Outpatient comprehensive care included in PhilHealth benefits
By: Rimaliza A. Opina
Outpatient comprehensive care packages or the Yakap Program towards disease prevention are now offered by PhilHealth as of 5 September 2025.
PhilHealth members who are not admitted in hospitals but are in need of outpatient services may now avail of benefits accorded to members, previously limited to those in medical facilities only.
Through the PhilHealth’s Yakap Program, members can now avail of checkups, laboratory tests, cancer screening tests, and medicines from accredited partners of the State health insurance provider.
In a media briefing on 5 September, PhilHealth Corporate Communications Officer Magnolia del Rosario said the enhanced benefits is geared towards prevention of diseases.
She said the enhanced and expanded benefits is in line with the Universal Health Care Act, which intends to give every Filipino an equitable access to quality health care.
Del Rosario said members could not fully avail of benefits due to some challenges. The top challenges include difficulty in obtaining accreditation especially in private health care facilities. She said if a member gets admitted in an unaccredited facility, a member will have to pay in full for the services.
Members are forced to buy medications because of the absence of or lack of medicine dispensed in rural health units (RHU) or health centers. Del Rosario said this is due to the procurement process a reason why local government units cannot deliver on time free medicines that are meant to be given to patients who consult at health centers and RHUs.
In response to these challenges, del Rosario said PhilHealth has extended its accreditation to private doctors, laboratories, and drugstores.
Del Rosario said every member, including their beneficiaries may avail of the P20,000 annual benefit package.
For instance, del Rosario said a family of five who happen to be active members has a total of P100,000 worth insurance from PhilHealth.
To avail of these benefits, one has to be an active paying member. Senior citizens and indigents as certified by the local social welfare office are also considered active members but have to enlist so they will be provided PhilHealth numbers.
If already a member, enlist with a Yakap provider of your choice, then have your consultation there.
To avail of laboratory or diagnostic services, or to be able to buy from drugstores, the lab request and/or prescription must be rendered by a PhilHealth accredited physician.
The laboratory or diagnostic center or drugstore must also be accredited by the PhilHealth, del Rosario said.
Accredited doctors are issued unique QR codes by the PhilHealth for monitoring and auditing purposes. These prescriptions will be given to the accredited drugstore or diagnostic center, which will submit and bill the PhilHealth.
There are currently 75 medications that may be bought from accredited drugstores. These include antimicrobials, antithrombotics, anti-asthma and chronic obstructive pulmonary disease, anti-dyslipidemia, anti-diabetes, anti-hypertensive and cardiology, nervous system, and support medications such as Iron supplement, paracetamol, oral rehydration salts, mefenamic acid, among others.
For laboratory services, complete blood count, lipid profile, fasting blood sugar, oral glucose tolerance, glycosylated hemoglobin, creatinine, chest X-ray, sputum microscopy, electrocardiogram, urinalysis, pap smear, fecalysis, and fecal occult blood test.
For cancer screening, mammogram, breast ultrasound, low-dose chest CT scan, alpha fetoprotein, liver ultrasound, and colonoscopy.
Members who want to avail of the Yakap services may register at the eGovPH Super app, PhilHealth member portal, PhilHealth offices, primary care providers (health centers, district health centers, super health centers, and rural health units), and other channels through P-Cares or PhilHealth personnel stationed at hospitals; P-AIMS or registration facilitated employers, and PhilHealth call centers.
Accreditation started in August. Del Rosario said more drugstores have submitted their intent to be accredited.
To check the list of accredited drugstores, laboratories, and doctors, visit the PhilHealth website. Del Rosario said the website is frequently updated to include those who have recently been accredited.
