NEW BENEFIT IN FOCUS: PHILHEALTH OUTPATIENT MENTAL HEALTH PACKAGE TO SUPPORT “INVISIBLE” PAINS OF FILIPINOS
PhilHealth is committed to holistically addressing the healthcare needs of every Filipino.
“Nais naming ipaabot na kahit hindi nakikita ang inyong daing, may PhilHealth na magbibigay ng suporta at alaga sa inyo. Ito po ay alinsunod sa mga prayoridad ng ating Pangulong Marcos,” said Dr. Edwin M. Mercado, PhilHealth Acting President and CEO.
Through the PhilHealth’s Outpatient Benefits Package for Mental Health [PhilHealth Circular 2023-0018], members and dependents aged 10 and above, can now access services encompassing initial assessments, follow-up consultations, diagnostic tests, and psychosocial support. It covers conditions such as depression, psychosis, epilepsy, child and adolescent mental and behavioral disorders, dementia, and self-harm or suicide risks, among others.
As such, those requiring specialized care are provided with access to interventions from psychiatrists, neurologists, and psychologists. PhilHealth provides annual coverage of Php 9,000 for general mental health services and Php 16,000 for specialized care.
Members can access these benefits at any accredited facility that provides general mental health services. These facilities include rural health units (RHUs), city or municipal health offices, level 1 and 2 hospitals, Department of Health (DOH) Medicine Access Program-mental health access sites, and stand alone mental health clinics.
On the other hand, specialized mental health services can be accessed at accredited Level 2 and 3 hospitals with specialized staff, custodial care facilities, and national specialty centers identified by DOH.
“We recognize the importance of accessible mental health services for every Filipino. Kaya naman, katuwang din natin ang Kagawaran ng Kalusugan sa patuloy pang pagpapalawig ng ating mga serbisyo para sa kalusugang pangkaisipan. We are calling for more providers to participate and make these services within reach of Filipinos with mental health struggles,” added Dr. Mercado.
Beyond the Mental Health package, PhilHealth encourages individuals experiencing suicidal thoughts or mental health distress to utilize readily available 24/7 crisis hotlines, including the National Center for Mental Health hotline at 0917-899 8727 or 989-8727, for immediate counseling.
PhilHealth remains committed to strengthening the nation’s mental health service infrastructure and ensuring that quality care is accessible to all Filipinos needing them. For more questions on the MH benefit package and other benefits, members can call the following 24/7 touch points: (02) 866-225-88; mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987 or 0917-1109812.###
Statement on the Appointment of Dr. Edwin Mercado as New President and CEO of PhilHealth
The Philippine Health Insurance Corporation (PhilHealth) welcomes the appointment of Dr. Edwin M. Mercado as its new President and Chief Executive Officer (PCEO). The entire PhilHealth family extends its full support to Dr. Mercado as he steers the Agency to new heights.
With Dr. Mercado’s solid experience in the medical field and proven leadership and management expertise, we are confident that through his leadership, PhilHealth will continue to successfully carry out the mandate of the National Health Insurance Program and fulfill the aspirations of Universal Health Care for the benefit of all 115 million Filipinos.
PhilHealth would also like to extend its deep gratitude to outgoing PCEO Emmanuel R. Ledesma, Jr. who spearheaded very important reforms in the last two years, especially in the area of claims payments and benefit enhancements. ##
Smooth Leadership Transition at PhilHealth
A simple turnover ceremony was held at the Philippine Health Insurance Corporation (PhilHealth) as outgoing PCEO Emmanuel R. Ledesma. Jr. formally handed over the reins to incoming chief, Dr. Edwin M. Mercado on February 10 in Pasig City. The event symbolized a smooth transition of leadership at the state health insurer.
Dr. Mercado, a US-trained orthopedic surgeon with 35 years of experience in hospital management, was sworn in by President Ferdinand R. Marcos Jr. at Malacañang Palace last February 4, 2025. His extensive background in strategic planning, financial management, and primary care programs positions him well to lead PhilHealth towards achieving its mission of providing financial access to quality healthcare for all Filipinos.
“Tayo po ay tumutugon sa direktiba ng ating mahal na Presidente Ferdinand “Bong- bong” Marcos, Jr., at ito ay siguruhing tuluy-tuloy ang ating serbisyo at palalawigin pa ang mga benepisyo”, Mercado announced in his first address to all PhilHealth employees who convened in a Corporate-wide flag ceremony.
Mercado thanked Ledesma for his leadership and emphasized his dedication to further enhancing the program for the benefit of all Filipinos. Under the two-year leadership of Ledesma, PhilHealth made significant strides especially in benefits enhancement.
Ledesma reaffirmed his continuing support to PhilHealth in the implementation of Universal Health Care. “Leaders may change, but our purpose to provide adequate health insurance coverage and to ensure that every Filipino has access to affordable, accessible, and acceptable health care remains the same”, the former PhilHealth PCEO said.
Meanwhile, Mercado, vowed to further lower out-of-pocket medical costs for patients down to as much as 25% from the current 45-47%. “Itutuloy natin ang pagpapalawak at pagpapabuti ng ating mga benepisyo upang lalo itong madama ng mga Pilipino sa tuwing sila ay magpapagamot sa ospital”, he pledged.
To do this, he underscored the importance of obtaining correct and relevant data that will be used as basis for future benefit enhancements. “Ito ay upang makamit natin ang hangaring mabawasan ang karagdagang gastusin na magmumula sa sariling bulsa ng ating mga miyembro tuwing sila’y nagkakasakit”, said Mercado.
The PhilHealth Chief will also prioritize computerization and digitalization using modern technologies to enhance member experience, strong engagement with stakeholders, and improvement of operational processes, “Gagamitin ko ang aking kakayanan at malawak na karanasan sa larangan ng kalusugan upang tuparin ang mandato ng Korporasyon”, he said.
With the help and support of the 9,000 strong employees, Mercado vowed to announce good news to the public, “We will strive na every 30 days po ay may ibabahagi tayong magandang balita (para sa mga miyembro)”, he ended. ### PR 2025-03
PHILHEALTH BOOSTS COVERAGE FOR CATARACT OPERATION
The Philippine Health Insurance Corporation (PhilHealth) announced the implementation of its enhanced benefits for Extracapsular Cataract Extraction with Insertion of Intraocular Lens (IOL) covering both adult and pediatric surgeries, effective January 30, 2025.
This initiative is aligned with President Ferdinand R. Marcos Jr.’s directive to continually improve and sustain healthcare benefits being provided by the state health insurer, ensuring adequate financial support to patients seeking medical treatment.
Based on PhilHealth Circular 2025-0001 published on January 15, 2025, benefits for adult cataract surgery have significantly increased by more than fourfold, with financial support starting at P20,200. Coverage varies depending on the type of lens used, with procedures involving a monofocal IOL or standard lens at P28,300 per eye. Premium lenses such as monofocal toric IOL that provides clear vision at one specific distance while correcting astigmatism are covered for P43,800 per eye, a multifocal IOL that helps see both near and far objects at P66,900 per eye, and multifocal toric IOL that corrects astigmatism and multiple viewing distances at P80,900 for the right eye.
Meanwhile, pediatric cataract surgery coverage has seen an unprecedented increase of tenfold, with benefits reaching up to P135,000 per eye and P139,050 for both eyes. If an intraocular lens (IOL) is included, coverage is at P179,000 per eye and P187,100 for both eyes.
Previously, PhilHealth pays for cataract extraction at P16,000 per eye with no differentiation between adult and pediatric cases.
To ensure timely and uninterrupted healthcare services, the state health insurer reminds all accredited healthcare facilities to maintain minimum stock levels of intraocular lenses, essential eye medications, life-saving drugs, IV fluids, and necessary supplies to avoid unwarranted out-of-pocket from outside purchases and services.
This notable increase in coverage for cataract extraction is expected to help reduce preventable blindness and improve the quality of life of Filipinos suffering from this type of eye condition.
In 2024, PhilHealth has disbursed a total of P3.58 billion for 224,209 cataract removal procedures.### Press Release | February 18, 2025
PhilHealth marks 30th year of insuring Filipinos’ health
Today, February 14, newly-appointed President and CEO Dr. Edwin M. Mercado will join 9,000 officers and employees from across the country in a solemn eucharistic mass to celebrate the state insurer’s 30th anniversary. Father Jerry Orbos, SVD, will officiate the mass.
To follow through with the directive of President Ferdinand “Bongbong” Marcos, Jr., on ensuring unhampered services, the mass shall be followed by a Board Meeting chaired by Health Secretary Teodoro Herbosa. Critical policy issues, addressing both the needs of providers and members, will be discussed.
“Nais nating tapatan ng buong-pusong paglilingkod ang mainit na pagtanggap ng ating stakeholders, public health and medical communities, at lalung-lalo na ng mga kawani ng PhilHealth na siyang katuwang natin upang mas palawigin pa ang ating serbisyo,” Mercado said.
Thirty years since its inception, PhilHealth remains committed to delivering even more responsive and quality healthcare for all Filipinos.###