The Philippine Health Insurance Corp. (PhilHealth) has disbursed nearly PHP9.3 billion in in-patient hospital claims in the Ilocos Region in 2024, while total collections from members’ premiums for the same year reached PHP3.8 billion.
During a meeting held Thursday night, PhilHealth 1 (Ilocos) Vice President Dennis Adre presented data indicating that the top 10 illnesses for which claims were paid in the region included pneumonia (moderate risk), hypertensive emergencies, dengue fever, acute gastroenteritis, peptic ulcer (without hemorrhage), urinary tract infection (admissible), upper respiratory tract infection, neonates affected by maternal factors, respiratory conditions due to external agents, and trauma related to the birth process.
As of May this year, PhilHealth’s in-patient hospital claims in the region amounted to PHP6.3 billion, against collections of PHP1.7 billion. Adre noted that the turnaround time for benefits claims payment is only 14 days.
PhilHealth President Dr. Edwin Mercado, in a separate interview, mentioned that the agency has been utilizing surplus funds accumulated from savings in previous years, especially amid budget cuts. “For this year, the projected benefit payout is at PHP300 billion, while the projected collection based on premium contributions is at PHP220 billion. The PHP80 billion deficit will be sourced from the surplus fund of around PHP480 billion. We have enough funds,” he stated.
Mercado also highlighted that, under the law, PhilHealth is required to maintain a reserve fund equivalent to a maximum of two years’ projected costs.
Additionally, he noted that the agency’s support value in terms of claims is increasing, with more than a 45% rise in private hospitals and about a 65% increase in government hospitals.