Daily TribuneThe circular was issued to all PhilHealth-accredited hospitals to implement the 50 percent hike in benefit packages for multiple health conditions starting 1 January 2025.
(FILE PHOTO) PhilHealth Board of Directors vetoes a P37.5M proposal for 30th-anniversary marketing collaterals to prioritize member benefits.
PNA
The Philippine Coalition of Consumer Welfare Inc. (PCCWI) is pushing for a 78 percent minimum coverage of medical fees for contributors of the state-owned Philippine Health Insurance Corporation (PhilHealth) this year.
PCCWI chairman and founder Ricardo Samaniego shared this in a Viber message to DAILY TRIBUNE.
On average, Filipinos seek financial aid to cover 56 percent of their medical fees, PhilHealth said in its Circular 2024-0037 signed by PhilHealth president and chief executive officer Emmanuel Ledesma Jr.
However, the circular added the National Health Insurance Program covers less than 40 percent of patients’ hospital fees.
The circular was issued to all PhilHealth-accredited hospitals to implement the 50 percent hike in benefit packages for multiple health conditions starting 1 January 2025.
Samaniego said PhilHealth shoulders only 9 percent of the medical fees based on his interactions with PhilHealth members in the past two decades and hospital transactions with family members.
Thus, Samaniego urged PhilHealth officials to exhibit more transparency in patients’ benefits data. “They must be honest in their figures.”
However, he remained optimistic that PhilHealth can achieve 78 percent coverage for patients’ medical fees due to its “huge” resources and favorable response to requests of lawmakers and President Ferdinand Marcos Jr. toward genuine universal healthcare.
“Yes, they can,” Samaniego said.
While PhilHealth was denied a government subsidy this year under the 2025 National Budget, PhilHealth said it will continue to provide benefits to members.
“The way to go is up and you can be assured that we will continue to implement our Board-approved plans to improve more packages to lower out-of-pocket expense patients,” Ledesma said.
In a statement to the media, PhilHealth said it still has P281 billion in reserves to meet benefit payments for two years, P150 billion in surplus, and P489 billion in its investment portfolio.
Senator Francis “Chiz” Escudero supported the zero-subsidy to PhilHealth, saying the insurer failed to mobilize its reserve funds to reduce the out-of-pocket expenses of PhilHealth members.
PhilHealth now implements a 50 percent increase in benefits coverage for several illnesses, bringing the total increase to 95 percent.
The new increase applies to nearly 9,000 benefit packages.
PhilHealth discloses the long list of packages on its “Circulars” page on its official website at www.philhealth.gov.ph.
