Programs and Services

Programs and Services of PhilHealth 

1. Inpatient Benefits
PhilHealth covers hospitalization costs for members confined for at least 24 hours in accredited hospitals. Benefits include room and board, medicines, laboratory exams, operating room services, and professional fees.

2. Outpatient Benefits
Coverage for day surgeries, dialysis, radiotherapy, outpatient blood transfusion, and other minor medical procedures performed in accredited facilities.

3. Primary Care / Konsulta Package
Provides access to preventive and promotive health services, including consultations, health screenings, laboratory tests, and medicines for maintenance conditions like hypertension and diabetes.

4. Z-Benefit Packages
Special benefits for catastrophic illnesses that are usually expensive to treat, such as cancer, kidney transplants, coronary artery bypass grafts, and other major procedures.

5. Maternity Care Package (MCP)
Covers prenatal, delivery, and postpartum care for normal spontaneous deliveries and emergency obstetric conditions.

6. TB-DOTS Package
Provides treatment and monitoring support for tuberculosis patients through accredited DOTS centers.

7. Animal Bite Treatment Package
Covers post-exposure prophylaxis, including rabies vaccination, in accredited animal bite treatment centers.

8. HIV/AIDS Treatment Package
Offers outpatient and inpatient services for people living with HIV/AIDS, including diagnostic tests and antiretroviral therapy.

9. Hemodialysis Package
Covers up to 156 sessions per year for patients with chronic kidney disease requiring dialysis.

10. Mental Health and Rehabilitation Benefits
Recently expanded to include coverage for mental health consultations, psychiatric treatments, physical medicine, and assistive mobility devices.

11. Konsulta Plus / Outpatient Medicines (GAMOT Program)
Ensures access to affordable and essential outpatient medicines for chronic diseases.

12. No-Balance-Billing (NBB) Policy
Implemented in government hospitals for indigent and sponsored members, ensuring that they pay nothing out-of-pocket for covered services.

13. Senior Citizen and Lifetime Member Program
Provides automatic PhilHealth coverage for all Filipino senior citizens and lifetime members who have paid at least 120 monthly contributions.

14. Overseas Filipino Program (OFP)
Extends PhilHealth benefits to OFWs and their dependents, ensuring health coverage even while working abroad.

15. Sponsored Program
Government and local government units subsidize contributions for indigent families identified through the Department of Social Welfare and Development (DSWD).

16. Expanded Primary Care Benefit for Children and Adolescents
Includes pediatric consultations, immunizations, and nutrition counseling to promote child and adolescent health.

PhilHealth’s Core Goal:
To provide accessible, affordable, and quality health care services to all Filipinos under the National Health Insurance Program (NHIP), ensuring financial risk protection and universal health coverage.