The Philippine Health Insurance Corporation (PhilHealth) has introduced substantial improvements to its Z Benefit Package for Peritoneal Dialysis (PD), offering distinct packages for adult and pediatric patients starting on January 1, 2025.
This enhancement aligns with President Ferdinand R. Marcos Jr.’s commitment to the continuous expansion of healthcare benefits, despite the absence of a subsidy.
According to the National Kidney and Transplant Institute, peritoneal dialysis (PD) is a form of renal replacement therapy (RRT) in which the patient’s peritoneal membrane, lining the abdominal organs, functions as an artificial kidney.
The updated PD package provides coverage for various treatment methods depending on the patient’s age. For adults, PhilHealth will cover Continuous Ambulatory Peritoneal Dialysis (CAPD), while for pediatric patients, both CAPD and Automated Peritoneal Dialysis (APD) are included.
“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 CEO Emmanuel R. Ledesma, Jr. “PhilHealth wants to push this as an option apart from hemodialysis, not just to give autonomy and flexibility to our members in choosing the treatment modality, but also to promote quality of life and mobility of patients,” he added.
For adult patients, the peritoneal dialysis coverage ranges from P389,640 to P510,140, depending on the amount of PD solution required daily. Previously, the coverage was set at P270,000 annually.
For pediatric patients, the benefits for CAPD range from P510,000 to P765,210, while APD coverage ranges from P763,000 to P1.2 million. In addition, PhilHealth also covers treatment for exit site infections, prevention of peritonitis, catheter insertion, outpatient care for PD-related peritonitis, and diagnostic tests and medications for both adults and children.
PhilHealth Circular No. 2024-0036 mandates that patients with Chronic Kidney Disease Stage 5 who wish to avail of this renal replacement therapy must first be registered in the PhilHealth Dialysis Database and meet the eligibility criteria. Patients must follow their prescribed treatment plans and attend follow-up appointments. The sharing, selling, or distribution of PD solutions is strictly prohibited.
Furthermore, contracted health providers or facilities are not allowed to charge co-payments for services covered by the essential health package. However, they may charge co-payments for services outside the scope of the covered benefits. Providers are required to clearly inform patients about any co-payments applicable.
The enhanced PD Z Benefits are available through any of the 51 contracted PD providers across the country, with a complete list available on www.philhealth.gov.ph.
Currently, Vicente Sotto Memorial Medical Center in Cebu City and Cebu South Medical Center in Talisay City are among the contracted Z Benefit Providers for Peritoneal Dialysis in the Central Visayas region.
For further inquiries, members can contact the 24/7 hotlines at (02) 866-225-88 or the mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987, or 0917-1109812.
