Enhanced benefits expected this year

Philhealth members can expect more benefits this year, the state health insurance chief Emmanuel R. Ledesma Jr. assures.

“Nasimulan na po natin ang pagpapabuti ng ating mga benepisyo sa nakaraang taon at magpapatuloy po ito ngayong 2024. Marami kaming nakalatag na enhancements na siguradong mararamdaman ng mga miyembro dahil sa mas mababang bayarin sa ospital, kung hindi man wala nang babayaran pa,” Ledesma said in a statement.

Ledesma’s pronouncement came on the heels of President Ferdinand Marcos, Jr.’s recent call that “any increase in premium will substantially be much more in value in terms of benefits and coverage to PhilHealth members.”

The 30-percent increase in most of its case rate packages already took effect for all admissions starting February 14, 2024, the first time that an acrossthe-board increase was implemented since the all case rate scheme was launched in 2013.

Aside from that, members have more to expect from PhilHealth including the rationalization of the case rates for bronchial asthma and bacterial sepsis in newborns and COVID-19 inpatient benefits.

Guidelines for outpatient therapeutic care benefits package for severe acute malnutrition in children aged 5 years old and below and services for physical medicine and rehabilitation will also be expected this year.

Another benefit to look forward to is the enhancement of peritoneal dialysis under the Z Benefits Package.

“This is where the importance of adjusting our contribution rates comes into play. It will generate funds necessary for us to complete our benefit plans, and more importantly to sustain the reforms in the benefit packages,” Ledesma stressed.

Philhealth has allotted some P243 billion to pay for these benefits, P30 billion of which is earmarked for its PhilHealth Konsultasyong Sulit at Tama or Konsulta package for this year.

The Konsulta package will also be further expanded to include treatment for TB, animal bite, malaria and HIV/AIDS. This is in addition to expanding coverage for medicines from the current 21 to 53 through PhilHealth's Guaranteed and Accessible Medications for Outpatient Treatment or GAMOT.

"We are set to expand access points for these medicines by engaging pharmaceutical service entities to make these essential medicines within reach by our Kababayans needing them," said Ledesma. --