THE Philippine Health Insurance Corporation (PhilHealth) yesterday launched an expanded program aimed at making medicines more accessible to Filipinos.
The expanded Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program covers 75 drug types that can be availed of by PhilHealth members for free, from only 21 during its initial phase in 2023 and 54 in its enhancement in 2024.
“PhilHealth GAMOT now includes 75 types of free medicines with an annual benefit limit of P20,000 per beneficiary,” PhilHealth president Edwin Mercado said at the program launch in Quezon City.
“We have expanded it even further. It is the right of every Filipino to have access to necessary medicines without having to bear heavy out-of-pocket expenses,” he added.
PhilHealth said the covered medications are common treatments for a wide range of conditions such as infections (anti-microbial), asthma and COPD, diabetes, high cholesterol (dyslipidemia), high blood pressure and heart conditions (cardiology), and nervous system disorders, along with other supportive therapies.
The plan to expand the medicine list to 75 was announced by President Ferdinand Marcos Jr during his last State of the Nation Address last month.
Health Secretary Teodoro Herbosa said the medicines covered by the expanded program “are for prevention.”
“PhilHealth will spend more for a stroke, a heart attack, a dialysis. That’s more expensive,” he said.
“If we can provide the (preventive) medicine, PhilHealth will be able to save more funds,” he added.
Herbosa said the public will have out-of-pocket expenses if they exceed the annual benefit limit of P20,000.
“That’s called a co-pay. We can’t cover it all,” he said.
For PhilHealth members to avail themselves of GAMOT, they should be registered in their PhilHealth YAKAP Clinic of choice. After a thorough medical assessment in their YAKAP Clinic, their primary care doctor will issue a prescription containing a unique prescription security code (UPSC). The beneficiary can then proceed to any GAMOT facility and show the prescription and present any government-issued ID.
Currently, the accredited GAMOT facilities are Vidacure (with branches in Muntinlupa City and Quezon City), Pharma Gen Ventures Corp or Generika Drugstore (with branches in Parañaque City, Navotas City, Quezon City, and Taguig City), CGD Medical Depot Inc. at Vertis North in Quezon City, and Chinese General Hospital in Manila.
