PhilHealth manually processes its members’ transactions at PhilHealth National Capital Region Central Branch in Quezon City. Maria Tan, ABS-CBN News/File

MANILA — The Philippine Health Insurance Corporation (PhilHealth) will further increase its benefits coverage amid its robust financial health, an official said on Monday.

PhilHealth President and CEO Emmanuel Ledesma Jr. said in a press briefing that the agency plans to implement a 30 to 50 percent increase in benefit coverage by November across all its benefit packages.

This comes after PhilHealth implemented a 30 percent increase in the coverage rate of most of its benefit packages last February 2024.

The state health insurer also wants to offer benefit packages for the top 10 most burdensome diseases in the country namely pneumonia, severe dengue, acute stroke, chronic kidney disease, asthma, sepsis, ischemic heart disease, cataracts, and cancers of the lung, liver, ovary, and prostate.

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PhilHealth currently covers 60 percent of these conditions under the expanded healthcare financial benefits.

Ledesma emphasized that the agency’s strong financial standing provides ample resources to reduce out-of-pocket expenses of Filipinos.

“One of the reasons why we are aggressively enhancing the case packages across the board is because maraming maraming pondo po ang PhilHealth,” Ledesma said.

“It’s been more than 10 years that the case packages of PhilHealth have been enhances. Almost 10 years ‘yan hindi nagagalaw so nagpile up na po ‘yong pera,” he explained.

Ledesma added that there have been fewer benefit claims during the COVID-19 pandemic while premium contributions continued to increase as set by the Universal Health Care Law.

As of September 30, 2024, investments in PhilHealth have reached P512 billion with over P9 billion already remitted by the national government. Payouts for case packages have reached P120 billion this year.

PhilHealth Senior Vice President Renato Limsiaco Jr. assured the viability of the insurance fund as it looks to cover around P160 to 170 billion this year.

“Bankrupt is not in the vocabulary of PhilHealth right now. The mission right now is the improvement of benefits,” Limsiaco said.

With the state health insurance fund’s good standing, PhilHealth reiterated its support for the reduction of premium contribution from 5 percent to 3.25 percent. 

Ledesma said the move will reallocate savings to contributors if passed.

Monthly payments to hospitals have also increased with PhilHealth disbursing over P15 billion per month to clear outstanding claims.