The Philippine Health Insurance Corporation (PhilHealth) has significantly upgraded its Z Benefit Package for Peritoneal Dialysis, now offering distinct packages for both adult and pediatric patients, effective January 1, 2025.
This move aligns with President Ferdinand R. Marcos Jr.’s commitment to expanding healthcare benefits despite the absence of a subsidy.
According to the National Kidney and Transplant Institute, peritoneal dialysis (PD) is a type of renal replacement therapy (RRT) in which the patient’s peritoneal membrane, the lining of the abdominal organs, acts as an artificial kidney.
The updated PD package is now age-specific, covering different treatment modalities. For adult patients, PhilHealth covers 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 undergoing peritoneal dialysis, the coverage ranges from P389,640 to P510,140, depending on the daily PD solutions required. Previously, the coverage was set at P270K annually.
For pediatric patients, CAPD coverage ranges from P510K to P765,210, while APD coverage ranges from P763K to P1.2 million. PhilHealth also covers exit site infection and peritonitis prevention care, as well as ancillary services such as catheter insertion, outpatient treatment of PD-related peritonitis, and laboratory and diagnostic tests, as well as medicines for both adult and pediatric cases.
As per PhilHealth Circular No. 2024-0036, patients with Chronic Kidney Disease Stage 5 who will undergo this type of RRT must first be registered in the PhilHealth Dialysis Database and comply with the eligibility guidelines. Patients must also follow the treatment plan and attend follow-up visits. Sharing, selling, or distributing PD solutions is strictly prohibited.
Furthermore, contracted providers or health facilities are not allowed to charge co-payments for essential health services. However, they may charge co-payments for non-essential services and amenities not covered by the package. Providers are also required to fully inform patients of any co-payments.
The enhanced PD Z Benefits are available at any of the 51 contracted PD providers nationwide. A list of these providers can be found at www.philhealth.gov.ph.
Currently, Vicente Sotto Memorial Medical Center in Cebu City and Cebu South Medical Center in Talisay City are the contracted Z Benefit Providers for Peritoneal Dialysis in Central Visayas.
For further information, members may contact the following 24/7 hotlines: (02) 866-225-88, or mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987, or 0917-1109812.
