PhilHealth: Up to P400B allotted for benefits, coverage this year

The Philippine Health Insurance Corp. (PhilHealth) on Tuesday said up to P400 billion has been allotted this year for benefit payments and coverage, following the return of P60 billion in “excess funds.”

“Taunan tayong gumagawa ng ating corporate operating budget. Ang pinakamalaking component nitong ating budget ay yung tinatawag nating benefit expense — ‘yan yung nilalaan natin para doon sa pagbabayad ng ating mga serbisyong binibigay ng ating mga provider,” PhilHealth president and chief executive officer Edwin Mercado said on “Bagong Pilipinas Ngayon.”

(We prepare our corporate operating budget annually. The largest component of this budget is what we call benefit expense — the amount allocated for the payment of services provided by our healthcare providers.)

The Philhealth official made the clarification after the Supreme Court had ruled that up to P60 billion of the state health insurer's excess funds may be transferred to the National Treasury if these are proven to be unused and no longer necessary for the state insurer’s operations and benefit obligations.

Mercado said the projected benefit spending covers both existing healthcare services and new programs introduced or planned by PhilHealth.

“So kasama diyan yung mga datihan na nating serbisyo, kasama rin yung mga nakaraang dalawang taon pa lang inumpisahan. Kasama rin yung mga bagong serbisyong inilalatag natin o pinaplano this year," he said.

(That [benefit expense] includes our long-standing services, as well as those introduced over the past two years. It also includes the new services we are rolling out or planning this year.)

"So sa kabuuan, ang tansya namin ngayong taong ito ay aabot ng almost P378 to P400 billion ang ating ibibigay na mga benefit payment at benefit coverage,” he added.

(Overall, we estimate that our benefit payments and coverage this year will reach around P378 billion to P400 billion.)

The state health insurer earlier confirmed that it had received the P60 billion from the National Treasury following a directive from President Ferdinand Marcos Jr.

PhilHealth then assured the public that the funds would be used to improve member benefits and services.

“Sisiguruhin ng Korporasyon na ang bawat pisong ito ay ilalaan sa pagpapahusay ng mga benepisyo, pagpapalakas ng mga sistema upang mapabilis ang mga proseso, at paghatid sa bawat Pilipino ng serbisyong mabilis, patas, at tunay na mapagkakatiwalaan,” PhilHealth said in a statement issued on May 6.

(The Corporation ensures that every peso will be dedicated to enhancing benefits, strengthening systems to speed up processes, and delivering services to every Filipino that are fast, fair, and truly dependable.)

Marcos earlier announced the expansion of PhilHealth’s maternity benefits starting April 30 this year.

The President said the enhanced package includes higher coverage for normal and cesarean deliveries, as well as additional prenatal checkups and improved postnatal care. — MCG, GMA News