January 31 ------ The Philippine Health Insurance Corporation (PhilHealth) announced that it has significantly enhanced its Z Benefit Package for Peritoneal Dialysis (PD), now offering separate benefits for adult and pediatric patients. In a statement, PhilHealth said the expanded PD package, effective Jan. 1, 2025, covers different modalities based on age.
For adults, PhilHealth covers Continuous Ambulatory Peritoneal Dialysis (CAPD), while pediatric patients can avail of both CAPD and Automated Peritoneal Dialysis (APD). "We want to encourage the availment of peritoneal dialysis as a first-line modality treatment for patients with Chronic Kidney Disease Stage 5," said PhilHealth President and Chief Executive Officer (CEO) Emmanuel R. Ledesma, Jr. "PhilHealth aims to promote this as an option alongside hemodialysis, not only to give our members autonomy and flexibility in choosing their treatment modality but also to enhance their quality of life and mobility," he added.
For adult patients, coverage can either be P389,640 or P510,140, depending on the required PD solutions per day. Previously, the package was capped at P270,000 per year. Meanwhile, benefits for pediatric patients under CAPD range from P510,000 to P765,210, while coverage for APD ranges from P763,000 to P1.2 million.
PhilHealth also covers exit site infection and peritonitis prevention care, along with ancillary services, including: catheter insertion, outpatient treatment of PD-related peritonitis, laboratory and diagnostic tests, and drugs and medicines for both adult and pediatric patients. According to PhilHealth Circular No. 2024-0036, patients with Chronic Kidney Disease Stage 5 who wish to avail of this Renal Replacement Therapy (RRT) must first register in the PhilHealth Dialysis Database and comply with existing membership eligibility guidelines. "Patients must also adhere to their treatment plan, including follow-up visits," PhilHealth stated. "They are strictly prohibited from sharing, selling, or distributing PD solutions provided to them."
Additionally, contracted providers or health facilities are prohibited from charging co-payments for essential health services. "However, co-payments may apply for services and amenities not covered by the package," PhilHealth clarified. "Providers must fully explain any co-payment charges to patients." The enhanced PD Z Benefits are available at any of the 51 contracted PD providers nationwide. The full list can be accessed at www.philhealth.gov.ph.
Citing the National Kidney and Transplant Institute, PhilHealth explained that peritoneal dialysis (PD) is a type of renal replacement therapy (RRT) in which the patient’s own peritoneal membrane—the lining of abdominal organs and body surfaces—functions as an artificial kidney. PhilHealth emphasized that the adjustments to the PD Z Benefits align with President Marcos' commitment to expanding healthcare benefits despite a zero subsidy.
Source: mb.com.ph
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