MANILA — Members of the Philippine Health Insurance Corp. (PhilHealth) can soon expect lower out-of-pocket expenses when getting medical treatment after it announced its plans to increase the coverage of its benefit packages by up to 30 percent.

• PhilHealth expands dialysis benefits, coverage for 2022

“Nasa 8,000 na mga medical cases at mga surgical cases na meron tayong katapat na benepisyo bilang health insurance ang siya pong isa-subject natin sa umento,” said Rey Balena, the acting Vice President of PhilHealth’s Corporate Affairs Group.

The agency said the hike in benefits is aimed at helping Filipinos cope with rising medical costs brought about by inflation.

This is good news for Judilene Panton, who has been undergoing dialysis for the past six months because of her chronic kidney disease.

Being a single parent, the cost of her treatment is extra burdensome. That is why she hopes that planned increase in PhilHealth benefits will push through.

“Bukod kasi sa dialysis, yung gamot sobrang dami. Yung laboratory, ang mahal, buwan-buwan. Yung mga ini-inject pa sa amin. Bilang solo parent, siyempre, saan ko kukunin?” she said.

PhilHealth’s Balena said the hike in benefits will not come with an increase in contributions.

“Hindi natin kino-contemplate yung magtataas agad tayo ng contribution. Naka-accumulate tayo ng sapat na pondo at matatag yan para tustusan natin itong increase na ito,” noted Balena.

Earlier this year, PhilHealth already expanded its dialysis coverage from 90 to 156 sessions. It also hiked its coverage for acute stroke.

PhilHealth is also set to expand its coverage for other conditions such as high risk pneumonia from P32,000 to P90,100 before the end of the year. And for next year, the agency plans to increase the benefits for qualified breast cancer patients.

But a group of private hospitals said PhilHealth should make sure it will be able to pay its obligations in time.

According to the Private Hospitals Association of the Philippines Inc (PHAPI), PhilHealth has yet to settle around P27 billion in hospital claims for both public and private facilities.

“Mas malaki ang ikakaltas nila (sa hospital bills) tapos hindi naman nila babayaran, eh 'di lalaki ang utang nila lalo diba? So maganda yun basta nababayaran,” said PHAPI President Dr. Jose Rene de Grano.

PhilHealth, meanwhile, vowed to speed up the process of paying back hospitals.

“Wala na silang dapat ipangamba. Sinabi din naman at nararamdaman ng mga hospitals natin na doon sa current claims, tayo ay nakakapagbayad nang mabilis,” said Balena.

The agency also committed to settle its obligations from previous years before the end of 2023.

“Naantala lang tayo dahil dito sa naging data breach incident pero tuloy-tuloy pa rin naman ang ating pagpo-proseso so hindi matatapos ang taon na ito, mase-settle natin kahit yung mga past years na payable sa mga hospitals,” added Balena.

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