The Philippine Health Insurance Corporation (PhilHealth) has announced that it will now cover all outpatient emergency cases in accredited hospitals across the country. The new coverage takes effect on February 14, 2025, and applies to levels 1 to 3 hospitals.
According to a GMA News Online report, this expansion is part of PhilHealth’s facility-based emergency (FBE) benefit, which falls under its outpatient emergency care benefit package. The state health insurer clarified that hospitals do not need separate accreditation to provide FBE benefits, as it is already included in their existing accreditation. However, hospitals with extension facilities must submit certification with the facility’s name and complete address to their respective PhilHealth Regional Offices.
PhilHealth also hinted at an upcoming announcement regarding coverage for ambulance services under the pre-hospital emergency benefit.
The outpatient emergency care benefit, introduced last month as part of PhilHealth’s expanded packages, ensures broader access to emergency medical services. It consists of two main components: facility-based emergency benefits, which cover treatment in accredited hospital emergency departments, and pre-hospital emergency benefits, which include transport services for non-admitted cases.
