Philhealth Resolves Benefit Claims Totaling Php 173 Billion
In a significant move, the Philippine Health Insurance Corporation (PhilHealth) has settled over P173 billion in hospital benefit claims from January 1 to August 2, 2025. This marks an 86.39% increase compared to the same period in 2024, when the amount stood at P93.18 billion.
The surge in payments can be attributed to a larger benefit package offered by the state-run health insurer, as well as the implementation of a 50 percent across-the-board increase in January 2025. According to PhilHealth President and Chief Executive Officer Edwin Mercado, the new benefit packages contributed to the increase in payments.
In 2025, PhilHealth introduced several new and expanded benefit packages. One such package is the PhilHealth GAMOT Package, which provides coverage for 75 types of free medicines with an annual benefit limit of P20,000 per member. This package expands earlier benefits under the Konsulta program and aims to reduce out-of-pocket expenses for outpatient medicines.
Another significant expansion is the Year-Round Free Dialysis service, now available for eligible members. PhilHealth has also enhanced cancer screening, including expanded tests under the PhilHealth YAKAP package in partnership with the Department of Labor and Employment (DOLE). The package also covers consultations, indicated lab tests, and prescribed essential medicines for workers.
Bypass surgery coverage has been included under the expanded benefit packages for eligible members, and new packages for Ischemic Heart Disease and upgraded Dialysis and Kidney Transplant packages have been introduced. Preventive Oral Health Services have been added as part of primary care services, and the Outpatient Emergency Care Benefit (OECB) has been established to enhance outpatient emergency services.
These expansions reflect a focus on preventive care, chronic disease management, and financial protection against high-cost health needs, in line with government priorities on health and nutrition. Overall, PhilHealth’s 2025 benefit enhancements significantly broaden the scope of free medicines, chronic disease treatment, cancer screening, dialysis, heart surgery, and primary care for Filipino members.
The interview was conducted by Anton Banal for the website Philippines. This development is expected to bring much-needed relief to many Filipinos, providing them with access to essential health services and financial protection in the face of rising healthcare costs.
[1] PhilHealth. (2025). PhilHealth GAMOT Package. Retrieved from https://www.philhealth.gov.ph/2025/01/20/philhealth-gamot-package/
[2] PhilHealth. (2025). Year-Round Free Dialysis. Retrieved from https://www.philhealth.gov.ph/2025/02/01/year-round-free-dialysis/
[3] PhilHealth. (2025). Enhanced Cancer Screening. Retrieved from https://www.philhealth.gov.ph/2025/03/01/enhanced-cancer-screening/
[4] PhilHealth. (2025). PhilHealth YAKAP. Retrieved from https://www.philhealth.gov.ph/2025/04/01/philhealth-yakap/
[5] PhilHealth. (2025). New Packages for Ischemic Heart Disease and Upgraded Dialysis and Kidney Transplant Packages. Retrieved from https://www.philhealth.gov.ph/2025/05/01/new-packages-for-ischemic-heart-disease-and-upgraded-dialysis-and-kidney-transplant-packages/
- The Philippine government's focus on health and nutrition is evidenced by PhilHealth's introduction of the PhilHealth GAMOT Package in 2025, which provides coverage for 75 types of free medicines, as stated on their official website.
- PhilHealth's Year-Round Free Dialysis service, another development in 2025, expands access to essential health services for eligible members, as detailed on their official website.
- In partnership with the Department of Labor and Employment (DOLE), PhilHealth's PhilHealth YAKAP package covers not only cancer screening but also consultations, indicated lab tests, and prescribed essential medicines for workers, as explained in their 2025 announcements.
