PhilHealth scales up HIV/AIDS coverage, guarantees privacy and wider support

by Info @Brand Zone | December 1, 2025

PhilHealth PR 2025-43

In commemoration of the World Aids Day with the theme “Overcoming disruption, transforming the AIDS response", the Philippine Health Insurance Corporation (PhilHealth) stands with the persons living with HIV (PLHIV) through its enhanced Outpatient HIV/AIDS Treatment (OHAT) Package which provides wider financial support to essential care. Through the Yaman ng Kalusugan Program or YAKAP, PhilHealth also raises awareness and early prevention efforts, assuring every member that all services are delivered with utmost confidentiality. 

This aligns with the Department of Health’s proposal for a declaration of a national public health emergency in the country due to a growing health concern stemming from rising human immunodeficiency virus (HIV) cases. On November 27, 2025, the Department of Health (DOH) reported over 5,500 new cases from July to September 2025. 

In response, Dr. Edwin M. Mercado, PhilHealth Acting President and CEO emphasized “Wala po kayong dapat ipag-alala, narito po ang PhilHealth upang tugunan ang inyong pangangailangang medikal. Kaya huwag po kayong matakot o mahiyang magpagamot. Makakaasa kayo na po-protektahan namin ang inyong mga personal na impormasyon.” 

The enhanced OHAT Package now offers an annual benefit of P58,500, a 95% increase from the previous P30,000. This benefit covers antiretroviral therapy (ART) for all individuals with confirmed HIV test results from certified facilities, regardless of their clinical or immunologic status. It also includes access to all necessary services required for effective HIV management. 

This enhancement is consistent with President Ferdinand R. Marcos, Jr.’s directive to continually improve and sustain the health insurer’s healthcare benefits by ensuring adequate financial support to patients seeking medical treatment. In his second State of the Nation Address, the President highlighted that 'The whole of society must exert efforts to suppress the alarming rise of HIV/AIDS. To stem the tide, the strategic plan is to ensure early diagnosis and treatment, and ample testing sites and medications. 

The OHAT Package can be accessed through 234 PhilHealth-accredited and DOH-designated HIV treatment hubs across the country. In 2024, PhilHealth disbursed a total of P1.66 billion for 176,819 OHAT benefit claims.

“Nakakabahala ang mga balita na pabata ng pabata ang mga PLHIV kung kaya’t nananawagan kami sa mga magulang ng mga kabataan, suportahan at iparamdam natin sa kanila na hindi sila nag-iisa at may kinabukasang naghihintay sa kanila sa pamamagitan ng early prevention at regular na pangangalaga sa ilalim ng ating mga YAKAP Clinics,” Dr. Mercado stated. 

For further inquiries on benefits and services, members may call PhilHealth’s 24/7 hotline at (02) 866-225-88 or at mobile numbers (Smart) 0998-857-2957, 0968-865-4670, (Globe) 0917-1275987 or 0917-1109812.

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PhilHealth, nagbayad ng higit P217 bilyong claims payment sa unang 9 na buwan

by Info @Brand Zone | October 30, 2025

PhilHealth PR 2025-43

Ipinahayag ng Philippine Health Insurance Corporation (PhilHealth) na nagbayad ito ng P217.93 B sa kabuuang benefit claims sa mga accredited healthcare facilities sa buong bansa. Ang benefit payout na ito ay nagpapakita ng 112.2 Bilyon o 94.18% na pagtaas kumpara sa parehong panahon noong nakaraang taon (Enero hanggang Setyembre). 

Sa nasabing benefit payout, P127.79 B ang naibayad sa mga accredited na pribadong health providers, habang P90.14 B naman ang naibayad sa mga pampublikong health care providers.  

Binigyang-diin ng PhilHealth na ang malaking bahagi ng nasabing halaga ay para sa benepisyo ng mga kumplikado at malubhang kondisyon.  Ito ay dahil sa patuloy na pagtaas ng claims para sa mga sakit na sakop ng Z Benefit Packages (kabilang ang heart surgery, kanser,at kidney transplantation) at mga serbisyongs tulad ng outpatient hemodialysis. Tinitiyak din ng PhilHealth na ang mga miyembrong may malulubhang sakit ay makakatanggap ng tuloy-tuloy at mataas na halaga ng pinansyal na suporta. 

Ayon pa sa PhilHealth, ang  turnaround time ng pagproseso ng claims ay 22 araw lamang.  Ito ay nagpapakita ng pagbuti ng proseso ng ng PhilHealth alinsunod sa direktiba ni Pangulong Ferdinand R. Marcos Jr. na pahusayin ang serbisyo ng ahensya. 

Ipinahayag din ng PhilHealth na mas makatutugon ang benepisyo kung magbabago ng sistema ng pagbabayad mula sa All Case Rates papuntang Diagnosis-Related Group (DRG) para sa mga mas komplikado at modernong paggamot,  

“Ang DRG ay mas makakatulong upang matukoy ang antas ng kalubhaan at ang mga resources na kailangan para sa pangangalaga ng pasyente. Sa gayon, matitiyak na ang ating mga healthcare provider ay mababayaran nang wasto at tuluy-tuloy para sa paggamot ng mga kumplikadong kondisyon,” paliwang ni Dr. Edwin M. Mercado, Pangulo at Punong Tagapagpatupad ng PhilHealth. ### 

Kung may katanungan sa benepisyo ng PhilHealth, tumawag sa tumawag sa 24/7 Action Center: (02) 8662-2588 o bisitahin ang www.philhealth.gov.ph.  

#Rise30 #SamasamangPagangatsaBagongPilipinas  

PhilHealth assures benefit coverage for flu

by Info @Brand Zone | October 28, 2025

PhilHealth PR 2025-42

The Philippine Health Insurance Corporation (PhilHealth) reminds that Filipinos can fully avail of its benefits for the treatment of influenza and influenza-like illnesses, emphasizing the role of its enhanced primary care package.

Members are urged to immediately consult with their chosen YAKAP Clinic upon experiencing flu-like symptoms. The PhilHealth YAKAP benefit provides coverage for consultations, essential medicines, laboratory tests, if recommended by the primary care physician. This package is designed to promote prevention and early disease detection to help curb financial hardship for the members in line with President Ferdinand R. Marcos Jr.’s directive to ensure a healthy nation.

PhilHealth encourages all Filipinos to select and be empaneled with a YAKAP Clinic to avail of primary care benefits through the eGovPH app, PhilHealth Member Portal or in PhilHealth Local Health Insurance Office.

Further, PhilHealth ensures coverage from the onset of severe symptoms. Patients rushed to the Emergency Room and classified as emergent or critical are covered by the Outpatient Emergency Care Benefit Package. PhilHealth also provides a P12,870 case rate package for influenza cases requiring confinement, with a separate package rate available for cases that develop complications like pneumonia.

Dr. Edwin M. Mercado, President and CEO of PhilHealth, reminded the public not only of the available benefits but also of the importance of prevention.

“We encourage everyone to avail their PhilHealth YAKAP benefit. Let us not wait for the cough, fever, or cold to worsen,” explained Dr. Mercado. “I also urge everyone to prioritize simple preventive measures: wash your hands frequently, cover your mouth and nose when coughing or sneezing, and avoid crowded places if you are already feeling sick.”

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Reference: PhilHealth CorComm