THE Philippine Health Insurance Corporation (PhilHealth) is broadening access to essential healthcare by integrating first-line anti-tuberculosis medications into its Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program.
Beginning November 1, 2026, eligible members and dependents diagnosed with drug-susceptible tuberculosis can secure prescribed anti-TB drugs from PhilHealth-accredited GAMOT facilities using prescriptions issued by YAKAP physicians.
Under PhilHealth Circular No. 2026-0018, this expansion reinforces the Yaman ng Kalusugan Program (YAKAP) and aligns with the Unified National Agenda for Health.
By streamlining the link between primary care consultations and medication access, the initiative bridges crucial treatment gaps and promotes long-term care continuity.
Crucially, anti-TB medicines obtained through this program will not count against the member’s ₱20,000 annual GAMOT benefit limit, safeguarding that allowance for other outpatient drugs.
Patients can receive up to a one-month supply per transaction, though accredited facilities must dispense the full quantity within two days of the prescription’s issuance.
Physicians must generate these prescriptions via the GAMOT Application, strictly following Department of Health National TB Control Program protocols.
Participating GAMOT facilities will receive direct reimbursements from PhilHealth based on a fixed fee schedule, provided they submit an updated Certification of Availability to their regional office beforehand.
This new rollout serves as a complementary mechanism rather than a replacement for the existing Outpatient TB-DOTS Package.
While TB-DOTS facilities remain the primary providers of comprehensive TB care, using a GAMOT facility instead will result in a 50% deduction on the TB-DOTS package claim per treatment phase.
PhilHealth encourages members to consult their YAKAP physicians or TB-DOTS providers to understand the best treatment pathways.
Through these targeted measures, PhilHealth continues to alleviate financial barriers and transform insurance coverage into tangible, life-saving care for Filipinos.
For inquiries regarding YAKAP clinic locations or registration, members may contact the PhilHealth Corporate Action Center at (02) 8662-2588 or visit their official website.
