Expect Dental Packages and More Benefits From PhilHealth in 2024

(SPOT.ph) Big changes are coming to PhilHealth. As of October 2, 2024, the state health insurer announced a series of updates in the Senate Committee on Health and Demography that aim to make healthcare more accessible and affordable for Filipinos.

First up, PhilHealth is officially scrapping the Single Period of Confinement (SPC) policy—a rule that’s been causing extra challenges for members since it took effect in 2013. The SPC policy meant that if you got admitted for the same illness within 90 days, you won't be able to claim benefits again in a bid to prevent fraud from taking place. 

However, it left a lot of patients, especially those with recurring conditions like pneumonia or kidney disease, footing the bill for repeat hospital stays. Case in point: the SPC policy resulted in the denial of 26,750 claims in 2023 as per the Department of Health (DOH).

After mounting pressure from lawmakers, PhilHealth finally lifted this rule. This change will allow members to claim benefits multiple times, regardless of how often they need treatment for the same illness. PhilHealth Executive Vice President Eli Santos said in the Senate Committee that this took effect on October 1, but the policy will be published on October 7.

Also read: Everything You Need to Know About PhilHealth

More benefits, lower premiums at PhilHealth

There's still plenty in store for PhilHealth for the remainder of 2024 as outlined by Santos in the Senate Committee on Health and Demography.

By November, PhilHealth will roll out a policy that will increase the reimbursement rates for medical procedures and treatments by up to 50%. With this change, members will see a higher portion of their medical bills covered by PhilHealth, reducing the amount they need to pay out-of-pocket for certain treatments.

By December, PhilHealth will introduce a dental package for the first time ever. This will include dental cleaning and checkups. Dental services have long been excluded from PhilHealth’s coverage, but this move finally addresses that gap.

It was also revealed in a recent news release by Senate President Francis “Chiz” Escudero that premium contributions are also set to be lowered soon. PhilHealth has yet to release more information about this, but we’ll keep you updated.

Also read: How Powerful Is PhilHealth Mafia? It Ousted Presidents, Enjoyed Lap Dances