Outpatient emergency cases in accredited hospitals are now covered by the Philippine Health Insurance Corporation (PhilHealth).
The state health insurer said this move seeks to lessen out-of-pocket expenses for patients requiring immediate medical attention.
The new policy, which took effect on Feb. 14, provides benefits under PhilHealth’s Facility-Based Emergency (FBE) package for emergency cases treated in Level 1 to 3 hospitals.
The coverage follows the introduction of the Outpatient Emergency Care Benefit (OECB) package late last year under PhilHealth Circular 2024-0033.
Per PhilHealth Advisory No. 2025-0009, published on Feb. 18, hospitals are not required to obtain separate accreditation to offer FBE benefits.
“Hospitals with affiliated extension facilities must submit to their respective PhilHealth Regional Offices a certification stating the name of the affiliated extension facility and its complete address,” the advisory stated.
While the FBE benefit expands hospital-based emergency care coverage, PhilHealth said it has yet to announce when it will begin covering ambulance services under the Prehospital Emergency (PHE) benefit.
Such an initiative, according to PhilHealth, is part of the broader effort to improve access to emergency medical services under the Universal Health Care Act.
Over the past year, the agency has introduced new benefit packages and increased case rate coverage for various medical conditions in a bid to reduce out-of-pocket costs for patients.