PhilHealth’s New Optometric Benefits for Filipino Children

The Philippine Health Insurance Corporation (PhilHealth) has announced an innovative Optometry Benefit Package aimed at improving the vision and overall well-being of Filipino children aged 0 to 15 years. This initiative, backed by PhilHealth Circular No. 2025-0002, addresses the growing prevalence of visual impairments in the Philippines and aligns with the Universal Health Care Act's commitment to equitable health access for all Filipinos.

The Vision Behind the Benefit Package

According to the 2018 Philippine Eye Disease Study, 1.98% of Filipinos suffer from visual impairments, primarily due to conditions like cataracts, uncorrected refractive errors, and glaucoma. Unfortunately, common vision issues among children, such as refractive errors, have remained largely unaddressed. Recognizing this gap, PhilHealth crafted a benefit package to ensure early detection and treatment for children's eye conditions, ensuring clear vision during their formative years.

The program also supports the National Vision Screening Act (RA 11358), which mandates vision screening for kindergarten pupils and the creation of comprehensive benefits for children with eye diseases.

Key Features of the PhilHealth Optometry Benefit Package

1. Inclusive Services:

   • Comprehensive vision assessments.

   • Prescription eyeglasses with regular frames and lenses (polycarbonate options included).

   • Follow-up consultations to ensure proper fit and eye care guidance.

2. Affordable Coverage:

   • The package offers financial aid of Php 2,500 per case, covering facility fees and professional services.

   • Beneficiaries can avail of this benefit once annually, with no additional co-payment for services under the package.

3. Eligibility:

   • Available for PhilHealth beneficiaries aged 0 to 15 years diagnosed with errors of refraction or other correctable eye conditions.

4. Accredited Providers:

   • Health facilities like optometric clinics with FDA licenses are eligible to provide these services.

   • Optometrists and ophthalmologists with updated licenses can deliver professional care under this package.

How the Program Works

1. Initial Screening: PhilHealth Konsulta Package Providers will conduct initial vision screenings as part of routine health check-ups. Children who fail these screenings will be referred to accredited optometric clinics for further evaluation.

2. Thorough Vision Assessment: Accredited clinics will perform age-appropriate eye exams to determine the child's prescription needs.

3. Prescription Glasses: Once diagnosed, children will receive eyeglasses made with child-safe materials to correct their vision.

4. Follow-ups: Regular follow-ups will ensure the glasses fit properly and provide necessary advice for long-term eye care.

Promoting Accessibility and Child Development

PhilHealth’s initiative is a game-changer for Filipino families, particularly those in underserved areas. By addressing common vision problems early, the package not only enhances children’s academic performance but also positively impacts their social and emotional well-being.

Accreditation and Monitoring

Health facilities and professionals interested in participating must meet PhilHealth’s accreditation requirements. Providers will also adhere to stringent guidelines to ensure high-quality service and fraud prevention.

Conclusion

The PhilHealth Optometry Benefit Package is a crucial step toward achieving comprehensive health care for all Filipinos. By prioritizing children's vision, the program paves the way for healthier and more productive future generations. Parents and guardians are encouraged to consult accredited PhilHealth providers to access these benefits and secure their children’s visual health.

For more information, visit the PhilHealth website or your nearest PhilHealth Regional Office.

Reference: PhilHealth Circular No. 2025-0002