THE Philippine Health Insurance Corporation (PhilHealth) has partnered with major health maintenance organizations (HMOs) and private health insurers (PHIs) to establish the PhilHealth YAKAP–HMO/PHI Benefit Complementation initiative, aiming to make primary healthcare more accessible and affordable for Filipinos under the Universal Health Care law.
A Memorandum of Understanding (MOU) was recently sealed by PhilHealth alongside 14 leading private health institutions, including Maxicare, MediCard, Intellicare, Pacific Cross, and Insular Health Care.
Under this framework, PhilHealth acts as the foundational layer of protection through its Yaman ng Kalusugan Program (YAKAP), while private insurers provide complementary coverage for additional healthcare needs.
PhilHealth Acting President and CEO Dr. Beverly Lorraine C. Ho explained that utilizing PhilHealth YAKAP as the initial source of protection allows private partners to focus their benefits beyond the standard package, ensuring citizens get maximized care for every peso.
Finance Secretary and PhilHealth Board Member Frederick D. Go added that the collaboration establishes a robust system that builds a healthier and more productive nation.
As secondary payers, HMOs and PHIs will cover expenses that exceed PhilHealth limits or fall outside primary care, such as specialized procedures, branded medications, and hospital room upgrades.
Meanwhile, YAKAP encompasses essential provisions including consultations, 13 laboratory tests, selected outpatient medicines under the GAMOT package, and outpatient screening for six types of cancer.
It also features specialized outpatient benefits for animal bite treatments, maternal care, TB-DOTS, HIV/AIDS management, and mental health services.
By directly integrating PhilHealth YAKAP with private policies, the initiative prevents duplicate payments and effectively reduces out-of-pocket medical costs for shared beneficiaries.
PhilHealth encourages all members and policyholders to register for YAKAP via the eGovPH app, the official Member Portal, or local offices.
Furthermore, the agency has invited other health insurers to join the network to further expand financial protection for families nationwide.