The Department of Health (DOH), as the supervising agency of the Philippine Health Insurance Corporation (PhilHealth), on Friday, Dec. 13 assured that the health benefits of the national health insurance agency will continue “with or without” subsidy from the forthcoming General Appropriations Act.
All inpatient, outpatient, and special benefit packages will remain available, it added.
This statement of the DOH comes in response to the Senate’s decision to allocate zero subsidy for PhilHealth under the 2025 national budget.
“The job of PhilHealth is to pay the health benefits of its members, with or without subsidy from the General Appropriations Act,” DOH Secretary and Chair of the PhilHealth Board Teodoro J. Herbosa said.
“We reviewed the financial statements of PhilHealth together with its established performance, and the DOH is confident that it has enough money to continue and even improve operations,” he added.
Secured funding
The DOH said it is confident that PhilHealth has sufficient funds to continue and enhance benefit delivery for the next two to three years.
It noted that the total benefit spending in 2023 was at P74 billion. From January 1 to September 30, 2024, with just three remaining months to the year-end, benefit spending is estimated at P135 billion.
By the end of Calendar Year 2023, PhilHealth’s accumulated net income was P463.7 billion.
In line with the Universal Health Care Act, PhilHealth has secured a Reserve Fund of P280.6 billion, sufficient for two years of benefits and other operating expenses.
At the start of 2024, the agency reported a surplus fund balance of at least P183.1 billion.
Benefit improvements
The DOH cited that since August, the PhilHealth Board has approved new or improved benefit packages for hemodialysis, peritoneal dialysis, dengue, PhilHealth Konsulta, and heart attacks.
It has also approved the implementation of benefits for rare diseases, oral/dental health, physical medicine andrehabilitation, including assistive devices like wheelchairs, and kidney transplantation.
Five more new or improved benefits are also expected to be approved before the Christmas break, including those for emergency care, children’s glasses, another round of increases in case rates, open heart surgery, heart valve repair or replacement, and cataract extraction, especially in children.