April 16, 2024

The Philippine Health Insurance Corp. (PhilHealth) has announced that majority of its case rates for most of its health benefit packages have increased to 30 percent.

The increase took effect on Feb. 14, coinciding with PhilHealth’s 29th anniversary, which is in response to appeals for the health insurance provider to increase its coverage.

PhilHealth Regional Vice President Dr. Dominga Gadgad said this restores substantial coverage affected by health inflation.

It is the first time that there will be an across the board increase as approved by the PhilHealth Board of Directors since the all-case rate payment scheme was introduced 10 years ago, making PhilHealth benefits relevant and responsive to the medical needs of Filipinos.

Gadgad said the move is timely since it will efficiently and effectively strengthen case base payment, which will have a significant impact on members’ coverage in terms of financial protection.

It will help in lowering down the out of pocket expenses of members, if not totally wipe out, through the no balance billing or “walang dagdag bayad” policy should they be admitted in a PhilHealth ward of hospitals.

Kung tataas ang benipisyo, bababa dapat ang gastusin sa pagpapagamot at mas mararamdaman ng miyembro ang benepisyo nila mula sa PhilHealth,” she said during the PhilHealth Konsulta Caravan: Konsultasyong Sulit on March 19 at SM City Baguio.

Gadgad said the 30 percent adjustment excludes those that have already been adjusted in the last five years.

During the Konsulta Caravan, an initiative that underscores the importance of equitable access to quality healthcare for all Filipinos, PhilHealth also introduced its Konsulta Package which provides free check-up, laboratory services, and some drugs and medicines.

The package covers 21 drugs and medicines such anti-microbial or antibiotics, fluid and electrolytes, anti-asthma, anti-hypertensive, anti-diabetic, and antihisthamine medications.

It also offers a range of laboratory tests such CBC, platelet count, urinalysis, fecalysis, and pap smear.

Gadgad said to date, there are 100 accredited Konsulta Package providers in the Cordillera: 16 in Baguio City, 17 each in Abra and Benguet; 14 each in Kalinga and Mountain Province; 13 in Ifugao, and nine in Apayao.

She enjoined the outpatient department of other government facilities to join the Konsulta Package.

Gadgad said in response to the call of President Ferdinand Marcos, Jr. for better health insurance coverage for all Filipinos, PhilHealth has started implementing important enhancements in benefits in 2023 such as the expansion and institutionalization of 156 hemodialysis sessions for patients with stage 5 chronic kidney disease from 90 sessions.

It also increased coverage for ischemic and hemorrhagic stroke and high risk pneumonia, among others.

It also launched the groundbreaking outpatient mental health package for 2024 due to increasing cases of mental health concerns.

Gadgad said PhilHealth is targeting to release more policies and guidelines for several new benefit packages and is also working on enhancing existing health benefit packages. – Hanna C. Lacsamana