Mental health is among the new benefits now covered by Philippine Health Insurance Corp. (PhilHealth), as the state-run insurer continues expanding its packages to address a wider range of health conditions nationwide.

“PhilHealth has answered the call—the clarion’s call—to address many diseases, and we now have a mental health package,” said PhilHealth Vice President for corporate affairs group Walter R. Bacareza in a press briefing on Friday, Nov. 14.

“Our challenge now is for doctors and general practitioners to undergo mental health gap action program (mhGAP) training through the Department of Health (DOH) in order to become accredited with PhilHealth, ensuring that our youth have accessible mental health services,” he said.

He urged trained doctors to proceed with accreditation, emphasizing that while 3,000 physicians have completed the required training, only about 100 are accredited so far. This, he noted, limits the youth’s access to mental health services and highlights the need to strengthen provider availability.

“Aside from mental health, we now have dental health and optical packages, and even wheelchairs are now covered by PhilHealth, along with many other benefits,” he added, underscoring the importance of expanding the network of accredited facilities nationwide so Filipinos—especially those seeking care in government hospitals—can avail themselves of services at no cost.

“Mental health is one of the rising conditions in the Philippines,” he said. He emphasized that services are divided into two packages—general and specialized—which will vary depending on the patient’s needs.

He underscored the significance of strengthening the supply side of health services, pointing out that local government units (LGUs) and medical societies play a key role in expanding access.

“I’m really challenging all the mayors, all the hospitals, all the doctors to have themselves accredited to provide the supply side,” he said.

Bacareza also highlighted that PhilHealth has increased and enhanced numerous benefits to better respond to the challenges within the Philippine health system.

“The first thing we did is we increased it, we doubled it—so 9,000 diseases, codes. Then we chose the most expensive, debilitating, financially frequent diseases—and we increased it more than 95 percent,” he said.

He clarified that the ₱60 billion returned to PhilHealth remains under processing but emphasized that the agency is currently financially stable. “But for now we still don’t need the ₱60 billion—so, we’re okay—we’re not affected by our budget,” he added.

PhilHealth acknowledged that implementation remains difficult in areas where necessary facilities are lacking, stressing that while benefits exist, supply-side readiness continues to be a challenge.

Meanwhile, the full transition to the diagnosis-related groups (DRG) payment system is not yet applicable to certain diseases, as the model is still under testing.

The agency said shifting to the DRG system aligns with global trends and supports the broader direction of universal health care.

Bacareza also encouraged local governments to participate in the Yaman ng Kalusugan (Yapak) program and other PhilHealth initiatives to maximize available benefits.

“We would like to be more responsive to the needs of each individual Filipino,” he added, moving away from a “shotgun approach” where women, children, and older adults all receive the same package. He explained that a more targeted system would ensure higher support for patients with more complex or costly conditions.

(Ricardo M. Austria)