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Hemodialysis Tops PhilHealth’s List of Claims

**PhilHealth Reports P210.09 Billion in Benefit Claims for First Half of 2024**

**MANILA, Philippines** — The Philippine Health Insurance Corp. (PhilHealth) reported that it paid a total of P210.09 billion in benefit claims during the first six months of 2024.

According to data released by the state-run insurer, hemodialysis treatments accounted for the largest share of procedure-based claims, totaling P48.76 billion as of June.

The top 10 procedures by claims payment were:
1. **Hemodialysis:** P48.76 billion
2. **Cesarean section:** P4.88 billion
3. **Chemotherapy sessions:** P3.5 billion
4. **Facility-based emergencies:** P3.15 billion
5. **Intensity-modulated treatments:** P3.11 billion
6. **Animal bite treatments:** P2.93 billion
7. **Expanded newborn package:** P2.81 billion
8. **Normal spontaneous delivery package:** P2.73 billion
9. **Outpatient HIV/AIDS package:** P2.46 billion
10. **Maternity care package:** P2.24 billion

PhilHealth also released a separate list detailing the top 10 medical cases by claims payment for the same period. Community-acquired pneumonia (specifically “pneumonia 3”) topped this list with P12.76 billion in payments.

The top 10 medical cases were:
1. **Community-acquired pneumonia 3:** P12.76 billion
2. **Cerebral infarction (stroke):** P2.76 billion
3. **Acute gastroenteritis:** P1.96 billion
4. **Dengue with warning signs:** P1.78 billion
5. **Urinary tract infection:** P1.6 billion
6. **Stage 2 hypertension:** P1.1 billion
7. **Chronic kidney disease stage 5:** P1.05 billion
8. **Bronchial asthma:** P978.18 million
9. **Malignant hypertension:** P975.2 million
10. **Acute gastritis:** P910.34 million

Additionally, PhilHealth reported paying P1.82 billion for its “Z benefits package,” which covers severe conditions requiring expensive, long-term treatment. As of June, this package benefited 34,268 members. Conditions covered under the Z package include breast cancer (up to P1.4 million in coverage), acute lymphocytic/lymphoblastic leukemia (up to P500,000), and prostate cancer (up to P100,000).

Article and image source: cebudailynews.inquirer.net

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