Here’s PhilHealth timeline for expected benefit expansion until 2028

PHILHEALTH. Philippine Health Insurance Corporation members process transactions at the PhilHealth National Capital Region Central Branch in Quezon City on September 26, 2023.

Jire Carreon/Rappler

PhilHealth is seeking from lawmakers an additional P170 billion for 2027 to fully implement its benefit expansion, as well as cover projected insurance claims of indirect contributors

AT A GLANCE

• PhilHealth plans to expand benefit packages until 2028 to reduce out-of-pocket healthcare expenses.
• The government is allocating P74.4 billion to PhilHealth for 2027, and additional funding is being sought to support the benefit expansion.

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MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) has a plan to expand various benefit packages until 2028, Bataan 2nd District Representative Albert Garcia said on Thursday, September 24. 

Garcia laid out the “roadmap,” which seeks to lower out-of-pocket healthcare expenses, as he was the sponsor of the Department of Health and PhilHealth during the House plenary deliberations on their proposed 2027 budget.

The rollout of enhanced benefits is based on health conditions with the highest disease burden and financial risk for Filipino patients, according to Garcia.

The announcement of the planned schedule came even as the state health insurer continued to flag its budget shortfall for next year.

Under the 2027 National Expenditure Program, the government will be giving P74.4 billion to PhilHealth. It is lower than the P129.78-billion allocation in the 2026 General Appropriations Act. 

Health officials are seeking from lawmakers an additional P170 billion in funding to fully implement the benefit expansion, as well as cover projected insurance claims of indirect contributors, or those whose premiums are subsidized by the government.

PhilHealth broadened its coverage for maternity benefits and for moderate to severe leptospirosis during the second quarter of this year.

Current benefits are listed on PhilHealth’s website.

Here’s the expected timeline of expansion of PhilHealth benefits per disease or package, as mentioned during the House plenary deliberations:

3rd quarter of 2026

• Children with developmental disabilities

4th quarter of 2026

• Phase 2 expansion for children with developmental disabilities
• Acute stroke 
• Palliative and hospice care 
• Rare diseases 
• Animal bites
• Emergency coronary artery bypass grafting
• Premature and small newborns 
• Mental health 
• Colorectal cancer

1st quarter of 2027

• Tuberculosis
• Human immunodeficiency virus and sexually transmitted infections
• Cervical cancer
• Prostate cancer

2nd quarter of 2027

• Lung cancer 
• Liver cancer 
• Family planning 
• Hepatitis 
• Leprosy 

3rd quarter of 2027

• Maternity care package
• Leukemia 
• Newborn care package for children with disabilities
• ZMORPH or Mobility, Orthosis, Rehabilitation, Prosthesis Help 

4th quarter of 2027

• Cardiac arrhythmia
• Congenital heart disorder 
• Uterine cancer 
• Ovarian cancer 
• Moderate acute malnutrition
• Dental packages

1st quarter of 2028

• X-Linked Dystonia-Parkinsonism 
• Glaucoma 
• Corneal transplant

2nd quarter of 2028

• Breast cancer
• Thalassemia
• Hemophilia 

3rd quarter of 2028

• Victims of violence against women and their children 
• Compression fracture of the spine 
• Alzheimer’s disease 
• Dementia

4th quarter of 2028

• Thyroid cancer
• Psoriasis 
• Hematopoietic stem-cell transplantation