PhilHealth Calls on Pharmacies for New Benefits
The Philippine Health Insurance Corporation (PhilHealth) is actively urging all FDA-licensed retail pharmacies to become accredited providers of its new benefit package, the Guaranteed and Accessible Medications for Outpatient Treatment, or Gamot. This move aims to expand access to essential medications for outpatients nationwide, officials reported.
Pharmacies interested in joining the Gamot program can submit their accreditation documents to the PhilHealth regional offices assigned to their areas. The accreditation process involves submitting specific documentary requirements, which are downloadable from the PhilHealth website, community members said.
Required Documents for Gamot Providers
The necessary documents include a checklist of requirements for Gamot facilities (Annex A), a provider data record for health facilities or pharmacies, a notarized performance commitment for health facilities, and a certificate verifying the availability of Gamot medicines (Annex B).
Additionally, pharmacies must provide updated copies of their FDA licenses to operate as retailers, certifications confirming compliance with IT requirements, and the most recent general information sheets. These documents ensure that pharmacies meet the standards needed to deliver the new benefit package effectively.
Hospitals Encouraged to Join Cancer Screening Benefit
In a related advisory, PhilHealth also called on hospitals to submit letters of undertaking to their nearest PhilHealth regional offices to become providers of selected outpatient cancer screening tests. Local leaders noted that this initiative supports the new Yaman ng Kalusugan Program (Yakap), which covers vital cancer screenings.
Hospitals can use the template provided under Annex B of Circular No. 2025-0014 for their letters of undertaking. Importantly, PhilHealth clarified that separate accreditation is unnecessary for hospitals to offer these cancer screening tests, as they are covered under existing Department of Health licenses. Furthermore, no pre-accreditation survey is required for facilities already accredited by PhilHealth.
Expanded Coverage for Cancer Screening and Medicines
Starting August 14, PhilHealth began covering selected outpatient cancer screening tests, including mammograms, breast ultrasounds, low-dose chest CT scans, alpha fetoprotein tests, and liver ultrasounds. This expanded coverage aims to enhance early detection and treatment of cancer among Filipinos, sources said.
Moreover, as of August 21, PhilHealth covers 75 types of medicines per member annually, with a yearly limit of PHP 20,000. These medicines address a wide range of conditions such as infections, asthma, chronic obstructive pulmonary disease, diabetes, high cholesterol, hypertension, heart ailments, nervous system disorders, and other supportive therapies.
Current Providers and Program Reach
As of mid-August, there are 16 accredited hospitals nationwide offering the selected cancer screening tests. Meanwhile, approximately 4,300 Gamot partner clinics complement the network of Gamot partner pharmacies, particularly in Metro Manila, PhilHealth President and CEO Edwin Mercado reported.
This expansion reflects PhilHealth’s commitment to improving healthcare accessibility and affordability for all Filipinos, community members affirmed.
For more news and updates on healthcare benefits, visit Filipinokami.com.
