The Philippine Health Insurance Corp. (PhilHealth) announced plans to expand its Guaranteed and Accessible Medications for Outpatient Treatment (Gamot) program nationwide before the end of 2026. The announcement was made by PhilHealth spokesman Dr. Israel Pargas on Thursday.
Expanding Access to Outpatient Care
The Gamot program aims to provide members with up to P20,000 worth of free outpatient medicines each year. This benefit covers 75 essential drugs used in the treatment of chronic conditions like hypertension, diabetes, and asthma, with the goal of reducing out-of-pocket expenses for long-term medication.
To access the Gamot program, members or their dependents must first consult with a physician at an accredited Yaman ng Kalusugan Program (Yakap) clinic. The Yakap physician will then issue a prescription, which can be presented along with required identification at an accredited Gamot provider to receive the medication. Regular follow-up visits with the Yakap physician are required to monitor a patient’s condition.
The expansion follows a launch event in Cebu on February 17, undertaken in partnership with the Cebu provincial government. The event featured a walkthrough of three Gamot-ready providers: Isidro Kintanar Memorial Hospital, Clinica Prime (with its partner pharmacy La Nueva), and the University of Cebu Medical Center.
Additional Health Benefits
Beyond the Gamot program, PhilHealth has also introduced free cancer screening tests under the Yakap program. These screenings include mammography and breast ultrasound for breast cancer, alpha-fetoprotein tests for liver cancer, low-dose chest CT scans for lung cancer, and colonoscopies for colorectal cancer.
PhilHealth indicated it is currently evaluating additional benefits that could be added to the Yakap program.
Frequently Asked Questions
What does the Gamot program cover?
The Gamot program covers 75 essential drugs used to treat chronic conditions such as hypertension, diabetes, and asthma.
How much medicine can a member receive annually through Gamot?
Members are eligible to receive up to P20,000 worth of free outpatient medicines annually through the Gamot program.
Where can members find an accredited Yakap clinic?
Members must choose an accredited Yaman ng Kalusugan Program (Yakap) clinic for initial consultation to access the benefits of the Gamot program.
As PhilHealth continues to evaluate and expand its offerings, how might these changes impact the overall accessibility and affordability of healthcare for Filipinos?