and rehabilitation.

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"Another benefit to look forward to is the enhancement of peritoneal dialysis under the Z Benefits Package," PhilHealth said.

But Ledesma also signaled that the hike in premiums should be implemented.

“This is where the importance of adjusting our contribution rates comes into play. It will generate funds necessary for us to complete our benefit plans, and more importantly to sustain the reforms in the benefit packages,” said Ledesma.

PhilHealth members' contributions were supposed to increase to 5 percent of members' wages this year, up from 4 percent.

Ledesma earlier said that Marcos had "no objections" to the hike, but Marcos himself later said that the planned increase was still under review.

The PhiliHealth chief noted that they already implemented a 30-percent increase in most of its case rate packages last Feb. 14.

PhilHealth's coverage for breast cancer under its Z Benefits Package also jumped from P100,000 to P1.4 million, he added.  

Hemodialysis treatments were also increased to 156 sessions per year from 90 sessions.

"This has increased the annual benefit coverage of patients with Chronic Kidney Disease Stage 5 to P405,600 from P234,000. In 2023, PhilHealth paid a total amount of P17.43 billion for hemodialysis claims alone," the state health insurer said.

The benefits packages for acute ischemic stroke were also increased from P28,000 to P76,000, and acute hemorrhagic stroke from P38,000 to P80,000. Ledesma said these two packages alone have increased by 200 percent, it added.