The Philippine Health Insurance Corporation (PhilHealth) is rolling out a significant increase in its benefit packages for 2025, with approximately 9,000 case rate packages set to receive a 50% increase this year.
PhilHealth Senior Vice President for Health Finance, Dr. Israel Francis A. Pargas, shared the news during the Bagong Pilipinas Ngayon televised briefing on Monday, January 6, despite a controversial decision to cut government subsidies for the state health insurer for this year.
“This increase follows our previous adjustment in February 2024, where we raised the rates by 30%. Now, as we close out 2024, we are implementing another round of increases, this time by 50% for around 9,000 packages starting January 1,” Pargas said.
The increase will cover a wide array of health services, including high-priority conditions. For example, the kidney transplantation benefit package, previously capped at P600,000, will now range from P800,000 to P2 million.
Similarly, the package for heart attack patients requiring angioplasty has seen a major boost, with benefits now reaching up to P530,000, compared to the previous P30,000.
When asked for clarification, Pargas assured that most illnesses covered by PhilHealth would see an increase this year, except for those that had been adjusted separately.
“Practically all the diseases covered by PhilHealth will have an increase, with some getting special adjustments based on their treatment needs,” Pargas said.
A major new addition this year is the outpatient emergency care benefit package. This will cover members who visit the emergency room due to illness or injury but do not require hospitalization.
“Dati meron tayong primary care, meron tayong inpatient care. Pero yung mga pasyente na nadadala sa emergency room pero hindi naa-admit, wala po silang benepisyo before,” Pargas said.
Another key development involves the expansion of primary health care services, particularly in dental care.
Under the Konsulta program, which offers free consultations and laboratory tests, PhilHealth will now cover preventive oral health services, including oral examinations, prophylaxis, fluoride treatments, emergency tooth extractions, and tooth restoration procedures.
“This service is available to all our members who need dental care, provided by accredited Konsultaproviders capable of offering dental services,” Pargas said.
The new benefit packages, which will be available through accredited healthcare providers across the country, reflect PhilHealth’s continued commitment to improving access to healthcare for all Filipinos.
President Ferdinand Marcos Jr. previously reassured the public that, despite concerns about the removal of government subsidies for the state health insurer, members would still be able to access expanded and enhanced benefits from PhilHealth. (TCSP)
