PhilHealth abolishes 45-day hospitalization limit in Philippines

The Philippine Health Insurance Corp. (PhilHealth) has announced the removal of the “45-day benefit limit” on hospital stays for members and their dependents. This change is effective April 4, 2025. PhilHealth officials described the old policy as outdated and recognized it prevented some patients from accessing essential health services. PhilHealth president Dr. Edwin Mercado stated that the previous limit was a cost-control measure but no longer aligned with today’s healthcare needs. He emphasized that medical needs cannot always be predicted, and sometimes patients require more than 45 days in a hospital. Under the old policy, PhilHealth would only cover a maximum of 45 days of confinement in a year for members. Dependents had a shared limit of another 45 days. After this period, patients were responsible for all costs. The new policy aims to ensure that individuals with severe illnesses or chronic conditions can receive necessary care without financial worries. To ensure quality care, hospitals will be required to review cases where patients are hospitalized beyond 45 days. PhilHealth will closely monitor admissions and the use of benefits to protect against potential abuses while ensuring patients get necessary treatments. This revision follows another policy change last October when PhilHealth ended the “single period of confinement” rule. This previous rule limited compensation for readmissions related to the same illness within 90 days, with only a few exceptions. The organization is working to provide better health care coverage and support for its members.