The Philippine Health Insurance Corporation (PhilHealth) has implemented a new benefit package covering outpatient emergency care services, which took effect on 1 January under PhilHealth Circular No. 2024-0033.
The Outpatient Emergency Care Benefit (OECB) package covers a wide range of services for patients treated in emergency departments (ED) of accredited facilities, including prehospital transport.
Health reforms crusader Senator Christopher “Bong” Go welcomed the development which in effect, abolished the 24-hour confinement policy where patients are required to be confined before being able to avail of PhilHealth coverage. However, Go stressed the need for further reforms to ensure Filipinos can access full healthcare services.
Most significant among these are the commitments made by PhilHealth that Go fought for which the state health insurer has started to implement. Specified in PhilHealth’s commitment letter are the following: A substantial increase in the benefit packages for the top 10 mortality diseases; increase in case rates by up to 50 percent across-the-board; expansion of benefit packages, such as dental benefits, outpatient drug benefits, mental health benefit, optometric services and the likes; scrapping of anti-poor policies, such as the 24-hour confinement rule which prevents the coverage of emergency outpatient services for patients not needing facility admission, among others.
Patients under the OECB package can now claim coverage for emergency services without requiring hospital admission. Cases, such as dizziness, diarrhea, persistent vomiting, elevated blood pressure, seizures and even sexual assault are covered. Additionally, diagnostic services such as X-rays, CT scans, nebulization and blood tests are included.