The Philippine Health Insurance Corporation (PhilHealth) has made a significant change that will directly benefit its members. The removal of the single period of confinement (SPC) policy now allows members to be readmitted for the same illness within 90 days and receive benefits, providing a sense of reassurance and optimism.
“After extensive evaluation, we have lifted the rule of Single Period of Confinement to ensure continuous coverage for patients with recurring conditions,” PhilHealth Chief Emmanuel Ledesma said.
The SPC previously prohibited PhilHealth members from being compensated for their medical bills when they were confined due to the same illness within 90 days. This resulted in the denial of 26,750 claims of benefits, including people with community-acquired pneumonia, acute gastroenteritis, urinary tract infection, and chronic kidney disease.
However, with the lifting of this policy, members can now be readmitted for the same illness within 90 days and receive benefits.
“We understand that health is not just a privilege but an essential right for every Filipino. In these challenging times, we stand with them and always deliver all the benefits they deserve,” he said.
Health Secretary Teodoro Herbosa said last month that the SPC was established under the Philippine Medical Care Act of 1969 to prevent fraudulent benefits claims.
Herbosa noted that this generation’s fraud prevention efforts are now advanced. The Universal Health Care Act of 2019, which aims to provide all Filipinos with affordable and accessible healthcare services, marks the beginning of an era of comprehensive healthcare coverage for all.
Ledesma reminds all members and eligible dependents that they can access a maximum of 45 days of coverage for room and board annually.
Meanwhile, this is not eligible for the hemodialysis benefits package, which has 156 sessions per year.