The Association of Health Maintenance Organizations of the Philippines, Inc. (AHMOPI) has reaffirmed its support for the Philippine Health Insurance Corporation (PhilHealth) and committed to strengthening collaboration with the state insurer to advance Universal Health Care and improve healthcare access for Filipinos.
In a statement, AHMOPI said the country’s health maintenance organizations continue to play a complementary role in the healthcare system, supporting PhilHealth’s mandate to provide universal health insurance while helping members manage healthcare costs through supplemental medical coverage.
The association stressed that the Universal Health Care Act of 2019 has significantly strengthened the country’s healthcare system by automatically enrolling all Filipinos in the National Health Insurance Program administered by PhilHealth and expanding access to essential health services.
According to AHMOPI, the implementation of Universal Health Care has enabled PhilHealth to broaden its benefit packages, including primary care through the Yaman ng Kalusugan (YAKAP) Program, outpatient emergency care, outpatient procedures such as minor surgeries, chemotherapy and hemodialysis, enhanced inpatient case rates, maternity and newborn care, and specialized ‘Z’ benefit packages for catastrophic and prolonged illnesses.
The association said these enhancements have reinforced PhilHealth’s role as the country’s primary healthcare payor while providing Filipinos with broader financial protection against medical expenses.
AHMOPI emphasized that HMOs complement these benefits by offering higher annual coverage limits and additional medical benefits that help reduce out-of-pocket healthcare expenses not fully covered by PhilHealth.
‘Considering that all Filipinos are now PhilHealth members, HMO benefits support PhilHealth benefits, with PhilHealth serving as the first payor,’ the association said.
The association added that the coordinated role of PhilHealth and HMOs allows members to maximize available healthcare benefits while ensuring greater financial protection during medical treatment.
AHMOPI also underscored the HMO industry’s long-standing role in the country’s healthcare delivery system, noting that the sector has been serving Filipinos for more than four decades by working alongside hospitals, physicians and other healthcare providers to improve access to quality medical care.
The association said it considers PhilHealth an invaluable partner in delivering accessible, affordable, preventive and life-saving healthcare services to Filipinos.
Under the leadership of PhilHealth President and Chief Executive Officer Dr. Edwin M. Mercado, AHMOPI said it remains committed to working hand in hand with the state insurer, accredited healthcare institutions, medical professionals and other stakeholders to further strengthen healthcare delivery, enhance patient outcomes and help build a healthier nation.