Free TB meds not deductible from GAMOT benefits — PhilHealth
PhilHealth members and their dependents are getting additional access point for prescribed medicines starting 1 November 2026.
The free medicines that eligible tuberculosis (TB) patients will get from Philippine Health Insurance Corporation (PhilHealth)-accredited drug stores will not be deducted from the annual P20,000 credit for drugs under the agency’s Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program.
This will allow GAMOT beneficiaries to allocate the amount for other outpatient medicines, PhilHealth said in a press statement.
Under the program, PhilHealth is also expanding access to selected first-line anti-TB medicines, giving eligible members and their dependents an additional access point for prescribed medicines starting 1 November 2026. The covered medicines can be obtained from PhilHealth-accredited GAMOT facilities through prescriptions issued by Yaman ng Kalusugan (YAKAP) physicians.
0YAKAP is another PhilHealth program that provides outpatients free consultations, diagnostic tests and medicines worth up to P20,000 yearly at their chosen clinic or hospital.
Up to a one-month supply of first-line anti-TB medications may be prescribed per transaction, and the accredited GAMOT facility must dispense the complete prescribed quantity within two days from the date of GAMOT prescription issuance. Patients must claim their medicines within the prescribed period; otherwise, they may still obtain them but must pay out of pocket or secure an updated prescription. YAKAP-accredited physicians must issue the prescriptions through the GAMOT application in accordance with the Department of Health-National TB Control Program (DoH-NTP) treatment protocols.
To facilitate timely access, accredited GAMOT facilities must submit an updated Certification of Availability to their PhilHealth Regional Office before dispensing anti-TB medicines.
PhilHealth will directly reimburse participating GAMOT facilities based on the fixed fees schedule specified in the circular.
The expanded benefit complements — not replaces — the Outpatient TB-DoTS Package, which remains PhilHealth’s primary benefit for comprehensive outpatient TB care.
Meanwhile, TB DoTS facilities shall continue providing comprehensive care and dispensing medicines when supplies are available and sufficient. If first-line anti-TB drugs are dispensed through a GAMOT facility instead of the TB-DoTS facility, an automatic 50 percent deduction will apply to the TB-DoTS package claim for each treatment phase.
Members are encouraged to consult their YAKAP Authorized Physician or TB-DOTS provider to determine the appropriate treatment arrangements and how to access the benefit.
For PhilHealth, strengthening primary care means turning health coverage into meaningful access to service.
Through YAKAP and complementary benefits such as GAMOT, PhilHealth continues to advance the national health agenda by helping Filipinos access essential medicines and services, supporting continuity of treatment, and reducing financial barriers to healthcare.