PhilHealth eyes faster benefit expansion to cut out-of-pocket costs

MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) is rapidly expanding its benefit packages to cover a wider range of illnesses, including several types of cancer, heart disease and maternal and neonatal care, as it seeks to lower out-of-pocket hospital expenses.

Bataan Rep. Albert “Abet” Garcia unveiled PhilHealth’s benefit expansion “roadmap” during a congressional floor debate on next year’s health sector funding, including the Department of Health’s (DOH) budget that he sponsored.

PhilHealth, the state health insurer for all Filipinos, has faced criticism over the perceived lack of depth in its coverage and the limited number of illnesses included in its benefit packages. Households’ out-of-pocket spending accounted for 41.2% of total health expenditures in 2025, according to Philippine Statistics Authority data.

Article continues after this advertisement

READ: Under 24-hour hospital stay covered – PhilHealth

FEATURED STORIES

NEWSINFO

NEWSINFO

NEWSINFO

“This is our roadmap to expand PhilHealth’s coverage,” Garcia, the second-ranking member of the House appropriations committee, told lawmakers.

For this year, PhilHealth plans to expand its benefit coverage for children with developmental disabilities and introduce the following packages in the coming months:

• Acute stroke;
• Palliative and hospice care;
• Emergency coronary artery bypass grafting;
• Animal bites;
• Neonatal care for premature newborns;
• Mental health treatment;
• Colorectal cancer.

For 2027, the state health insurer aims to expand its packages to cover the following conditions:

• Tuberculosis;
• Sexually transmitted infections, including human immunodeficiency virus (HIV);
• Lung, liver, cervical, uterine, ovarian and prostate cancer;
• Hepatitis;
• Leprosy;
• Leukemia;
• A newborn care package for children with disabilities;
• Cardiac arrhythmia;
• Congenital heart disorders;
• Malnutrition;
• Dental care.

For 2028, PhilHealth plans to roll out these packages:

• X-linked dystonia, a neurodegenerative movement disorder affecting Filipinos;• Glaucoma and corneal transplant;• Breast and thyroid cancer;• Thalassemia and hemophilia;• Medical care for victims of violence against women and their children;• Spinal compression fractures;• Alzheimer’s disease and dementia;• Psoriasis;• Stem cell transplant. /das