Philippines’ state-owned health insurance now covers 75 types of meds; yearly limit at P20,000

These medicines include “common treatments” for a wide range of conditions, such as for infections, asthma and chronic obstructive pulmonary diseases, diabetes, high cholesterol, high-blood pressure and heart conditions, nervous system disorders, among others.

Gillian Villanueva

Gillian Villanueva

Philippine Daily Inquirer

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Thematic image only. 'PhilHealth Gamot' expands on the initial 21 free medicines under the Konsultasyong Sulit Tama or Konsulta benefits package with an additional 54, and will take effect on Aug. 21 based on PhilHealth Circular No. 2025-0013. PHOTO: AFP

August 15, 2025

MANILA – Members will soon have access to 75 types of medicines for free at select clinics and pharmacies, with a limit of P20,000 per year, under the Philippine Health Insurance Corp.’s (PhilHealth) new Guaranteed and Accessible Medications for Outpatient Treatment (Gamot) package.

Launched on Thursday, PhilHealth Gamot expands on the initial 21 free medicines under the Konsultasyong Sulit Tama or Konsulta benefits package with an additional 54, and will take effect on Aug. 21 based on PhilHealth Circular No. 2025-0013.

“Based on our data, one of the biggest out-of-pocket spending of our countrymen is what we call medical goods—the medicines and items that we pay for outside the hospital. That’s why we see that this is the first thing we should address,” PhilHealth President and CEO Edwin Mercado said during the launch.

‘Common treatments’

These medicines include “common treatments” for a wide range of conditions, such as for infections, asthma and chronic obstructive pulmonary diseases, diabetes, high cholesterol, high-blood pressure and heart conditions, nervous system disorders, and other supportive therapies.

The entire list of free medicines is included in the PhilHealth circular which can be accessed through the link https://www.philhealth.gov.ph/circulars/2025/PC2025-0013.pdf.

“This program is not just about providing medicines. It’s about having peace of mind to families, strength to breadwinners, and hope to patients who thought they had none. This is a big help, especially to the ordinary middle-class worker,” Health Secretary Teodoro Herbosa said at the event.

“For me, the medicine that I take…[it costs] P5,000 a month. I just bought [my medicine] last month, it got raised to P7,500. Pharmacies had increased their prices. I think all the medicines are also increasing. But with the P20,000 package, that will be a big help,” he added.

Where to go

To avail of the new Gamot package, one must first register as a beneficiary of the PhilHealth’s Yaman ng Kalusugan Program para Malayo sa Sakit (Yakap), which can be done through the eGovPH app, PhilHealth member online portal, at PhilHealth offices, or through other channels.

Beneficiaries must then get a prescription from a Yakap or PhilHealth-accredited physician before they can avail themselves of the free medicines at any Gamot facility. They only need to present any government-issued ID, alongside the doctor’s prescription, at the clinic.

According to Mercado, there are around 4,300 Gamot partner clinics for the new benefit. For those in Metro Manila, they may also go to Gamot partner pharmacies.

“As for the pharmacies, since we had just launched [the program], they are only located in Metro Manila for now. So, just give us some time because every day we are able to add more,” Mercado said.

Prevention, maintenance

Herbosa said the new benefit package signaled a “paradigm shift” for PhilHealth as it sought to focus on prevention and primary care, making sure members would have maintenance medicines within easier reach, reducing dependence on expensive tertiary care.

“Secondary prevention is taking your chronic meds. If you have hypertension, then it would not lead to stroke. If you are diabetic and you are taking your diabetic meds, you would not have diabetic nephropathy which leads to dialysis,” Herbosa said.

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