PhilHealth vows to enhance benefit package, services

By Filane Mikee Cervantes

February 14, 2024, 4:36 pm

<p>PNA file photo</p>

PNA file photo

MANILA – The Philippine Health Insurance Corporation (PhilHealth) on Wednesday committed to enhance their services and patients’ benefit package.

PhilHealth president and CEO Emmanuel Ledesma Jr. made the commitment during the hearing of the House health committee in response to the call of Speaker Martin Romualdez to expand the state-run health insurer's benefit packages for its members.

“We are one we are one with Speaker Martin when he says we have to aggressively and continuously increase the case packages of PhilHealth across the board,” Ledesma said.

Ledesma said as part of PhilHealth's mandate, they would increase the benefit packages to make it easier for Filipinos to avail of healthcare services.

He added that it would be better for the country and its healthcare system if Filipinos could enjoy significantly lower out-of-pocket medical expenses.

PhilHealth’s vice president Eli Santos echoed Ledesma’s statement, saying he fully supports Romualdez’ directive for a review of their charter to expand patient benefits, including early cancer detection and to explore ways to provide more comprehensive healthcare coverage.

“We will be able to fulfill and comply with the directive of our Honorable Speaker Martin Romualdez,” he said. “We submit to the directive of our Honorable Speaker and the Committee to focus our resources in safeguarding the health of the populace."

Santos said the review of the charter should also look into PhilHealth's investment strategies to ensure its funds are used in ways that directly benefit the health and well-being of the Filipino people.

Ledesma said that while PhilHealth is increasing by as much as 30 percent the coverage rate of most of its benefit packages starting February 14, additional increases are still needed.

“Umpisa pa lang yung 30 percent (The 30 percent [increase] is just the beginning and we would really move forward,” he said.

Other enhancements

Ledesma noted that the PhilHealth’s benefit committee has recently approved the enhancement of the Z Benefits for breast cancer effective in March 2024.

He also highlighted that the agency enhanced several benefit packages after 13 years without changes, including: High Risk Pneumonia, from PHP32,000 to PHP90,100, or a 182-percent increase; Acute Stroke Ischemia from PHP28,000 to PHP76,000, a 171-percent increase; and Acute Stroke Hemorrhagic from PHP30,000 to PHP80,000, a 111-percent increase.

He said the Z Benefits package for colon and rectal cancers were also recently enhanced, allowing patients with metachronous colorectal tumor to re-avail of the package for colon and rectal cancer.

Ledesma said PhilHealth also revised the policy on select orthopedic implants, which allowed beneficiaries to avail of a maximum of two Z Benefits packages, regardless of laterality for procedures that were done on different dates, or on the same day, within the same confinement period by patients with single or multiple injuries that requires more than one implant.

He said the package rate for select orthopedic implants were increased to respond to the increasing costs of orthopedic implant devices and minimize delay in surgeries.

Ledesma, meanwhile, said PhilHealth has settled its PHP50 billion-debt to health facilities from August to December 2023 in compliance with his commitment during a House hearing in September last year.

"It is in line with our promise, and we complied with it,” he said.

In directing the House committee to review PhilHealth's charter, Romualdez said there is a need for PhilHealth to function as a health maintenance organization, focusing its resources on safeguarding the health of the populace rather than investing in commercial banks and bonds.

"With substantial annual allocations from Congress and regular contributions from private employees, there is no excuse for PhilHealth to scrimp on coverage. The effectiveness of the Universal Health Care system depends on our ability to provide for our citizens, ensuring they receive the medical attention and preventive care they deserve," he said. (PNA)