Filipinos with long-term illnesses and recurring medical needs will no longer face the pressure of exhausting their PhilHealth coverage within a year, as the state health insurer officially lifted its 45-day annual benefit limit effective April 4.

Dr. Israel Francis “Ish” Paragas, the spokesperson of PhilHealth, said the change is expected to ease the burden on vulnerable groups, especially patients undergoing extended treatment or suffering from chronic conditions.

“Ang pagtatanggal ng 45-day benefit limit rule ay magsisimula na ngayon, April 4, para po sa mga admissions starting today effective na po ito (The removal of the 45-day benefit limit rule starts today, April 4. It takes effect for all admissions starting today),” he said.

Under the old rule, PhilHealth members could only avail of coverage for up to 45 days of hospital confinement each calendar year, regardless of the frequency or severity of illness. Such left many patients with chronic conditions paying out-of-pocket once their cap was reached.

“Kung dati po ang ating mga miyembro ay mayroon lamang 45 days in a year para magamit po ang kanilang benepisyo sa PhilHealth, ngayon po ay tinatanggal na natin ito (Before, our members only had 45 days a year to use their PhilHealth benefits. We are now removing that),” said Paragas.

The state health insurer said the policy shift allows members to utilize their benefits year-round without worrying about limits, particularly those battling long-term diseases like cancer, kidney failure, or diabetes.

“Ibig sabihin po nito, sa lahat ng dahilan ng ating pagkakasakit, lalong-lalo na po ‘yung mga may pagkakasakit na nangangailangan ng gamutan nang matagal na panahon o merong mga pabalik-balik na pagkakasakit, maaari na po natin magamit ang ating benepisyo the whole year round, 365 days at wala na pong limitasyon doon sa tinatawag na 45 days (This means that for any reason we fall ill, especially for illnesses that require long-term treatment or are recurring, we can now use our benefits the whole year round—365 days—with no 45-day limit),” the spokesperson stated.

Paragas said the reform is in line with the Universal Health Care (UHC) Act, which guarantees timely access to health services and financial protection for every Filipino.

“Ang pagbabago pong ito ay of course naaayon doon din sa mga nasa provision po ng ating Universal Health Care Act na ang bawat Pilipino sa panahon ng pagkakasakit o karamdaman ay dapat makakakuha kaagad-agad ng karampatang benepisyo mula sa National Health Insurance Program (This change is in line with the provisions of the Universal Health Care Act, which ensures that every Filipino should immediately receive appropriate benefits from the National Health Insurance Program when they fall ill),” he stated.

He added that the move is also consistent with President Marcos’ directive to ensure no Filipino is left behind when it comes to accessing health benefits.

It can be recalled that healthcare advocates have long pushed for the removal of the benefit cap, saying it disproportionately affected those patients with conditions that don’t conform to time-limited care.