San fernando: The Philippine Health Insurance Corporation (PhilHealth) disbursed PHP1.76 billion in inpatient hospital claims in La Union province in 2024, while its total collection from members' premiums in the same year amounted to PHP700 million. PhilHealth La Union Local Health Insurance Office head Raymund Maningding, in a phone interview on Wednesday, said that of the total amount, PHP400 million was paid for maternity care package. "This covers normal spontaneous delivery and caesarean," he said.
According to Philippines News Agency, some PHP276 million of the total amount was paid for dialysis, he said. "That's why we are asking the health board in the province to consider the data and address the problem, since it might be due to lifestyle or the food we eat," he added. Other top illnesses with paid claims are pneumonia, dengue, and hypertension, Maningding said. He added 70 percent of the inpatient claims was for the elderly while 20 percent was for the sponsored sector like members of the Pantawid Pamilyang Pilipino Program. The rest were for the self-employed, employed, and overseas Filipino workers.
The turnaround time of claims in the province is 15 days. Maningding said as of June this year, PhilHealth has already paid PHP1 billion in inpatient hospital claims this year. PhilHealth President and Chief Executive Officer Edwin Mercado, in an earlier interview, said they have been using the surplus accumulated from their savings in the past years amid a subsidy cut. "For this year, the projected benefit payout is at PHP300 billion. The projected collection based on the premium contributions is at PHP220 billion. The PHP80 billion deficit will be sourced from the surplus fund of around PHP480 billion. We have enough funds," he said.
Nonetheless, Mercado said that under the law, PhilHealth should have a reserve fund equivalent to a maximum of two years' projected costs. Meanwhile, Mercado said the agency's support value in terms of claims is increasing at more than 45 percent in private hospitals and about 65 percent in government hospitals.
