PhilHealth to pursue expanded benefit coverage in 2024

State insurer Philippine Health Insurance Corporation (PhilHealth) will continue to expand the coverage of its benefits packages in 2024 regardless of the decision on the mandated increase in its premium rates stipulated by the Universal Health Care (UHC) Law.

In January, President Ferdinand Marcos Jr. ordered the suspension of the premium rate and income ceiling hike of PhilHealth for the calendar year 2023, citing the socioeconomic challenges caused by the pandemic.

The scheduled increase is based on the UHC Law, which mandated hikes in the PhilHealth contribution rate until it reached 5% by 2024.

“’Yung pag-increase sa mga benefits natin sa PhilHealth, masasabi natin na hindi naka-depende sa scheduled na contribution rate na naka-schedule yan para sa 2024,” said PhilHealth Corporate Affairs Group Acting Vice President of Rey Baleña in PTV-4’s Bagong Pilipinas Ngayon.

(The expansion for the coverage benefits is not dependent on the scheduled contribution rate for 2024.)

“Matuloy man ‘yung implementation ng naka-schedule na contribution rate for 2024 o hindi, tuloy po tong pagtaas sa ating mga benepisyo,” he said.

(Whether the mandated premium rate increase will be implemented or not, we will continue to increase our benefits.)

In November, PhilHealth announced it would increase benefit packages by up to 30% next year.

This means lesser out-of-pocket expenses for Filipinos availing of health care services using PhilHealth.

“Ang dahilan natin kung bakit natin itataas ‘yang coverage ng PhilHealth ay dahil sa inflation na nakaapekto rin sa mga gastusing medikal ng ating mga miyembro,” Baleña said.

(We did this because of inflation's impact on the medical fees of our members.)

“Ang nais natin dito ay maramadaman ng mga kababayan natin ‘yung mga benefits nila at mapababa ‘yung out of pocket o mga karagdagan pa o mga balanse na binabayaran pa ng ating mga miyembro kung hindi man totally ma-eradicate natin ‘yang ating out of pocket,” he added.

(We want our members to feel their benefits and lessen their out-of-pocket expenses.)

PhilHealth previously expanded its coverage for dialysis patients from 90 sessions to 156 sessions. It also increased coverage for ischemic and hemorrhagic stroke patients.

Meanwhile, the state insurer said it had enough funding for the hospitals that would be affected by the increased coverage.

Baleña also said PhilHealth was eyeing to reinstate the debit-credit payment method — a mechanism the agency used during the COVID-19 pandemic — to speed up the process of paying for hospital claims.

“Mataas po ang ating financial standing. Kayang-kaya ng PhilHealth na tustusan po tong gagawing malawakang pagtataaas ng benepisyo para sa ating mga miyembro,” he said.

(We have good financial standing. PhilHealth can pay for hospital claims.)

“Itong ating mga partner-hospitals, wala po silang dapat ipangamba dahil pagdating sa pagbabayad ng claims, mabilis po tayo,” he added.

(Our partner hospitals have nothing to worry about. We will speed up the process of paying for their claims.) — DVM, GMA Integrated News