PhilHealth to offer outpatient MRI, CT, PET

State health insurer Philippine Health Insurance Corporation (PhilHealth) is expanding its benefits package, adding Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Computed Tomography (CT) scans to its outpatient services before the end of the year.

Currently, MRI, CT and PET scans are covered by PhilHealth only if they are done as inpatient services.

The MRI uses strong magnetic fields to generate detailed images of soft tissues, while the PET visualizes metabolic processes through radioactive substances. The CT combines X-ray images for cross-sectional views of the body.

In a letter signed by Health Secretary Teodoro Herbosa and PhilHealth president and CEO Emmanuel Ledesma Jr., the diagnostic tests will now be covered, along with 80-percent coverage for cancer treatments such as chemotherapy and procedures for heart diseases.

Pediatric and adult prescription glasses will also be covered starting in November. Moreover, PhilHealth will implement another round of benefits package enhancements, increasing coverage across the board by 50 percent effective the same month.

In addition, PhilHealth has guaranteed an increase in benefit payments from P140 billion to P250 billion for next year to lower the out-of-pocket expenses of Filipinos for hospitalization costs and health services.

The Department of Health and PhilHealth assured the rollout of the expanded benefits coverage following an attempt to derail the approval of their P297.6-billion proposed allocation for 2025 during the last session of Congress on Wednesday.

Agri Partylist Rep. Wilbert Lee tried to postpone the passage of the Department of Health’s budget, citing PhilHealth’s failure to expand its health coverage despite the availability of funds exceeding P500 billion.

The lawmaker argued that PhilHealth’s benefits committee remained unresponsive to the needs of its members despite the substantial funds.

Ledesma admitted that PhilHealth’s benefits program is outdated, but they have been “very aggressive” in increasing almost all packages.

Nevertheless, he said that PhilHealth has been striving to make significant efforts to cater to its members.

Earlier, PhilHealth increased its coverage for dialysis treatments from 90 to 156 sessions, and the payment per session has been raised by 51 percent from P2,600 to P4,000.