Philippine Health Insurance Corporation (PhilHealth) Chief Emmanuel Ledesma Jr. reassured President Marcos of significant improvements in health benefits for members and their beneficiaries.
In a statement on Wednesday, March 6, he said PhilHealth is committed to delivering better and more responsive health packages that members can avail of at any accredited health facility across the country.
"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 (We have started improving our benefits last year, and this will continue into 2024. We have laid out many enhancements that members will surely feel due to lower hospital fees, if not none at all)," he said.
Ledesma's announcement follows President Marcos’ call for increased premium value in benefits and coverage for PhilHealth members.
He also said that the Health Insurer already implemented a 30 percent increase in most case rate packages effective since Feb. 14, 2024, marking the first across-the-board increase since the launch of the all-case rate scheme in 2013.
"The 30 percent increase in case rates will restore substantial coverage affected by health inflation," said Ledesma.
PhilHealth also noted that under the enhanced benefits, coverage for breast cancer in the Z Benefits Package has surged from P100,000 to P1.4 million, an astounding 1300 percent increase.
Moreover, he said that PhilHealth expanded its coverage for hemodialysis sessions and increased benefits packages for conditions such as acute ischemic stroke, acute hemorrhagic stroke, high-risk pneumonia, colorectal cancer, and selected orthopedic implants.
"Para naman sa mga may high-risk pneumonia, halos na-triple po ang benepisyo mula P32,000 to P90,100 (For those with high-risk pneumonia, the benefits have nearly tripled from P32,000 to P90,100)", Ledesma explained, adding that PhilHealth even improved its Z Benefits Packages for colorectal cancer and on selected orthopedic implants.
It also mentioned that in a move towards mental health support in October 2023, PhilHealth introduced the Outpatient Mental Health Package, providing coverage for general and specialty mental health services.
However, despite the suspension of the scheduled contribution rate adjustment in 2023, from 4 percent to 4.5 percent, PhilHealth managed to implement these enhancements, demonstrating its commitment to providing responsive benefit packages to Filipinos.
"Our commitment to continuously provide Filipinos with responsive benefit packages remains, as guided by our thrust of "Pinalawak at mga Bagong Benepisyo para sa Mamamayang Filipino," Ledesma added.
Moreover, looking ahead to 2024, PhilHealth plans to rationalize case rates for various conditions, including bronchial asthma, bacterial sepsis in newborns, and Covid-19 inpatient benefits.
Additionally, Ledesma stated that guidelines for outpatient therapeutic care benefits for severe acute malnutrition in children and services for physical medicine and rehabilitation are expected this year.
To support these initiatives, he said that PhilHealth aims to “adjust contribution rates” to generate the necessary funds.
Another benefit to look forward to is the enhancement of peritoneal dialysis under the Z Benefits Package, Ledesma stated.
"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," he stressed.
Furthermore, Ledesma mentioned that PhilHealth has allocated P243 billion for benefits in 2024, including P30 billion for the PhilHealth Konsultasyong Sulit at Tama (Konsulta) package.
This package will be expanded to include treatment for TB, animal bites, malaria, and HIV/AIDS, along with an expansion of coverage for essential medicines through the Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program.
Ledesma affirmed PhilHealth's commitment to expanding access to essential medicines and vowed to engage pharmaceutical service entities to make these medications more accessible to Filipinos in need.
"We are set to expand access points for these medicines by engaging pharmaceutical service entities to make these essential medicines within reach of our Kababayans needing them," Ledesma vowed.
As PhilHealth continues its efforts to provide comprehensive health coverage, members can expect further enhancements and expanded benefits throughout 2024, he said.