Handog ng PhilHealth sa Pilipino sa Bagong Taon – Message of PCEO Emmanuel R. Ledesma, Jr.

A Happy New Year to all our valued PhilHealth members, and a warm welcome to our first Stakeholders’ Meeting of the year.

As begin 2025, I am filled with pride and gratitude for the milestones we achieved in advancing the health and well-being of the Filipino people.

Last year, we made a promise—to expand our coverage and prioritize the top 10 most burdensome diseases, addressing the financial challenges these conditions bring to our members and their families. I am proud to share that we delivered on this commitment.

In under two years, PhilHealth introduced and upgraded a total of 30 benefit packages—an unprecedented achievement under our ambitious Benefit Development Plan. These advancements are the fruits of our dedication to your feedback and our commitment to act decisively on your needs.

I am pleased to announce that your PhilHealth was able to introduce the latest set of enhancements in benefits during the last days of 2024. We came out and published the necessary policy instruments (the Circulars) for the following:

1. Benefits Package for Ischemic Heart Disease – Acute Myocardial Infarction – This package offers crucial coverage for heart disease–one of the critical health issues prevalent among us Filipinos. Our goal is to alleviate financial strain on Filipino patients and ensure timely access to life-saving services from hospitalization, diagnostic tests and procedures (like angioplasty and stenting) and medication.

2. The Z Benefits Package for Peritoneal Dialysis addresses the needs of patients suffering from Chronic Kidney Disease Stage 5. We also want to encourage the availment of Peritoneal Dialysis as a first line modality treatment for patients with End-Stage Renal Disease. We want to push this as an option apart from hemodialysis, not just to give autonomy and flexibility to our members in choosing the treatment modality, but also to promote the quality of life and mobility of the patients.

3. The Z Benefits Package for Kidney Transplantation offers our members the gold standard intervention for patients with end-stage kidney failure. We have included comprehensive coverage for pre-transplant evaluations, transplantation, and post-operative care. We expect this package to be especially encouraging to our members who need transplantation. They can now rest a little easier that the package will stave off the danger of financial ruin caused by the medical expenses.

4. We also now offer Preventive Oral Health Services in Primary Care, which will be an integral component of the Konsulta Program. This package puts essential dental health services within reach of all our members as we accredit more Konsulta providers. The Konsulta brings primary healthcare to wherever our members spend most of their time. Sa pamamagitan po nito, tutulong tayong maibalik ang matamis na ngiti sa bawat Pilipino.

5. Next, the Outpatient Emergency Care Benefit covers the costs of urgent medical care that does not require hospitalization of at least 24 hours. This will include treatments for life-threatening medical emergencies. Ngayon po, sagot na ng PhilHealth ang sinumang itatakbo sa ER ng mga ospital.

6. Finally, we implemented a 50% Adjustment in the Case Rates packages. We stand true to our commitment of ensuring that our benefits make a real difference for each and every PhilHealth member. Last year, we implemented a 30% adjustment to over 9,000 case rates. This year, we have taken it a step further by increasing the adjustment by another 50%, reflecting our dedication to providing greater financial support and coverage for common illnesses and diseases. Just to give you an example…

This is just to illustrate what the increased case rates mean for our members. With your permission, my colleagues from our Benefits Development Team can take us in depth to the details of these benefit packages.

As we implement these transformative changes, we are not merely enhancing benefits—we are building a stronger foundation for Universal Health Coverage, one that prioritizes every Filipino’s right to quality and equitable healthcare. This is a collective mission that requires the full commitment of our healthcare providers, stakeholders, and members.

To ensure that every member truly experiences the benefits of PhilHealth, I call on our partner healthcare providers: Let us strictly implement the “No Co-Payment” policy for patients admitted in basic or ward accommodation of health facilities, as mandated in Section 9 of the Universal Health Care Act and in relevant PhilHealth Circulars. Our members should not be charged additional fees beyond what PhilHealth covers for the standards of care and services included in our benefit packages.

Healthcare should be equitable and accessible. By strictly adhering to the “No Co-Payment” policy and fostering transparency in all transactions, we can ensure that no Filipino is left behind. Together, let us prove that Universal Health Care is not just a vision, but a reality we are delivering today.

To our members, these advancements are a testament to PhilHealth’s unwavering dedication to your well-being. With expanded coverage, preventive care, and access to life-saving treatments, we aim to lighten the burden of healthcare costs and provide you with the peace of mind that comes from knowing you are cared for.

There is still a lot to look forward to. We are set to release new packages for prescription glasses designed for children 0-15 years old; outpatient rehabilitation services and assistive mobility devices that will include access to wheelchairs, walkers, crutches, and canes; and our expanded rates for cataract extraction.

I encourage each of you to take full advantage of these benefits, stay informed, and trust that PhilHealth is here to serve you at every step.

I look forward to 2025 as a milestone year for Universal Health Coverage, and building a healthier, more resilient, and more united Philippines.

Mabuhay ang mga miyembro ng PhilHealth! Mabuhay ang Bagong Pilipinas!