By Ma. Teresa Montemayor | Philippine News Agency
The Philippine Health Insurance Corporation (PhilHealth) has rolled out an expanded maternity care benefit package designed to guarantee near-zero out-of-pocket expenses for pregnant women, following an “alarming” increase in preventable maternal deaths nationwide.
During a media forum on Wednesday, the state insurer cited that maternal mortality nationwide reached 1,852 in 2024 based on Philippine Statistics Authority (PSA) data.
The maternal mortality rate ratio is 119 deaths per 100,000 live births.
While it has decreased from 151 in 2020, the figure remains above the United Nations Sustainable Development Goals (SDGs) target threshold of 70 maternal deaths per 100,000 live births by 2030.
“Kaya po naglabas po ang PhilHealth nitong bagong expanded na maternal care benefit package so that ang ating mga nanay at mga buntis ay maalagaan talaga pag umpisa pa lang ng kanilang pagbubuntis hanggang po sila ay manganak,” PhilHealth acting Vice President for Corporate Affairs Group Mae Villa told reporters.
VP Villa highlighted that the revamped package covers the entire continuum of pregnancy, from prenatal visits and delivery to postnatal care.
“Ang pinakamaganda po dito sa maternal care benefit package ng PhilHealth ay yung care coordination. So, nagkaroon na po tayo ng benefit package sa pag-a-assign po ng ating specific person in the health facility who will assist yung ating mga buntis para sa kanyang buong journey,” she said.
PhilHealth Medical Officer IV Dr. Laurence Sabido clarified that under Department of Health (DOH) Administrative Order guidelines, specific criteria dictate whether a pregnancy must be handled in a hospital rather than a local lying-in clinic.
All first-time mothers (primigravidas) and mothers entering their fifth or subsequent pregnancies (multigravidas) are strictly classified as high-risk.
“The DOH set guidelines, and in their guidelines, they said that all first pregnancies and pregnancies at the fifth and beyond are considered high risk, and therefore they should not be managed in a lying-in clinic. They should be managed in a hospital setting,” Sabido said.
She said common complications like gestational hypertension and diabetes must be carefully monitored.
Dr. Sabido said medical data show first-time births carry higher unpredictable risks, while fifth-term pregnancies face severe hazards like spontaneous or uncontrolled uterine bleeding.
Addressing the public’s tendency to avoid hospital deliveries due to rising healthcare costs, PhilHealth significantly adjusted its reimbursement packages to eliminate financial concerns.
VP Villa clarified that PhilHealth covers maternal services across all accredited platforms, provided the facility matches the patient’s risk profile.
“Kaya, dapat po, huwag silang matakot doon sa gastos. Sa hospital na panganganak dahil sagot po ng PhilHealth iyan,” Villa said.
Under the expanded maternity care benefit package, normal spontaneous delivery (NSD), Caesarian Section (CS), Endometrial Sampling (ES), and Dilation and Curettage (D & C) can be availed of in all PhilHealth-accredited hospitals.
The NSD new case rate in infirmaries and primary care facilities is up to P14,000, while the new case rate in hospitals is up to P29,000.
The new case rate for CS is up to P58,000, while the new case rate for Caesarian delivery only following attempted vaginal delivery after a previous Caesarian delivery is up to P62,000.
For ES, the new case rate is up to P31,500. The new case rate for DS is up to P36,500.
Antenatal care, which includes up to eight check-ups and diagnostics, step-up referral for complications during labor, and postpartum care of up to three visits after discharge, is also included in the benefit package.
With all the additional benefits, Villa urged women with high-risk pregnancies to seek medical consultation and services at PhilHealth-accredited hospitals to avoid maternal deaths or mortality.
