PhilHealth: In Case You Missed It: OUTPATIENT EMERGENCY CASES NOW COVERED

by Info @Brand Zone | Feb. 19, 2025

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Press Release | February 19, 2025 | Reference:  Dr. Israel Francis A. Pargas

Starting February 14, all outpatient emergency cases in accredited levels 1 to 3 hospitals are covered by PhilHealth’s Facility-Based Emergency (FBE) benefit in accordance with the Outpatient Emergency Care Benefit (OECB) package introduced late last year through PhilHealth Circular 2024-0033.

This is according to PhilHealth Advisory No. 2025-0009 published on February 18, 2025. Meanwhile, coverage for ambulance services under the Prehospital Emergency (PHE) benefit will be announced at a later date.

Hospitals are also reminded that they do not need separate accreditation to provide FBE benefits as it is already included in their accreditation as hospitals. 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.

For more information, members may call the following 24/7 touch points: (02) 866-225-88; mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987 or 0917-1109812.

PhilHealth boosts coverage for cataract operation

by Info @Brand Zone | Feb. 18, 2025

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Press Release | February 18, 2025

The Philippine Health Insurance Corporation (PhilHealth) announced the

implementation of its enhanced benefits for Extracapsular Cataract Extraction with

Insertion of Intraocular Lens (IOL) covering both adult and pediatric surgeries,

effective January 30, 2025.

This initiative is aligned with President Ferdinand R. Marcos Jr.'s directive to

continually improve and sustain healthcare benefits being provided by the state

health insurer, ensuring adequate financial support to patients seeking medical

treatment.

Based on PhilHealth Circular 2025-0001 published on January 15, 2025, benefits for

adult cataract surgery have significantly increased by more than fourfold, with

financial support starting at P20,200. Coverage varies depending on the type of lens

used, with procedures involving a monofocal IOL or standard lens at P28,300 per

eye. Premium lenses such as monofocal toric IOL that provides clear vision at one

specific distance while correcting astigmatism are covered for P43,800 per eye, a

multifocal IOL that helps see both near and far objects at P66,900 per eye, and

multifocal toric IOL that corrects astigmatism and multiple viewing distances at

P80,900 for the right eye.

Meanwhile, pediatric cataract surgery coverage has seen an unprecedented increase

of tenfold, with benefits reaching up to P135,000 per eye and P139,050 for both eyes.

If an intraocular lens (IOL) is included, coverage is at P179,000 per eye and P187,100

for both eyes.

Previously, PhilHealth pays for cataract extraction at P16,000 per eye with no

differentiation between adult and pediatric cases.

To ensure timely and uninterrupted healthcare services, the state health insurer

reminds all accredited healthcare facilities to maintain minimum stock levels of

intraocular lenses, essential eye medications, life-saving drugs, IV fluids, and

necessary supplies to avoid unwarranted out-of-pocket from outside purchases and

services.

This notable increase in coverage for cataract extraction is expected to help reduce

preventable blindness and improve the quality of life of Filipinos suffering from this

type of eye condition.

In 2024, PhilHealth has disbursed a total of P3.58 billion for 224,209 cataract

removal procedures.

Pagdiriwang ng ika-30 taong anibersaryo ng PhilHealth

ni Fely Ng @Bulgarific | Feb. 16, 2025

Hello, Bulgarians! Ang newly-appointed President at CEO ng PhilHealth na si Dr. Edwin M. Mercado, kasama ang 9,000 opisyal at empleyado mula sa buong bansa ay ipinagdiwang ang ika-30 taong anibersaryo ng state insurer sa isang solemn Eucharistic Mass noong Pebrero 14 at si Father Jerry Orbos, SVD, ang nangasiwa nito.

Upang masunod ang direktiba ni Pangulong Ferdinand “Bongbong” Marcos, Jr., sa pagtiyak na walang hadlang na mga serbisyo, ang misa ay nasundan ng isang board meeting na pinamunuan ni Health Secretary Teodoro Herbosa. Tinalakay ang mga isyu sa critical policy, na tumutugon sa parehong mga pangangailangan ng mga provider at miyembro.

“Nais nating tapatan ng buong pusong paglilingkod ang mainit na pagtanggap ng ating stakeholders, public health and medical communities, at lalung-lalo na ng mga kawani ng PhilHealth na siyang katuwang natin upang mas palawigin pa ang ating serbisyo,” pahayag ni Mercado.

Tatlumpung taon mula nang mabuo, ang PhilHealth ay nananatiling nakatuon sa paghahatid ng de-kalidad at mas tumutugon sa pangangalagang pangkalusugan para sa lahat ng Pilipino.

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Para sa anumang impormasyon, opinyon, isyu o maging imbitasyon, mag-e-mail sa bulgarific@gmail.com o sumulat kay Ms. Bulgarific at ipadala sa Bulgar Bldg., 538 Quezon Avenue, Quezon City.