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Enhanced benefits await PhilHealth members

BATANGAS CITY (PIA) — The Philippine Health Insurance Corporation (PhilHealth) has announced that it will expand the Rationalized Benefit Packages for its members starting this year.

This was confirmed by Eugene Coronel and Cynthia Asi, representatives of the regional office of PhilHealth IV-B during their interview with ‘PIA Ngayon’, a radio program by the Philippine Information Agency Batangas Information Center.

According to Asi, the premium rate adjustment for PhilHealth is in accordance with Republic Act 1123, or the Universal Healthcare Law, which mandates the increase in the PhilHealth contribution rate to increments of 0.5 percent every year starting in 2021 until it reaches 5 percent from 2024 to 2025. 

The income floor based on the contribution table for these five years is set at P10,000, and the ceiling gradually increases from P10,000 to P100,000 in 2024.

"Each PhilHealth member earning P10,000 will have a monthly contribution of P500, with a ceiling of P100,000. Even if their income exceeds this, only the maximum amount will be considered for the monthly contribution reduction," said Asi.

Meanwhile, Coronel discussed the rationalized benefit packages of PhilHealth, which underwent coverage upgrades, including increasing coverage for acute stroke, which includes ischemic stroke, which covers up to P78,000 from the previous P28,000.

Hemorrhagic stroke coverage is now up to P80,000 from the previous P38,000, according to Coronel. 

PhilHealth also highlighted PhilHealth Circular 0027 s. 2023 with upgraded pneumonia high- risk coverage now at P90,100, which previously ranges at P32,000. 

Coronel added that PhilHealth now includes packages on mental health for outpatient services. For psychiatric cases, the patient must be 10 years old, while for neurologic cases, beneficiaries of these services must be registered in the Mental Health Registry, as stated in PhilHealth Circular 0018 s. 2023.

General mental health services cost P9,000 and specialty mental health services have a coverage of up to P16,000.

Additional benefits were also granted for cataract surgeries. Previously, PhilHealth only allowed one ophthalmologist to perform 50 surgeries in a month, and now, 200 cataract surgeries are permitted, not exceeding 10 operations in a day.

Coronel emphasized that despite the increase in monthly PhilHealth contributions, they assure that the benefit packages for members will also improve. 

Aside from improved benefit packages, their program also includes the KonSulta program. Under this program, PhilHealth has partner health facilities that provide free services such as laboratory tests and medications, especially in government facilities.

In the coming years, PhilHealth will introduce free medications, increased coverage rate adjustments for severe acute malnutrition packages, rationalization for conditions like dengue hemorrhagic fever, chemotherapy for lung, liver, ovarian, and prostate cancers, bronchial asthma, and bacterial sepsis in newborns. 

However, these will be subject to review by PhilHealth doctors, as well as Z-benefits for kidney transplants, breast cancer, cervical cancer, prostate cancer, and open heart surgery for children. 

They reminded members with varying monthly incomes to contact PhilHealth to update their information and monthly contributions.

For those with "missed-out contributions," PhilHealth said members should contact their offices to find out how to settle their balances for monthly contributions and avoid larger penalties. (BPDC,CH/PIA-Batangas)

About the Author

Mamerta De Castro


Region 4A

Information Officer III at PIA-Batangas

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