The Philippine Health Insurance Corporation (PhilHealth) expressed hope last week that incoming administrations at the local government units in the province would help convince rural health units and other health facilities in being accredited as a KonSulTa provider.
In a media forum held last June 24, 2025 at its Virac office, Eusebio Vidal of PhilHealth Local Health Insurance Office disclosed that only five RHUs, one Municipal Health Office, and four hospitals are currently accredited to provide the program’s services.
Among them are Virac Municipal Health Office, Catanduanes Doctors Hospital, Inc, (CDHI), Bato Maternity and Children’s Hospital, Bato RHU, Baras RHU, San Miguel RHU, Bagamanoc RHU, Juan M. Alberto Memorial District Hospital, Caramoran Municipal Hospital, and Caramoran RHU.
He said since the 2022 rollout of Konsulta, PhilHealth has been conducting yearly visits to the local health facilities but it has proven difficult to convince some of them to accredit with the program.
“Maraming nawawalang financial benefits sa community,” Vidal stressed, pointing out that PhilHealth pays for the preventive and promotive services for those who are sick or healthy.
PhilHealth Konsultasyong Sulit Tama (Konsulta) is a comprehensive outpatient benefits as mandated by the Universal Health Care Law which aims to protect the health of every Filipinos against chronic illnesses, avoid complications through early detection, and provide affordable drugs and medicines.
Under the KonSulta program, members will be given access to free medical consultations, free health risk screening and assessment, free selected laboratory and diagnostic testing, and free selected drugs and medicines in line with their pre-existing condition.
Anyone can register in the program using either the PhilHealth Member Portal, going to the local PhilHealth office, or seeking assistance from providers, LGUs and health facilities.
The first patient encounter is made by primary health workers who will get the medical profile of the registered member.
On the other hand, PhilHealth said that in addition to the 30% increase in case rate packages in 2024, all admissions beginning Jan. 1, 2025 were provided with an extra 50% in case rate packages.
Among the new packages are optometric services for those 15 years and below, especially those whose eyes have been overexposed to gadgets.
The accreditation papers of four local optometrists and their clinics are now being processed, it bared.
PhilHealth is also accrediting dentists in the government and private sector so they could provide Preventive Oral Health Services in Primary Care.
However, it could not yet provide services to address severe acute malnutrition among children 5 years old and below as no RHU has been accredited due to lack of training of their personnel.
For the delivery of the mental health benefit package, only the Virac municipal health office is accredited by PhilHealth, with the applications of Bato RHU and JMA Memorial District Hospital awaiting the signature of concerned officials at the regional office.
The three health facilities, however, would be able to provide only the general mental health service package consisting of screening, assessment, diagnostics, 12 follow-up visits, psychoeducation, psychosocial support, and 25 medicines in the mhMAP.
Also applying for Level I accreditation for the package are Viga district hospital, Pandan district hospital, Immaculate Heart of Mary Hospital, CDHI and Eastern Bicol Medical Center, with the latter to be accredited for specialized care.
As of now, there is no hospital in Catanduanes specializing in mental health, as they would need to hire a psychologist or neurologist to be able to provide psychotherapy included in the package.
PhilHealth said that since last year, more than a hundred patients have availed of the general mental health service package.
With the package in demand due to stress and anxieties being experienced specially by Gen Z, it clarified that if the patient is below 21, he or she will be registered as dependent of any parent enrolled as member.
On the other hand, those suffering from HIV/AIDS can not avail of the Outpatient Treatment Package worth P39,000 for one year of drugs and diagnostics at the EBMC which has been accredited as an HIV Treatment Facility.
Vidal cited the 50% increase in case rates as the highlight of PhilHealth’s accomplishment so far this year.
Among the new outpatient benefits are Cataract Surgery, P16,000; Glaucoma, P12,675; Congenital Opthalmologic Disorders, P8,385; Chemotherapy, P14,196 per cycle; outpatient blood transfusion, P4,732; 156 dialysis sessions at P6,350 each; Caesaran Section Delivery, P37,050; Maternity Care Package, P12,675; Normal Spontaneous Delivery, P9,750; Newborn Care Package, P5,752.50; TB DOTS treatment, P5,200; OPB Malaria, P1,170; and Animal Bite Treatment, P5,850.
Also increased were Catastrophic Benefits including Breast Cancer, P1.4 million; Colon Cancer, P150,000 for Stage I-II and P300,000 for Stage II to III; Coronary Artery Bypass Graft, P550,000; Acute Lymphocytic/Lymphoblastic Leukemia, P500,000; End-stage Kidney Disease requiring transplantation, P600,000; Peritoneal Dialysis, P270,000;
He likewise described as very beneficial to members the removal of the 90-day waiting period for availment of treatment package for the same disease.
Members were advised to use the PhilHealth ACR Search app, available on the web, to learn more about the case rate packages.