The Philippine Health Insurance Corporation (PhilHealth) has significantly expanded its Z Benefit Package for Peritoneal Dialysis (PD), effective 1 January 2025. This includes separate packages for adult and pediatric patients, despite a zero subsidy, in line with President Ferdinand R. Marcos Jr.'s commitment to expanding healthcare benefits.
Peritoneal dialysis is a renal replacement therapy that utilizes the patient’s own peritoneal membrane to filter waste from the body, serving as an alternative to hemodialysis. According to the National Kidney and Transplant Institute, this method is often used for patients with Chronic Kidney Disease Stage 5.
PhilHealth president and CEO Emmanuel Ledesma Jr. emphasized the importance of encouraging PD as a first-line treatment for patients with chronic kidney disease, offering more autonomy, flexibility, and better quality of life for patients. The enhanced PD package now covers Continuous Ambulatory Peritoneal Dialysis (CAPD) for adults and both CAPD and Automated Peritoneal Dialysis (APD) for pediatric patients.
Coverage for adults has increased, with benefits ranging from P389,640 to P510,140, depending on the PD solutions needed per day. This is an increase from the previous annual coverage of P270,000. For pediatric patients, coverage under CAPD ranges from P510,000 to P765,210, while for APD, it ranges from P763,000 to P1.2 million. The package also includes coverage for exit site infection and peritonitis prevention care, as well as ancillary services such as catheter insertion and outpatient treatments.
PhilHealth Circular No. 2024-0036 mandates that patients with Chronic Kidney Disease Stage 5 must be registered in the PhilHealth Dialysis Database and adhere to membership eligibility guidelines. They are also required to follow prescribed treatment plans and attend follow-up visits. The sharing, selling, or distributing of PD solutions is strictly prohibited.
Contracted healthcare providers are not allowed to charge co-payments for essential health services included in the package, although co-payments may apply for non-essential services. Providers are required to fully explain any additional charges to patients.
The enhanced PD Z Benefits are available at 51 contracted providers nationwide, with more information available on the PhilHealth website or through its 24/7 hotlines.