The Philippine Insurance Corporation (PhilHealth) announced a 30 percent increase in the coverage rate of most of its benefit packages, effective Feb. 14.
"This will restore substantial coverage affected by health inflation," said Ledesma Jr., during a press conference on Friday, Feb. 23.
He also highlighted that the increase will strengthen PhilHealth's case-based payments, ultimately reducing the financial burden on members for medical treatment.
"You can now view the complete list of adjusted case rates on our corporate website. For example, the new case rate for Caesarian Section delivery is now P24,700, up from P19,000. Those who have been admitted on Feb. 14 onwards to deliver their babies through a caesarian section can avail of this adjusted rate," he explained.
"Kung tataas ang benepisyo, bababa ang gagastusin sa pagpapagamot at mas mararamdaman ng miyembro ang benepisyo nila mula sa PhilHealth (If the benefits increase, the expenses for medical treatment will decrease, and the members will feel more the benefits from PhilHealth)," Ledesma emphasized.
He also noted that this marks the first across-the-board increase since introducing the all-case rate payment scheme a decade ago.
"I thank the Board of Directors for approving the 30 percent inflation adjustment in our case rates and for making PhilHealth benefits relevant and responsive to the medical needs of the Filipino people," he said.
Ledesma stressed that this move will greatly help lower the out-of-pocket expenses of our members, if not wiped out through our No Balance Billing or “Walang Dagdag Bayad” policy should they be admitted to the PhilHealth ward of hospitals.
Furthermore, PhilHealth Chief clarified that the 30 percent adjustment excludes certain benefit packages already adjusted in the last five years and those undergoing re-costing.
He also mentioned packages recently developed, such as the Outpatient Mental Health Package.
Moreover, in response to inquiries regarding PhilHealth's 30 percent increase in health benefits alongside the suspension of premium payments, Ledesma disclosed, "Ang cash position ng PhilHealth ngayon ay close to P500 billion pesos (The cash position of PhilHealth now is close to P500 billion pesos)."
He emphasized that while PhilHealth appears financially robust, public awareness underscores the necessity for prudent management and the maintenance of a substantial financial buffer to ensure responsible expenditure.
"I told PBBM that we were cut off from the budget by P40 billion at the last minute, and now we're talking about P35 billion if we increase the premium from four to five percent," he added.
Despite challenges such as budget cuts, he affirmed PhilHealth's commitment to moving forward and fulfilling its mission.
"Because of our aggressiveness and plans, and because it's the first time in so long, of course, the P35 billion is still a big help," Ledesma pointed out.
Furthermore, PhilHealth Senior Vice President Renato Limsiaco Jr. highlighted a historic milestone as he revealed that the PhilHealth board has sanctioned a record-breaking allocation of P244 billion for benefit payouts, marking a significant moment in the organization's history.
"And the mission of PhilHealth right now is to give these to our members and our health care providers as payment for the services they provide," he added.
Limsiaco underscored that the significance lies not only in the 30 percent increase but in numerous other reforms, including the streamlining of benefits cases as directed by the president.
"Kailangan natin ang mga pondo na ito para the next years na tuloy tuloy na ang pag-increase ng mga benepisyo ay mayroon na tayong magagamit na nga pondo (We need these funds so that in the next years, as the continuous increase of benefits progresses, we already have available funds that we can utilize)," he said.
PhilHealth said that the move signals its dedication to enhancing healthcare accessibility and affordability for all its members, aligning with its mission to provide comprehensive health coverage for every Filipino.