The Philippine Health Insurance Corporation (PhilHealth) has scrapped its long-standing 45-day benefit limit, aiming to provide uninterrupted healthcare coverage for its members.
PhilHealth President and CEO Edwin Mercado described the limit as an outdated cost-containment measure that no longer aligns with the evolving healthcare system.
“We understand why it was implemented before, but with our updated payment mechanism, it is time for reform,” Mercado stated.
He emphasized that medical needs are often unpredictable, and many treatments require extended coverage beyond 45 days. Mercado thanked the PhilHealth Board for approving the policy update, which ensures more comprehensive healthcare support for Filipinos.
PhilHealth had earlier expanded its hemodialysis package, increasing the number of covered sessions from 90 to 156.
To uphold responsible implementation, PhilHealth will monitor patient admissions, readmissions, and benefit utilization beyond the previous 45-day cap. Compliance with clinical standards and reimbursement rules will also be evaluated through the Health Care Providers Performance Assessment System (HCPPAS).
