Manila: 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.
According to Philippines News Agency, 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. PhilHealth acting Vice President for Corporate Affairs Group Mae Villa emphasized the importance of the new package in providing comprehensive care for expectant mothers from the start of pregnancy through childbirth.
Villa highlighted that the revamped package covers the entire continuum of pregnancy, from prenatal visits and delivery to postnatal care. The benefit package includes care coordination, assigning a specific individual within the health facility to assist expectant mothers throughout their entire pregnancy journey. 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. Dr. Sabido explained the DOH guidelines, stating that all first pregnancies and pregnancies at the fifth and beyond are considered high risk and should be managed in a hospital setting. Common complications like gestational hypertension and diabetes require careful monitoring.
Addressing the public's tendency to avoid hospital deliveries due to rising healthcare costs, PhilHealth significantly adjusted its reimbursement packages to eliminate financial concerns. Villa clarified that PhilHealth covers maternal services across all accredited platforms provided the facility matches the patient's risk profile. Under the expanded maternity care benefit package, various procedures such as normal spontaneous delivery (NSD), Caesarian Section (CS), Endometrial Sampling (ES), and Dilation and Curettage (D and C) are covered in all PhilHealth-accredited hospitals.
The package includes a new case rate for NSD up to PHP14,000 in infirmaries and primary care facilities, and up to PHP29,000 in hospitals. The new case rate for CS is up to PHP58,000, while the rate for Caesarian delivery following attempted vaginal delivery after a previous Caesarian delivery is up to PHP62,000. For ES, the new case rate is up to PHP31,500, and for DS, it is up to PHP36,500. 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.
