New PhilHealth premium hike in 2023

STATE health insurer Philippine Health Insurance Corporation (PhilHealth) will again increase the workers’ monthly contributions from 4 percent of workers’ income this year to 4.5 percent effective January 1, 2023.

The Universal Health Law (UHL), signed into law by former President Rodrigo Duterte allows the incremental increase of member contributions until 2025.

Monthly contributions would range from P450 to P4,050 depending on the income of the PhilHealth member. Workers will equally share the cost of premium payment with their employers. On one hand, businessmen and freelancers will have to shoulder the full premium contributions.

Based on the implementing rules and regulations of the UHL, here is the scheduled premium rate increase per year:

YEAR	PREMIUM RATE	INCOME FLOOR	INCOME CEILING
2019	2.75%	Php 10, 000.00	Php 50, 000.00
2020	3.00%	Php 10, 000.00	Php 60, 000.00
2021	3.50%	Php 10, 000.00	Php 70, 000.00
2022	4.00%	Php 10, 000.00	Php 80, 000.00
2023	4.50%	Php 10, 000.00	Php 90, 000.00
2024	5.00%	Php 10, 000.00	Php 100, 000.00
2025	5.50%	Php 10,000.00	Php 100, 000.00

Why increase Philhealth premium?

PhilHealth’s Senior Manager Rey Baleña said members’ contributions ensures “every Filipino be given competent access to medical services and with this, they can be given enough financial protection.”

“Because we know that there is a cost to our treatment, hospitalization, and that’s where PhilHealth comes in. And your benefits come from our combined contributions to the program,” Baleña said in Filipino during Malacañang’s Laging Handa public briefing.

Baleña said that the purpose of the contribution increase is to “sustain the current level of benefits” and to expand these benefits to its contributing members.

KonSulTa Package

Contributions collected from the increased percentage rate will be allocated to PhilHealth’s KonSulTa, Baleña said.

The KonSulTa program is PhilHealth’s expanded primary care benefit package. 

Baleña said the package will ensure that all Filipinos must be assigned to an accredited KonSulTa provider where they will get routine check-ups, health risk screening, laboratories, and medicines that will be financed by the KonSulTa package. 

This is free of charge provided that there is a KonSulTa provider assigned by the state insurer, he said.

By 2023, Baleña said “we will double our target population coverage for KonSulTa. Maybe half of our population will be assigned to the KonSulTa providers and, therefore, this is one of the programs where our contributions will go.”

The updated list of accredited KonSulaTa Package Providers are on this link.

Outpatient Therapeutic Care

One of the programs that Philhealth plans to allocate, according to Baleña, is the Outpatient Therapeutic Care program which agency plans to roll out by 2023.

The outpatient therapeutic care program covers assistance to severe and acute malnutrition, COVID-19, and mental health, he said.

Mental health is included in the outpatient package because the agency knows that  there are people “who will need it because of their mental health issues.”

Since the pandemic is still underway, the COVID-19 benefit package is available and covered by PhilHealth’s funding, which is intended to support the government’s effort to put an end to the pandemic.

At the same time, Baleña noted that the law also stipulates that the country must have comprehensive outpatient benefits. “This is one of the big preparations of PhilHealth, so I hope that we will continue to support our program by paying our contribution regularly.”

Aside from the KonSulTa and Outpatient Therapeutic Care packages, PhilHealth plans to roll out the transition to diagnostic-related groups where the government-owned corporation can better rationalize payment to its patients, depending on their health status or risk profile, he said.

However, PhilHealth did not disclose the proposed funding for the packages but noted that it was able to pay P88 billion to its members in 2021. 

As of October, the state insurer has paid P110 billion to its members who claimed their benefits, an increase of P22 billion from last year.

Photo Credit: PhilHealth