Strict, transparent PhilHealth availment
An ordinary Filipino, despite being covered by PhilHealth, feels insecure about going to the hospital because the amount PhilHealth will cover is often unknown and, when provided, is often low.

An ordinary Filipino, despite being covered by PhilHealth, feels insecure about going to the hospital because the amount PhilHealth will cover is often unknown and, when provided, is often low.


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Senator Loren Legarda on Saturday called for a “strict and transparent” implementation of the increased benefits provided by Philippine Health Insurance Corporation (PhilHealth) to its members.
The increased coverages include several medical services such as treatments for ischemic heart disease (coronary heart disease), emergency outpatient services, kidney transplants and adjustments in 50 percent of select case rates.
Legarda expressed optimism about the reforms even as she flagged the health insurer for its “inconsistent execution” of its programs.
“Although these reforms are welcome, we still need to see how PhilHealth will implement them effectively,” Legarda said.
“For instance, while there’s a 50-percent increase in select case rates, PhilHealth has not clarified which cases will be covered and how much will be allocated. This uncertainty only contributes to the lack of trust among PhilHealth members, who often delay seeking medical treatment until emergencies arise,” she said.
Legarda lamented that some Filipinos feel insecure about going to the hospital to receive medical treatment despite being covered by PhilHealth.
“An ordinary Filipino, despite being covered by PhilHealth, feels insecure to go to the hospital because the amount PhilHealth will cover is often unknown and, when provided, is often low,” she said.“As a result, their out-of-pocket expenses go toward a substantial part of the bill. Poor patients, despite universal healthcare coverage, are forced to seek assistance from other government programs, such as guarantee letters, or resort to loans to cover the remaining healthcare costs,” she noted.
Legarda said PhilHealth’s success should be measured according to patients’ confidence knowing that they will meet their needs.
“True universal healthcare cannot exist if the coverage remains insufficient and uncertain,” she added.
Legarda reminded the state health insurer of its priorities and core mission — to provide accessible healthcare for all Filipinos.