DOH: Middle-class Pinoys to get better PhilHealth packages

MANILA, Philippines — Middle-income Filipinos who directly contribute to the Philippine Health Insurance Corp. may soon receive expanded health care benefits, as PhilHealth explores upgraded programs under the guidance of the Department of Health (DOH).

During a live radio broadcast, Health Secretary Teodoro Herbosa explained that the new initiatives aim to provide better services for members who pay their PhilHealth premiums directly from salaries or business earnings, complementing existing programs for sponsored members.

“For many years, our focus has been on the so-called indirect or sponsored programs, where beneficiaries do not pay premiums themselves, but still receive PhilHealth benefits funded by the government,” Herbosa said. “With this new program, he said we should enhance services for the middle class.”

Herbosa added that President Marcos has emphasized the need to support direct contributors, and the agency is considering specific enhancements, including upgraded hospital accommodations.

“So, in our discussions with Executive Secretary Ralph Recto, we talked about possibly giving direct members better accommodations. Right now, all members get basic accommodations, but maybe we can have two patients per room or add air conditioning, so that direct members can enjoy improved benefits,” he said.

Another recommendation, Herbosa noted, involves expanding PhilHealth packages for hospitals implementing the zero-balance billing (ZBB) program.

“This is logical as it encourages LGU (local government unit) hospitals to adopt ZBB. I will have our actuarial team study whether PhilHealth can sustain this. We are already paying a large amount to hospitals, reaching up to P300 billion, and it may increase this year due to the number of PhilHealth packages being released,” he added.

Marcos announced last year that ZBB would be implemented in all 87 DOH-run hospitals.

PhilHealth spokesperson Dr. Israel Francis Pargas confirmed that the directives from  President Marcos and Executive Secretary Recto aim to ensure that middle-income contributors receive adequate and meaningful benefits under the Universal Health Care (UHC) Act.

Section 9 of the UHC Act stipulates that “PhilHealth shall issue the necessary guidelines on the additional Program benefits for direct contributors, where applicable.”

“It is written in our law. Actually, this directive comes from President (Marcos) and the Executive Secretary, especially to ensure that our middle-income earners are given benefits and receive the full and adequate benefits of PhilHealth,” Pargas said.

He added that benefits are available to all members, regardless of whether they have paid, missed, or are continuously paying their contributions, ensuring coverage even for those who have not made premium payments.