PhilHealth expands benefit packages for members

Individuals continue to avail services as face-to-face operations and transactions continue at the Philippine Health Insurance Corp. (PhilHealth) in Quezon City on September 26, 2023.
STAR/Michael Varcas

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) has increased coverage of several of its benefit packages for its members.

Among these are benefit packages for high-risk pneumonia and ischemic and hemorrhagic stroke, PhilHealth president and chief executive officer Emmanuel Ledesma Jr. said.

“These are among the commonly availed cases by our kababayans,” said Ledesma in a press briefing on Oct. 18.

For high-risk pneumonia, he said PhilHealth coverage will now be at P90,100 from the current P32,000, or an increase of 181 percent.

For ischemic stroke, PhilHealth will now cover as much as P76,000, which is a 171 percent increase from the existing P28,000. For hemorrhagic stroke, PhilHealth will be covering P80,000 from the existing P38,000, or a 111 percent increase.

He added that more enhancements of benefit packages will be made including those for outpatient therapeutic care for severe acute malnutrition as well as the enhancement of Z benefits packages, such as breast cancer, prostate cancer, cervical cancer, and open-heart surgery for children.

At the same time, PhilHealth said it will soon publish the implementing guidelines for the outpatient drug benefit of the PhilHealth GAMOT to expand choices for outpatient medications.

The package increases the initial 21 medications covered by the Konsulta program to include additional 32 other commonly prescribed outpatient medicines.

“This will bring PhilHealth’s coverage to a total of 53 outpatient medications, ranging from regiments covering infections up to maintenance medications for non-communicable diseases,” Ledesma said.

The state health insurer also recently launched its outpatient mental health package where members may avail themselves of the general mental health services package amounting to P9,000, and the specialty mental health services package that amounts to P16,000 per person annually.

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