The Philippine Health Insurance Corporation (PhilHealth) is studying possible ways to expand and enhance benefits for middle-income workers who directly pay into the national health insurance fund, health officials said.
Health Secretary Teodoro Herbosa said current PhilHealth programs have long focused on sponsored members whose premiums are paid by the government, but President Ferdinand “Bongbong” Marcos Jr. has now directed the agency to prioritize direct contributors as well.
“For many years, ang tinututukan natin yung ating indirect o sponsored programs [na] wala silang binabayaran pero may benepisyo sila ng PhilHealth [dahil] estado nagbabayad ng premium nila,” Herbosa said.
“Sa ating bagong programa, sabi niya pagandahin natin ang serbisyo para sa ating mga middle class,” he added.
According to Herbosa, Executive Secretary Ralph Recto has proposed improvements such as better hospital accommodations and expanded coverage under the Zero-Balance Billing scheme for middle-income members.
“Baka pwedeng two in a room lang or may aircon, para yung mga direct member naman mas maganda yung benefit,” he said.
Recto also suggested increasing PhilHealth benefit packages in hospitals that implement zero-balance billing.
“Mayroon pa siyang isang [suggestion] na gustong-gusto ko at ipapasok ko sa benefits committee, na pag yung hospital ay nagiimplement ng zero-balance, gusto niyang madagdagan ang package ng PhilHealth,” Herbosa said.
The Health Secretary said the proposals would undergo actuarial review to determine their financial viability.
“Ipapaaral ko sa aming mga actuarials yung kaya ng PhilHealth,” he added.
PhilHealth Senior Vice President and Health Finance Policy Sector head Dr. Israel Pargas confirmed that the agency has received instructions from both the President and Recto to roll out additional benefits for middle-income contributors, stressing PhilHealth’s mandate to “provide additional programs to direct contributors where applicable.”