Manila: The Philippine Health Insurance Corp. (PhilHealth) has eliminated the 45-day benefit limit to ensure its services remain unhampered. PhilHealth President and Chief Executive Officer Edwin Mercado stated that the 45-day benefit limit was an outdated cost-containment strategy. He emphasized that medical needs cannot always be predicted or scheduled, noting that many services require more than just 45 days of coverage.

According to Philippines News Agency, PhilHealth has already extended the number of sessions covered by its hemodialysis benefit packages from 90 to 156 sessions. The state insurer reminds members that benefits must be availed based on proper medical indication, necessity, and alignment with the patient’s treatment plan. They must also adhere to widely accepted standards of care, Clinical Practice Guidelines approved by the Department of Health (DOH), and PhilHealth Circulars on quality standards.

To ensure responsible implementation of this policy, PhilHealth will monitor patient admissions, readmissions, and benefit utilization exceeding 45 days. Compliance with clinical standards and reimbursement rules will be assessed through the Health Care Providers Performance Assessment System.

Health Secretary and PhilHealth Board Chair Teodoro Herbosa mentioned that the move aligns with President Ferdinand R. Marcos Jr.’s directive to ensure continuous healthcare services for all members. Herbosa highlighted that under the Universal Healthcare (UHC) Act, PhilHealth pays for individual-based services, which is why the administration is focused on expanding health benefits for every Filipino.

The PhilHealth Board, the highest governing body of the corporation, comprises 13 seats, five of which are held by ex-officio members, including the secretaries of health, social welfare and development, labor and employment, finance, and budget and management.