By Perfecto T. Raymundo, Jr.
QUEZON CITY — The Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD) on Wednesday (June 11) held the Talakayang HeaRT Beat on PhilHealth STUDIES at the Ardenhills Suite here.
In his video message, DOST Secretary Renato Solidum, Jr. expressed deepest gratitude to the officials of PhilHealth for their active participation in today’s event.
Solidum cited the Mental Health Benefit Package provided by PhilHealth under the Universal Health Care Law.
The DOST Chief stressed the importance of the Outpatient Benefits Package for Mental Health (PhilHealth Circular 2023-0018) Development of PhilHealth Package for ST-Evaluation Myocardial Infarction, the Benefits Package for Ischemic Heart Disease-Acute Myocardial Infarction (PhilHealth Circular 2024-0032) Technical Assistance on the Development of Rehabilitation Package for Adults (18 years and above) in the Philippines, and the Benefits Package for Physical Medicine, Rehabilitation Services, and Assistive Mobility Devices (PhilHealth Circular 2025-003).
Solidum expressed the hope for the sustainability of the DOST-PCHRD and PhilHealth initiatives under the Universal Health Care Law in the generations to come.
Dr. Jaime C. Montoya, Executive Director of PCHRD, expressed his gratitude for the participants and support extended for the initiatives undertaken by the DOST-PCHRD and PhilHealth.
Dr. Montoya stressed that the initiatives are undertaken with the provision of funds for research dissemination and the use of the data for the formulation of health packages.
He cited the 38 projects were supported, 6 capacity building activities and research.
Dr. Montoya said the PhilHealth STUDIES the Development of Benefit Package for Mental Health, which complies with the Mental Health Act. Among others, recommended were the formulation of monitoring and evaluation.
He added that the Outpatient Benefits Package for Mental Health (PhilHealth Circular 2023-0018) is a tiered system for the general care and specialist.
The members and dependents of PhilHealth will have access to mental health packages.
Dr. Montoya stressed the Development of PhilHealth Package for ST-Evaluation Myocardial Infarction, particularly the benefit package for patients with ST-Elevation Myocardial Infarction or STEMI, which covers services for the first medical contact phase, acute care phase, inpatient management, and rehabilitation phase for the comprehensive package of PhilHealth members.
He also cited the Development of Rehabilitation Packages for Adults (18 years and above) in the Philippines, specifically the benefit package for patients in need of medical rehabilitation due to various diseases, which covers patient assessment, rehabilitation services sessions, laboratory and diagnostic tests, drugs and medicines depending on the condition of the patient, and provision of assistive mobility devices for rehabilitation programs.
The rehabilitation packages were launched through PhilHealth Circular 2024-0032.
Dr. Montoya also noted that the Benefits Package for Physical Medicine, Rehabilitation Services, and Assistive Mobility Devices was launched through PhilHealth Circular 2025-003, particularly the benefit package.
In the open forum on PhilHealth-Benefits Development and Research Department (BDRD), Dr. Mel C. Santillan, Senior Manager, said that the Z Benefits Package of PhilHealth are for catastrophic cases, which is different from regular health benefits or diagnosis.
Dr. Montoya said “if it is in the area of financing, the DOST-PCHRD is collaborating with PhilHealth.”
He added that there should be a recommendation from the Health Technology Assessment Council (HTAC) to be submitted to the DOST Secretary on whether or not the health package can be financed by PhilHealth.
Dr. Montoya said that he cannot comment on “new research areas” as it is the PhilHealth that decides on the matter.
Dr. Santillan noted that the health providers in the Z Benefits are contracted by PhilHealth and are strictly monitored within 30 days while the regular benefits are within 60 days.
When it comes to funds, Dr. Santillan said, PhilHealth has sufficient funds for service and that their priority for now is to develop new health benefit packages, inclusive of the actuarial provision.
Dr. Santillan said that in terms of supply and demand, the health benefits are in the demand side. “The Philippine Heart Center (PHC) is tasked to capacitate the regional health centers. Coronary bypass can now be provided by the DOH-accredited regional health centers,” she said.
“We have political dimension in terms of policy development, which is based on evidence and not on eminence,” she added.
As of March 2025, Dr. Santillan said that PhilHealth has paid PGH (Philippine General Hospital) PHP22.8 Billion for 27 claims for the period of from December 2024 to Marh 2025.
She added that there are ongoing policy developments for the inclusion into the Z Benefits such that for every region, there should be a contracted hospital for the Z Benefit Package.
“The target of the National Health Insurance Program of the current administration is to lower the ‘out of packet’ expenses for the PhilHealth members, which will redound to their economic benefit,” Dr. Santillan said.
She added that under the National Health Insurance Program as provided for by the Universal Health Care Law, all Filipinos are qualified to avail of the health benefit packages from PhilHealth, regardless of social status.
Dr. Santillan said that there’s no such thing as “zero billing”, however, there is the “balance billing” wherein what PhilHealth has already covered cannot be billed by the hospital to the concerned patient.
Merla Rose D. Reyes, Head of Product Team for Special Benefits, said that the Z Benefit Package is focused on the patient where there is a coordinator for a cancer patient’s therapy session, which is not the same with that of the regular health benefits.
Reyes said PhilHealth and the DOST-PCHRD are now studying the Z Benefits for Mobility, as well as Prostisis, Scoliosis, Orthosis where below knee were implemented in 2013.
Glenn I. David, Senior Social Insurance Specialist of the Product Team for Special Benefits, said that the inclusion services were also studied for the program to be included in the outpatient program.
David said that the PhilHealth benefits and other mandatory deductions will be factored in before the hospitalization or health cards come in. ###
