PhilHealth claims for COVID-19 pneumonia hit P14.6 billion

MANILA, Philippines — COVID pneumonia topped the medical cases that the Philippine Health Insurance Corp. (PhilHealth) reimbursed last year, with claims amounting to more than P14 billion.

Latest data from PhilHealth showed that total reimbursements for COVID pneumonia amounted to P14.6 billion.

PhilHealth said it received 72,511 claims for the disease from Jan. 1 to Dec. 31, 2023.

Claims for moderate and high-risk pneumonia have the second highest amount of reimbursements amounting to P7.1 billion, with 479,632 claims.

PhilHealth said moderate and high-risk pneumonia have been among the top 10 medical cases reimbursed since 2009.

Pneumonia is the leading cause of death among children worldwide.

The disease is a ”consequential burden” among households everywhere, PhilHealth said.

The agency said claims for stroke infarction followed pneumonia, with 128,054 worth P3.5 billion; dengue fever (mild and severe), P1.5 billion, and acute gastroenteritis, P1.2 billion.

Hypertensive emergency ranked sixth in PhilHealth’s list at P1.1 billion with 141,436 claims; urinary tract infection, P1 billion with 160,548 claims, and peptic ulcer, P940,713,421 with 150,215 claims.

Data showed that P716,998,093 worth of reimbursement was received by PhilHealth for asthma (in acute exacerbation) with 90,080 claims, and upper respiratory tract infection, P283,451,909 with 75,935 claims.

PhilHealth had earlier urged healthcare facilities to ensure that their claims are in accordance with the rules and regulations of the agency so that they can be properly and immediately reimbursed.