One in six Filipinos struggle with mental health issues. Until recently, however, insurance coverage for this very real health issue has been virtually nonexistent. That’s changing fast.
PhilHealth leads the charge
The Philippine Health Insurance Corporation (PhilHealth) has recently transformed mental health coverage through its comprehensive outpatient benefits package (PhilHealth Circular No. 2023-0018). This landmark development provides accessible mental health services for Filipinos aged 10 and above, with no age restrictions for neurological conditions like epilepsy and dementia.
The new package offers substantial financial support with annual coverage of Php 9,000 for general mental health services and Php 16,000 for specialized care. This represents a significant improvement from the previous limited coverage of Php 7,800, which only addressed hospitalization for extreme cases.
PhilHealth’s enhanced coverage now includes:
- Initial assessments and up to 12 follow-up consultations
- Laboratory and diagnostic tests
- Medications through the Mental Health Medicines Access Program
- Psychoeducation and psychosocial support based on WHO guidelines
The package specifically addresses conditions including depression, psychosis, epilepsy, child and adolescent mental disorders, dementia, and risks of self-harm or suicide. Services can be accessed at various PhilHealth-accredited facilities, from rural health units to specialty centers.
Private sector innovation
Private insurers are also stepping up to close the mental health coverage gap. FWD Life Insurance has launched “The One for mental wellbeing,” a customizable one-year plan starting at approximately Php 330 per year. This affordable option includes life protection coverage while providing access to mental health assessments and counseling through digital platforms.
Similarly, AIA Philippines has integrated mental health provisions into their offerings by partnering with counseling service providers. Other health maintenance organizations (HMOs) like iCare offer comprehensive healthcare plans that may include mental health services depending on the specific plan.
Accessing mental health services
For those seeking care under PhilHealth’s new outpatient mental health benefits package, the process is fairly simple. Here are the steps:
- Selecting a PhilHealth-accredited facility offering mental health services
- Undergoing an initial screening by an mhGAP-trained health professional
- Registration in the PhilHealth Mental Health Registry
- Access to diagnostic tests, follow-up consultations, psychoeducation, and medications as needed
The accredited facility handles all PhilHealth claims, streamlining the process for patients.
Toward a healthier future
These advances align with the Universal Health Care Act and Mental Health Act, signaling growing support for mental healthcare in the Philippines.
As coverage expands and stigma decreases, more Filipinos can access affordable mental health support – a crucial step toward a healthcare system that values mental wellbeing equally with physical health.
