PhilHealth removes 45-Day benefit limit for members
PhilHealth President and CEO, Edwin Mercado, explained in a statement on March 20 that the policy, which has been in place since 2006, is now considered an 'outdated cost-containment strategy.'
Mercado acknowledged the policy's initial purpose but emphasized that with recent changes in the payment system, it is time for reform. He highlighted that medical needs are unpredictable, and many services require coverage beyond 45 days.
Under the old policy, members were entitled to a maximum of 45 days for room and board, with an additional 45 days shared among dependents. PhilHealth has already expanded coverage in some areas, such as hemodialysis, which was increased from 90 to 156 sessions.
The state health insurer is committed to ensuring that Filipinos with chronic illnesses or severe conditions continue to receive the necessary care.
However, PhilHealth stressed that benefits should be utilized based on medical necessity, and patient care will be monitored to ensure proper adherence to clinical standards and reimbursement rules.
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