The Philippine Health Insurance Corporation (PhilHealth) has made significant improvements to its Z Benefit Package for Peritoneal Dialysis, now offering separate packages for adults and pediatric patients starting January 1, 2025.
This update follows President Ferdinand R. Marcos Jr.’s promise of continuous expansion of healthcare benefits despite the lack of a subsidy.
The National Kidney and Transplant Institute explains that peritoneal dialysis (PD) is a renal replacement therapy (RRT) where the patient’s own peritoneal membrane, which lines the abdominal organs, serves as an artificial kidney.
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The newly improved PD package covers different treatment options based on the patient’s age. For adults, PhilHealth will pay for Continuous Ambulatory Peritoneal Dialysis (CAPD), and for younger patients, 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 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 coverage for peritoneal dialysis ranges between P389,640 and P510,140, depending on the amount of PD solution needed daily. Previously, the coverage was set at P270K annually.
For pediatric patients, CAPD benefits range from P510K to P765,210, while APD coverage ranges from P763K to P1.2 million. Additionally, PhilHealth covers treatment for exit site infections and peritonitis prevention, along with other services such as catheter insertion, outpatient treatment for PD-related peritonitis, and diagnostic tests, including medications for both adults and children.
As per PhilHealth Circular No. 2024-0036, patients with Chronic Kidney Disease Stage 5 who wish to avail of this RRT must first be registered in the PhilHealth Dialysis Database and follow the eligibility requirements. Patients must also comply with their treatment plans and attend scheduled follow-up visits. The sharing, selling, or distribution of PD solutions is strictly prohibited.
Moreover, contracted providers or health facilities cannot charge co-payments for essential health services covered by the package. However, they may charge co-payments for services that are not part of the essential benefits. Providers are required to clearly inform patients about any co-payments that may be charged.
The enhanced PD Z Benefits are available at any of the 51 contracted PD providers nationwide, with the full list accessible at 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 Central Visayas.
For more details, members can reach out to the 24/7 hotlines: (02) 866-225-88, or mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987, or 0917-1109812.
