PHILHEALTH BENEFIT PROGRAMS

This module seeks to inform you about the different benefit programs of PhilHealth along with its enhancements of package rates, development of new benefit packages, and the KonSulTa Benefit Package Program.

All Case Rates (ACR) Application

PhilHealth has developed an innovative application designed to provide all members with easy access to our case rates. With this user-friendly tool, you can effortlessly search for package rates of interest right from your mobile device—no need to visit a PhilHealth office or accredited hospitals. Simply connect to the internet, and with just a few clicks, you will have the vital information right at your fingertips. 

OMNIBUS: Pinalawak at mga Bagong Benepisyo para sa Mamamayang Filipino (PBBM)

On February 14, 2024, PhilHealth Circular No. 2024-0001 took effect, implementing an adjustment of case rates by at least 30% for the majority of cases. Priority or higher adjustments were made to certain case rates identified as "Prioritized Case Rates." 

PhilHealth KonSulTa Benefit Package

With the implementation of Universal Health Care (UHC), PhilHealth guarantees that all Filipinos have access to quality and affordable health care services, protecting them from financial hardship. This initiative has sparked a paradigm shift toward primary care, leading to the creation of the PhilHealth Konsultasyong Sulit at Tama (KonSulTa) Benefit Package. This program emphasizes a preventive approach, focusing  more on primary health care. 

Outpatient Benefits Package for Mental Health

PhilHealth introduced a new benefit package in October 2023, integrating mental health services to enhance Filipinos' overall well-being and ensure accessible mental health care as part of public health. 

Z Benefits Package

One notable enhancement is a more than 30% increase in the "Priority" Case Rate, specifically designed to cover catastrophic illnesses such as cancer, kidney disease, and heart disease. This implementation strengthens services by promoting preventive care and offering financial protection to mitigate financial risks. It ensures that all members can access high-quality healthcare, ultimately contributing to improved health outcomes for everyone. 

Immediate Eligibility

One of the major reforms of Universal Health Care (UHC) is ensuring that all Filipinos have immediate access to PhilHealth benefits. Previously, members were required to update their contributions for at least 3 to 6 months before being eligible for benefits. Now, under UHC, whether you are a new or long-standing member, provided that you are a registered PhilHealth member, you can access all available benefits, regardless of your contribution status.