CAGAYAN DE ORO CITY (PIA) -- Under the Universal Health Care Law, the Philippine Health Insurance Corporation (PhilHealth)-10 assured members of new and enhanced benefits in 2023 and rationalized case rate packages for the most burdensome diseases and commonly availed cases.

In celebration of PhilHealth's 29th anniversary and National Health Insurance Month every February, Regional Vice President Delio Aseron II shared that this year’s anniversary theme, “Damang dama ko ang Benepisyo,” aids to lower out-of-pocket expenses for members whenever they get hospitalized and to celebrate these developments in benefits.

“Ang pinakamagandang probisyon ng nasabing batas (RA 11223 or the Universal Health Care Law), lahat ng Pilipino ay kasali na sa programa, at ang maganda rin po dyan, immediate illegibility [The best provision of the said law (RA 11223 or the Universal Health Care Law), all Filipinos are already included in the program, and the good thing about that is immediate illegibility],” said Aseron.

In 2023, PhilHealth launched the institutionalization of 156 hemodialysis sessions (from 90 to 156 sessions), raising the case rate for acute stroke, ischemic stroke, and hemorrhagic stroke from P28,000 to P76,000 and hemorrhagic stroke from P38,000 to P80,000.

Meanwhile, case rates for high-risk pneumonia range from P32,000 to P90,100. Further, the enhancement of the Z Benefit package for selected orthopedic implants and colorectal cancer and the outpatient benefits package for mental health, particularly general mental health services (P9,000) and specialty mental health services (P16,000), with inclusions of screening, assessment, diagnostics, 12 follow-up visits, free medicines, psychoeducation, psychosocial support, and psychotherapy.

For 2024 onwards, PhilHealth shall implement inflation case rate adjustment, PhilHealth Guaranteed Accessible Medications for Outpatient Treatment (GAMOT), a severe acute malnutrition package, rationalization of other top conditions such as dengue hemorrhagic fever, chemotherapy (lung, liver, ovarian, and prostate), bronchial asthma, bacterial sepsis in newborns, and enhancement of Z benefits for post-kidney transplant, breast cancer, prostate cancer, cervical cancer, and open heart surgery for children.

Although there are these enhanced benefits from PhilHealth, Aseron urged members not to wait to see a physician when the illness is already severe, saying there is still this challenge to encourage them to have the first patient encounter.

“Doon po tayo pupunta sa preventive, kasi lagi doon tayo sa curative. Hindi mo kailangan magkasakit sa loob ng isang taon, pwede kayo ng iyong pamilya magpatingin, napakahalaga ng first patient encounter, kasi dyan po kukunin ang ating baseline data, ano ba ang kondisyon ko?” he shared.

[That's where we need to go for prevention because we are always curative. You don't have to be sick for a year, you and your family can see a doctor. The first patient encounter is very important, because that's where our baseline data will be taken. What is my condition?]

In terms of the Konsulta package, the focus of PhilHealth this year is to encourage members to register with their primary care provider of choice and to increase the number of doctors who will join the program to provide this benefit.

Under the package, all Filipinos may choose a Konsulta facility accredited by PhilHealth, while health care institutions may register as Konsulta providers, which can provide check-ups, health screening assessments, laboratories, and medicine based on the health risk, age, and needs of the patient.

In the region, there are 115 Konsulta providers, whereas PhilHealth registered members total 1,964,538. 

"We need to invest in our health, and PhilHealth is here," said Aseron. (JMOR/PIA-10)