PhilHealth Outpatient Benefit for Hemodialysis: Coverage & Guidelines

Guide on PhilHealth Outpatient Benefit for Hemodialysis Coverage & Claims

PHILHEALTH OUTPATIENT BENEFIT FOR HEMODIALYSIS – Here are the guidelines and the coverage under this PhilHealth benefit.

Members of the Philippine Health Insurance Corporation (PhilHealth) with updated accounts may be eligible for the several offers of the state-run social insurance institution. These include both inpatient and outpatient benefits.

One of the outpatient benefits is the PhilHealth outpatient benefit for hemodialysis. Under it, the case rate is P2,600.00 per session and you can process multiple claims under a single claim. There is a 90-day benefit limit and if the procedure was done during a hospital confinement, “only the total number of confinement days shall be deducted”.

PhilHealth Outpatient Benefit for Hemodialysis
Photo Credit: InCorp Philippines

How to Process your Claim for PhilHealth Assistance?

  • Step 1 – There are documents that you need to prepare and it is a case-to-case basis depending on the type of benefit you need to claim (inpatient, outpatient, or Z benefits). In the case of claiming a PhilHealth Inpatient Benefits, you should prepare the following:
  • Step 2 – Present your document to the billing office of the accredited hospital or Health Care Institution (HCI) where you got confined or operated. The case rate amount will be deducted by the HCI from your total bill. The deduction includes both the case rate and the charges or professional fees of the attending physician(s).
  • Step 3 – Pay for the remaining hospital bill.

It is important to keep your PhilHealth account updated to secure a turn to in times of medical emergencies and even on non-emergency situations relating to health. It does not only benefit the account holder but as well as the beneficiaries – the spouse, children, parents of the account owner.

You can apply for PhilHealth membership online. To check on the online application process, you may visit – How To Apply for PhilHealth Membership Online & the Requirements to Submit.

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