Outpatient emergency cases now covered by PhilHealth

The Philippine Health Insurance Corporation (PhilHealth) announced that it is now covering all outpatient emergency cases in accredited levels 1 to 3 hospitals nationwide.

The state health insurer said that starting February 14, 2025, the outpatient emergency cases would be covered by its facility-based emergency (FBE) benefit in accordance with the outpatient emergency care benefit package.

PhilHealth reminded hospitals that a separate accreditation to provide FBE benefits is not required as it is already included in their hospital accreditation.

“However, those with extension facilities must submit to their respective PhilHealth Regional Offices a certification stating the name of affiliated extension facility and its complete address,” it added.

PhilHealth is also expected to announce soon the coverage for ambulance services under the pre-hospital emergency benefit.

The outpatient emergency care benefit was introduced by PhilHealth last month under its set of new and expanded benefit packages for this year.

It provides comprehensive coverage for emergency services, focusing on two main components: facility-based emergency and pre-hospital emergency benefits.

These cover essential care in accredited hospital emergency departments and emergency transport services for cases that do not result in hospital admission and may be availed in OECB accredited facilities. — RSJ, GMA Integrated News