DOH Orders Expansion of PhilHealth Benefits for Middle-Class Contributors

Middle-income Filipinos who directly pay contributions to the Philippine Health Insurance Corporation (PhilHealth) may soon receive expanded health benefits as the agency studies new programs under the guidance of the Department of Health (DOH).

During a live radio broadcast, Health Secretary Teodoro Herbosa said the proposals aim to improve services for members who pay premiums from salaries or business income, in addition to existing programs for sponsored members.

“Sa loob ng maraming taon, ang pokus namin ay ang tinatawag na indirect o sponsored programs, kung saan ang mga benepisyaryo ay hindi nagbabayad ng premium ngunit patuloy na tumatanggap ng benepisyo ng PhilHealth na pinopondohan ng gobyerno,” ayon kay Herbosa sa salitang Ingles.

Dagdag pa niya, “sa bagong programang ito, kailangan nating pagbutihin ang mga serbisyo para sa middle class.”

Herbosa also said President Ferdinand “Bongbong” Marcos Jr. emphasized the need to support direct contributors. Among the measures being considered are improved hospitalization services.

Direct contributors include employees, self-employed individuals, and business owners who regularly pay premiums.

“Napag-usapan namin [ni Executive Secretary Ralph Recto] ang posibilidad ng mas maayos na accommodations para sa mga direct member. Sa ngayon, pare-pareho ang basic accommodations ng lahat, ngunit maaari nating pag-isipan ang dalawang pasyente kada kuwarto o paglalagay ng air conditioning upang mas mapabuti ang benepisyo para sa mga nagbabayad,” ani Herbosa.

Another proposal under review is the expansion of PhilHealth packages for hospitals implementing the zero-balance billing (ZBB) program.

“Makatuwiran ito dahil hinihikayat nito ang mga LGU hospital na ipatupad ang ZBB. Pag-aaralan ng aming actuarial team kung kakayanin ito ng PhilHealth. Malaki na ang ibinabayad namin sa mga ospital—umaabot sa P300 bilyon—at maaari pa itong tumaas ngayong taon dahil sa dami ng inilalabas na PhilHealth packages,” dagdag niya.

It can be recalled that President Marcos announced last year that ZBB would be implemented in all 87 hospitals operated by the DOH.