PHILIPPINE HEALTH Insurance Corp. (PhilHealth) is aiming to collect P204 billion from members this year as it plans to continue expanding benefits despite having zero government subsidy.
“For this year, we are targeting to have a collection of around P204 billion, especially from the direct contributors. Our proposed benefit expense for the year is around P270 billion,” PhilHealth Spokesperson and Senior Vice-President for Health Finance Policy Sector Israel Francis A. Pargas told BusinessWorld earlier this month.
PhilHealth’s net income declined by 41.66% to P46.43 billion in the first nine months of 2024, its financial statement showed.
At end-September 2024, premium contributions inched up by 2.02% year on year to P167.39 billion, while benefit expenses rose by 43.26% to P134.7 billion.
Operating expenses went up by 41.15% year on year to P140.66 billion.
PhilHealth also wants to maintain its investment income, Mr. Pargas said, which as of September last year was at around P19.69 billion, up by 29.95% from the same period in 2023.
The state health insurer’s approved corporate operating budget for 2025 is around P280 billion.
Mr. Pargas said PhilHealth aims to continue expanding members’ benefits this year despite having zero subsidy from the government.
“We are doing our best to improve on our services, on our benefits, and we are, of course, hoping that by next year’s round of budget preparation, especially for 2026, we will be given a subsidy already by the Congress,” he said.
PhilHealth recently released a new policy to cover post-kidney transplant medicines, including anti-rejection medicines, immunosuppressants, antibiotics, and diagnostics, to complement its kidney transplant package.
It will review its coverage of catastrophic cases, such as expanding its Z benefit packages for cancers like lung, liver, prostate, ovarian, and cervical, Mr. Pargas said.
PhilHealth will also continue the rationalization of case rates, the official added.
“We are doing it in two directions. One is improving our current benefits. The second one is we are also introducing and coming out with benefits that would actually support the Universal Health Care (UHC) Act. So, until such a time that we are completely implementing the reforms and the benefits espoused in the Universal Health Care Law, then that is the time that we will slow down. But we will not stop because we will continue reviewing and expanding our benefits,” Mr. Pargas said.
He added that PhilHealth’s current actuarial life is until 2028.
“We don’t need to have a long actuarial life because we’re not the same as any pension insurances, but rather our system is like pay as you go… We of course want to increase it, but it will have an impact on our benefit expansion and all our benefit plans,” Mr. Pargas said.
Under the UHC Act, PhilHealth is required to maintain a reserve fund equivalent to two years of its projected expenditures.
President Ferdinand R. Marcos, Jr. this month appointed Edwin M. Mercado as PhilHealth’s new president and chief executive officer. — Aaron Michael C. Sy
