PhilHealth earmarks up to P400B for expanded benefits

Philippine Health Insurance Corporation (PhilHealth) said it has earmarked as much as P400 billion this year for healthcare benefits and coverage expansion following the return of P60 billion previously remitted to the National Treasury.

In a Tuesday radio interview, Edwin M. Mercado, president and CEO of the state-owned health insurer, said benefit payments remain the largest component of the agency’s budget.

“We prepare our corporate operating budget annually. The largest component of this budget is what we call benefit expense — the amount allocated for the payment of services provided by our healthcare providers,” he said.

“Overall, we estimate that benefit payments and benefit coverage this year will amount to around P378 billion to P400 billion,” Mercado added.

The announcement comes amid continued scrutiny over PhilHealth’s financial management following the controversy surrounding the transfer of so-called excess funds to the National Treasury. 

The Supreme Court of the Philippines previously ordered the return of P60 billion to PhilHealth after concerns that the transfer had been approved to allegedly fund flood control projects through unprogrammed appropriations in the national budget, while also affecting the state insurer’s capacity to expand benefits and improve services.

PhilHealth has since committed to using the restored funds to enhance healthcare coverage, improve information systems, and reduce members’ out-of-pocket expenses.

The agency has also recently expanded benefit packages covering maternity and gynecologic services, including higher reimbursement rates for normal deliveries, cesarean sections, and related procedures.