PhilHealth Launches New Benefits for Rehabilitation Services

The Philippine Health Insurance Corporation (PhilHealth) recently issued Circular No. 2025-0003, detailing a comprehensive benefits package for physical medicine, rehabilitation services, and assistive mobility devices. This landmark initiative aligns with the Universal Health Care Act and seeks to improve access to essential healthcare services for millions of Filipinos, particularly those with disabilities.

The Rationale Behind the Initiative

According to the Global Burden of Disease study, 2.6 billion individuals globally could benefit from rehabilitation services, highlighting the growing need for specialized care. In the Philippines, 12% of individuals aged 15 and above experience severe disabilities, underlining the urgency for accessible and affordable healthcare options.

PhilHealth's new benefits package builds on previous programs, such as the Z Benefits for stroke and cardiac rehabilitation, by extending coverage to adults and enhancing outpatient services.

Key Objectives

PhilHealth aims to:

• Provide equitable access to quality rehabilitation services.

• Reduce financial risks associated with obtaining healthcare.

• Enhance the quality of life for individuals requiring physical medicine and assistive mobility devices.

Scope of the Benefits

This package applies to all PhilHealth-contracted health facilities offering rehabilitation and mobility aid services. Key stakeholders include healthcare providers, patients, and allied health professionals.

Core Services and Benefits

The package includes various services and devices, each tailored to meet the unique needs of patients:

1. Physical Medicine and Rehabilitation Services

   • Initial, follow-up, and discharge assessments by specialists like physiatrists, physical therapists, and speech therapists.

   • Comprehensive therapy sessions, including physical, occupational, and speech therapy.

2. Assistive Mobility Devices

   • A range of mobility aids, such as basic wheelchairs, motorized wheelchairs, crutches, and white canes.

   • Subsidized rates for essential devices to promote independence and mobility.

3. Laboratory and Diagnostic Tests

   • Coverage for tests like MRIs, X-rays, and pulmonary function evaluations.

4. Drugs and Medicines

   • Subsidized medication for conditions requiring rehabilitation and mobility assistance.

Eligibility and Availment

All Filipinos are entitled to this benefits package, provided they meet membership eligibility rules. Patients must undergo assessments by qualified specialists and adhere to prescribed treatment plans.

Key points include:

• No 45-day annual benefit limit for eligible services.

• A clear copayment mechanism for non-covered amenities, explained through the Member Empowerment (ME) Form.

Assistive Mobility Devices at a Glance

PhilHealth now covers the cost of various mobility aids:

• Basic Wheelchair: PHP 7,500 (Maximum of 2 in a lifetime).

• Motorized Wheelchair: PHP 40,000 (Once in a lifetime).

• White Cane: PHP 3,000 (Maximum of 2 in a lifetime).

Replacement periods range from one to two years, ensuring long-term usability for patients.

Conclusion

PhilHealth Circular No. 2025-0003 marks a significant step toward improving the healthcare system in the Philippines. By addressing the needs of individuals requiring rehabilitation and mobility assistance, this initiative not only enhances accessibility but also underscores PhilHealth’s commitment to achieving universal health care for all Filipinos.

For more information, visit the official PhilHealth website or contact their Corporate Action Center.

Reference: Circular No.: 2025-0003