The Philippine Health Insurance Corporation (PhilHealth) has scrapped its single period of confinement policy in which beneficiaries can only be covered once for the same illness in a 90-day period.

PhilHealth Senior VP and spokesperson Israel Francis Pargas said the policy has been scrapped starting October 1.

https://news.abs-cbn.com/news/2024/9/10/philhealth-says-to-scrap-single-period-of-confinement-policy-this-month-1442

“Starting October 1, lahat ng miyembro na mako-confine of mare-readmit because of the same illness ay makakakuha ng the same benefit,” he said in a TeleRadyo Serbisyo interview.

Pargas said PhilHealth denied coverage of 1,700 pneumonia patients in 2023 after they were readmitted for the same illness within the 90-day period. 

The top 3 illnesses wherein patients are usually readmitted are pneumonia, acute gastroenteritis and urinary tract infection.

Hemodialysis and chemotherapy patients are exempted from the single confinement policy even before it was scrapped.

“Lahat ng miyembro na maco-confine o ma re-readmit for the same illness ay makakakuha na po o makaka-avail na po ng benepisyo ng PhilHealth,” he said.

Pargas said Philhealth will institute control measures to ensure quality of care for patients and stave off abuse of the readmission policy.

Patients with mild to moderate type of pneumonia are covered up to P32,000 while severe pneumonia is covered up to P90,000.

 “Kasama sa ilalabas na issuance ‘yung transitory clause kung saan i-aalow ang retrospective ‘yung effectivity ng October 1 re-admission. Pwedeng ‘yung reimbursement is direct to the patient o pwedeng ang ospital ang mag-file for the patient. Babayaran ‘yan ng PhilHealth,” he said.