MANILA — Filipinos can expect new and enhanced health benefit packages beginning 2025, state health insurer PhilHealth said on Monday.

Among the latest string of benefit packages which policies are being finalized following the approval of the PhilHealth board is the oral health benefit package that allows members to avail of annual routine preventive oral care services.

Considered as the first oral healthcare benefit package, it covers up to P1,000 annually per patient with P300 for the visit for mouth examinations, oral prophylaxis and fluoride varnish application. 

Another P300 covers the second visit given that it is done at least four months after the first, and P200 for pit and fissure sealant per tooth.

While PhilHealth President and Chief Executive Officer Emmanuel Ledesma admitted that the amount may not be as much as others expected, he says the fact that oral healthcare is now covered by PhilHealth is a step in the right direction.

“Yes, maybe one thousand may be low or too little, but at least it’s already started. But you have our assurance that we will not stop. Tuloy-tuloy yan until we get there,” he said.

NEW AND ENHANCED PACKAGES 

Following a PhilHealth Board meeting last November 29, it also approved new packages for 10 rare diseases under the Konsulta package, as well as “assistive mobility devices for priority conditions affected those in need of physical rehabilitation.”

Rare diseases, according to PhilHealth, continue to challenge and affect over 443,000 Filipinos.

“The development of the Z-Benefits Package for Rare Diseases is a major step forward inaddressing the healthcare needs of Persons Living with Rare Diseases (PLWRDs) in thePhilippines. This comprehensive and sustainable package aims to bridge gaps in healthcarefinancing, reduce the financial burden on families, and improve care and health outcomes for rare disease patients,” it said.

Among the diseases covered by this package is maple syrup urine disease, Methylmalonic acidemia/propionic acidemia, clagtosemia, phenylketonuria, gaucher disease, pompe disease, fabry disease, hunter syndrome, morquio syndrome and osteogenesis imperfecta where package rates range beteen P99,000 to P739,000.

Rehabilitation services by specific types of therapists are also covered. Various types of assistive mobility devices like wheelchairs, walkers, rollator, quad cane and crutch triceps among a few also have coverage from Philhealth.

PhilHealth spokesperson Dr. Ish Pargas explained that while they would like craft packages for all types of diseases to fully achieve the goals of universal health care, they have to  be careful in prioritizing and selecting which diseases get covered first.

“The priorities are dependent on the burden of disease in the country, kung ano ang top ten leading causes of mortality and morbidity. Depende rin sa claims of utilization and amount of support na naibibigay,” Pargas said.

Because of this, Philhealth has enhanced its packaged for acute myocardial infarction where some rates have seen an increase between 321% to 1,629% or P21,000 to P524,000.

Patients with chronic kidney diseases will also be able to enjoy enhanced benefit packages for peritoneal dialysis and post kidney transplantation services.

PhilHealth officials say the new and enhanced packages are now in the process of having their policies finalized prior to publication with a realistic implementation by early 2025.

Back in October, Ledesma assured the Senate Committee on Health chaired by Senator Bong Go that it would fulfill its promises of uplifting the quality of life of Filipinos by rolling out improvements to its current coverages as well as developing new packages.

Earlier this year, it also acted upon the request of lawmakers to scrap the single period of confinement policy which allows coverage for patient confinement due to an illness once within a 90-day period.