ILOILO — Moderate-risk pneumonia emerged as the biggest healthcare claims burden in Western Visayas and Negros Occidental as Philippine Health Insurance Corporation (PhilHealth) paid ₱10.79 billion in benefits covering nearly 800,000 patients in the first six months of 2026.
The Philippine Health Insurance Corporation (PhilHealth) said it disbursed ₱883.79 million for 31,520 moderate-risk pneumonia claims alone, making the illness the leading category in terms of benefit payments during the period.
The figures underscore the continuing financial toll of major illnesses on households and the national health insurance system, with stroke, hypertension and chronic kidney disease also accounting for hundreds of millions of pesos in claims.
PhilHealth Western Visayas Regional Vice President Marjorie Cabrieto said stroke infarction accounted for ₱254.98 million covering 3,389 claims, while hypertensive emergency or urgency reached ₱170.40 million for 10,230 claims.
Another ₱129.86 million was paid for 4,583 chronic kidney disease claims.
Dengue, while not among PhilHealth’s top 10 claims, still accounted for ₱61.6 million in benefit payments covering 3,232 cases during the first semester.
Overall, PhilHealth’s ₱10.79-billion payout benefited nearly 800,000 patients across Western Visayas and Negros Occidental during the six-month period.
Cabrieto also reported a sharp improvement in the agency’s claims-processing efficiency, with the average turnaround time dropping from 5.29 days in June to only two days in July — far below the 30-day processing period prescribed by law.
“This reduction in processing time is a testament to our dedication to enhancing service delivery for our members,” she remarked.
PhilHealth also reported 7,794,521 members and dependents as of June 30, representing 95.47 percent of the projected population in its coverage area.
Iloilo accounted for 2,447,992 members and dependents; Negros Occidental, 3,114,281; Capiz, 794,896; Antique, 633,709; Aklan, 612,701; and Guimaras, 190,942.
Cabrieto said PhilHealth continues to reach out to the remaining less than five percent of the population to further expand health insurance coverage.
Meanwhile, PhilHealth reminded employers to take advantage of the one-time waiver of interest on missed contributions covering July 2013 to December 2024.
The program, available until the end of 2026, allows employers to settle outstanding contributions with zero or minimal interest.
“This is an important reminder for employers and members alike to prioritize updates on their contributions. Starting next year, PhilHealth plans to impose interest on any missed contributions,” Cabrieto stated.
She said the interest rate would not exceed 1.5 percent, compounded monthly, underscoring the need for employers to settle their obligations before the waiver expires./PN
