PhilHealth continues to strengthen its role in providing affordable healthcare under the Universal Health Care (UHC) Law, with expanded benefits that now include preventive dental care and enhanced primary services through the Yaman ng Kalusugan Program (YAKAP). For members, knowing what’s available and where to access it is key to maximizing coverage.
Primary Care Benefits under YAKAP
The YAKAP program is PhilHealth’s enhanced primary care package, designed to keep Filipinos healthy and prevent costly hospitalizations. It includes:
- Consultations with accredited primary care doctors.
- Laboratory tests such as blood sugar, cholesterol, urinalysis, and cancer screenings.
- Essential medicines: 21 core drugs remain available nationwide, with expanded lists in some facilities.
- Dental Package: Up to ₱1,000 annually for preventive dental services like check-ups and cleaning.
- Health counseling and monitoring to detect illnesses early and avoid complications.
Hospital and Inpatient Benefits
- Case Rate Coverage: Fixed amounts are deducted from bills for conditions like pneumonia, dengue, and hypertension.
- Day Surgeries: Elective procedures performed safely within the same day.
- Room and Board: Coverage for hospital stays, including professional fees.
- Maternity Care: Benefits for normal deliveries, complicated deliveries, and cesarean sections.
- Specialized Packages: Dialysis, cancer treatment, TB-DOTS, HIV programs, and mental health consultations.
Accredited Facilities and Clinics
PhilHealth-accredited facilities nationwide include:
- Hospitals and Infirmaries
- Ambulatory Surgical Clinics
- Freestanding Dialysis Clinics
- Maternity Care Package Providers
- TB-DOTS Centers
- HIV Treatment Hubs
- Cancer Treatment Facilities
- Oral Health Benefit Package Providers (for dental services)
Members can verify accreditation through the PhilHealth website or by asking the clinic directly.
How to Avail
- Bring your documents: PhilHealth ID, Member Data Record (MDR), or PhilHealth Benefit Eligibility Form (PBEF).
- Visit accredited facilities, such as hospitals, YAKAP clinics, or primary care providers.
- Submit claim forms: Accomplish PhilHealth Claim Form 1 at the billing section.
- Automatic deduction: Benefits are deducted directly from your bill.
0 Comments