The Philippine Health Insurance Corporation (PhilHealth) has significantly improved its Z Benefit Package for Peritoneal Dialysis (PD), with separate packages for adult and pediatric patients, effective January 1, 2025.
This update follows President Ferdinand R. Marcos Jr.’s commitment to expanding healthcare benefits despite the absence of a subsidy.
Peritoneal dialysis, as explained by the National Kidney and Transplant Institute, is a type of renal replacement therapy (RRT) in which the patient’s peritoneal membrane, which lines the abdominal organs, serves as an artificial kidney.
The updated PD package now includes coverage for different treatment methods depending on the patient’s age. For adults, PhilHealth covers Continuous Ambulatory Peritoneal Dialysis (CAPD), while for younger patients, both CAPD and Automated Peritoneal Dialysis (APD) are covered.
“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, coverage for peritoneal dialysis ranges from P389,640 to P510,140, depending on the daily requirement for PD solution. Previously, the coverage was set at P270,000 annually.
For pediatric patients, benefits for CAPD range from P510,000 to P765,210, while APD coverage is between P763,000 and P1.2 million. PhilHealth also covers prevention and treatment of exit site infections and peritonitis, along with other necessary services such as catheter insertion, outpatient care for PD-related peritonitis, and diagnostic tests and medications for both adult and pediatric patients.
Under PhilHealth Circular No. 2024-0036, patients with Chronic Kidney Disease Stage 5 must be registered in the PhilHealth Dialysis Database and comply with the eligibility guidelines to avail of this RRT. Patients must follow their treatment plan and attend all follow-up visits. The sharing, selling, or distribution of PD solutions is prohibited.
Additionally, contracted health providers or facilities cannot charge co-payments for essential services covered by the package. However, co-payments may apply for services not included in the essential benefits. Providers are required to clearly inform patients about any additional co-payments.
The enhanced PD Z Benefits are available at any of the 51 contracted PD providers nationwide, with the full list available on www.philhealth.gov.ph.
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 information, members may contact the 24/7 hotlines: (02) 866-225-88 or mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987, or 0917-1109812.
