The Philippine Health Insurance Corporation (PhilHealth) has reaffirmed its commitment to provide Filipinos with continuing access to their healthcare benefits despite the Bicameral Conference Committee’s decision not to grant subsidy for CY 2025.
“We assure the public of uninterrupted access to their benefits. Wala pong mawawala, walang mababawas na benepisyo. Despite the zero-subsidy for next year, your PhilHealth has adequate funds to cover your medical expenses,” PhilHealth President and CEO Emmanuel R. Ledesma, Jr. assured.
Ledesma emphasized that the decision reflects the wisdom of the Bicameral Conference Committee, a manifestation of its confidence on PhilHealth’s strong and healthy financial position.
As of October this year, the state health insurer has P281 billion in reserves set aside to meet benefit payments for two years and P150 billion in surplus. It also has an investment portfolio of P489 billion as of November 2024.
The robust financial standing can manage this zero-subsidy scenario and adequately fund the rollout of more benefit packages that are due for enhancement in 2025 and beyond.
“We adhere to what the UHC law is saying, that the current benefit packages for members will not be reduced. The way to go is up and you can be assured that we will continue to implement our Board-approved plans to improve more packages to lower out-of-pocket expense of patients,” he asserted.
The PhilHealth Chief reminded members not to delay treatment when sick, urging them to fully utilize their benefits whenever necessary: “Huwag na po kayong matakot sa pagpapagamot, sagot po kayo ng PhilHealth.“
Ledesma also allayed fears, especially among Indirect Contributors, that the lack of government subsidy will hinder their access to healthcare. “I say again, the benefits of our indigents, senior citizens, persons with disabilities and those from the marginalized sectors are guaranteed, with or without the subsidy.”
In fact, another set of benefit enhancements will be rolled out after the Board of Directors’ approval on December 16. These enhancements include emergency care, optometric services, heart surgeries, cataract surgery and lens implantation. PhilHealth will also implement another 50% increase in the rest of case rate packages not included in the rationalization track, bringing the total increase equivalent to 95% of the case rates just this year.
Meanwhile, the guidelines for recently announced packages will be out soon. These packages refer to acute myocardial infarction or heart attacks, peritoneal dialysis, and kidney transplants, ten rare diseases under Z Miracles, oral health services under Konsulta package, and assistive mobility devices for priority conditions affecting those in need of physical rehabilitation.
PhilHealth also completed the rationalization of seven packages among the top ten high-burden and mostly claimed health conditions, with increases ranging from more than a hundred to even more than 200 percent. With all these developments, PhilHealth has enhanced a total of 30 benefit packages over a two-year period, an unprecedented feat accomplished under the leadership of Ledesma, who assumed office on November 2022.
