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PhilHealth to expand outpatient care program by end of year

by Rachel Morgan News Editor February 19, 2026
written by Rachel Morgan News Editor

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.

Did You Know? The Gamot program was initially launched in Manila in 2025.

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.

Expert Insight: Expanding access to both essential medications and preventative cancer screenings represents a significant step toward proactive healthcare management for PhilHealth members. The requirement for ongoing consultation with a Yakap physician underscores the importance of continuous care in managing chronic conditions and monitoring screening results.

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?

February 19, 2026 0 comments
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News

US-trained doctor is new PhilHealth chief

by Chief Editor February 4, 2025
written by Chief Editor

Presidential Appointment Signals a New Era for PhilHealth

The recent appointment of Dr. Edwin Mercado as the new president and chief executive officer of the Philippine Health Insurance Corp. (PhilHealth) suggests significant shifts and future trends in the health insurance landscape in the Philippines. Mercado’s leadership may bring transformative changes to how healthcare is delivered and managed in the country. With his extensive background in health care administration and his innovative approach, what reforms and improvements might we expect from PhilHealth?

The Impact of Leadership on Healthcare Reform

Strong leadership often serves as a catalyst for significant change in large organizations. Dr. Mercado’s proven track record in expanding health care facilities and his leadership style indicate potential for a positive impact on PhilHealth. His work at Mercado General Hospital and QualiMed Health Network, which transformed into a national chain, showcases his capability to scale operations efficiently—an essential skill for revitalizing PhilHealth.

Read more about Dr. Mercado’s healthcare journey and leadership repertoire.

Leveraging Technology for Healthcare Efficiency

One of Dr. Mercado’s notable contributions is his focus on leveraging technology to enhance health systems, particularly in financial management and primary care programs. With his involvement in ongoing studies on artificial intelligence as a tool for community health workers, PhilHealth could see technological advancements that streamline processes and improve service delivery.

Did you know? Artificial intelligence is increasingly being used to predict patient care needs and reduce administrative burdens, leading to more efficient healthcare services globally.

Advocacy and Partnership in Health Economics

Dr. Mercado’s history of advocacy and collaboration with numerous health organizations, including the Zuellig Family Foundation, indicates a potential increase in partnerships and consultation for PhilHealth. These efforts will be pivotal in aligning health economics with the Universal Health Care Act, ensuring comprehensive and sustainable healthcare coverage for Filipinos.

Innovative Solutions for Global Health Challenges

Studying the cost structures of global coverage and implementing robust economies of scale are vital trends that Dr. Mercado could bring to PhilHealth. Such innovations can help in designing a cost-effective healthcare model that doesn’t compromise on service quality. By examining and adopting best practices from other nations, PhilHealth could set a benchmark for health system efficiency.

Explore global innovations in healthcare systems for more insights.

Pro Tip: How PhilHealth Can Improve Healthcare Delivery

  • Data-Driven Decisions: Utilizing data analytics for better decision-making can help identify areas of improvement in PhilHealth operations.
  • Public Engagement: Translating policies into practice through public consultation and feedback ensures that healthcare reforms meet the needs of communities.
  • Continuous Education: Upgrade the skills of healthcare workers via continuous training programs to keep pace with technological and procedural advancements.

Frequently Asked Questions

  1. What immediate changes can be expected under Dr. Mercado’s leadership?

    Mercado is likely to initiate reforms focusing on transparency, accountability, and leveraging technology to optimize healthcare delivery.

  2. How can individuals support healthcare reforms?

    By staying informed and participating in public consultations, individuals can play a significant role in shaping healthcare policies.

  3. Will there be increased emphasis on digital health tools?

    Yes, with AI and machine learning set to play a crucial role in enhancing operational efficiencies and patient care.

Calling on the Future: A Journey Toward Better Healthcare

As we look toward the future, Dr. Mercado’s leadership holds promise for a revitalized Philippine Health Insurance Corporation. This transformation can lead to improved health outcomes and a more resilient healthcare system for all Filipinos. Explore further developments by following our updates on PhilHealth.

Call to Action: Join the conversation and share your thoughts on the future of healthcare in the Philippines. Comment below, explore more articles, or subscribe to our newsletter for the latest updates.

February 4, 2025 0 comments
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