PhilHealth coverage to include dental care services in 2025
The Philippine Health Insurance Corp. (PhilHealth) will be covering its members’ dental health starting sometime in 2025.
Health Secretary and PhilHealth Chairman Teodoro Herbosa stated that the health insurance provider's board members have approved the inclusion of dental services to their healthcare benefit packages to push for universal health care.
The Board agreed on a preventive oral health benefit to be delivered by dentists working in PhilHealth Konsulta package providers, and also by stand-alone dentists based on referrals from the Konsulta providers," Herbosa said, per ONE News.
He highlighted that the move was made as "universal health care must have oral health care, and the best way to make it sustainable and felt by all Filipinos is through primary care."
Once this is officially implemented, PhilHealth members can enjoy services such as oral screening, dental cleaning, fluoride varnish application, pit and fissure sealants, Class V procedures, emergency tooth extractions, and consultations.
According to the Philippine News Agency, each patient is allotted a maximum payment of P1,000 for oral health services per year.
From this amount, P300 will be paid for the first visit for mouth examination or oral screening, among others, and another P300 will be paid for the second visit which must be made at least four months after the first one.
The remaining amount is reserved for pit and fissure sealant or a Class V procedure for a maximum of two teeth per year.
While public dentists are not allowed to charge co-payments, this is a different case for private practitioners as they may charge up to P1,500 for oral exams and cleaning, P600 for sealants or Class V procedures, and P600 for emergency tooth extractions.
While no date has been finalized, PhilHealth said that they are planning to implement the package in the first or second quarter of 2025.
Recently, it was reported that the state insurer has started covering its members' optometric services and prescription glasses this November.
This was shared by PhilHealth executive vice president Eli Dino Santos during the Senate Health and Demographic Joint Hearing on Oct. 2, in response to Sen. Bong Go's question about the possibility of rolling out free eyeglasses to help prevent eye problems in children.
"As our part in the whole-of-government and whole-of-society approach in the healthcare delivery system? Yes, in fact, Mr. Chairperson, we already committed to cover the prescription glasses as part of PhilHealth packages, and the date is November 2024," he said.
Santos added, "That's already part of our commitment and timeline."
PhilHealth also has plans to cover crutches, walkers, and wheelchairs starting January 2025.
