2 days Ago By Cherry Ann Virador
THE Philippine Health Insurance Corp. (PhilHealth) has announced a significant increase in its benefits for Extracapsular Cataract Extraction with the Insertion of Intraocular Lens (IOL), covering adult and pediatric patients. The enhanced coverage takes effect on Jan.
30, 2025, in line with President Ferdinand Marcos Jr.’s directive to strengthen and sustain the country’s healthcare benefits. Under PhilHealth Circular 2025-0001, published on Jan.
15, financial support for adult cataract surgery has more than quadrupled, starting at P20,200. Coverage varies depending on the type of intraocular lens (IOL) used. Procedures involving a monofocal IOL or standard lens are now covered at P28,300 per eye.
Premium lenses such as the mono-focal toric IOL, which corrects astigmatism at one specific distance, have a coverage of P43,800 per eye. For those requiring multifocal IOLs, which provide clear vision for both near and far objects, the coverage is P66,900 per eye. Meanwhile, multifocal toric IOLs, which correct astigmatism and multiple viewing distances, have the highest coverage at P80,900 per eye.
For pediatric cataract surgery, the coverage now reaches P135,000 per eye and P139,050 for both eyes if no intraocular lens is used. Previously, PhilHealth provided a flat rate of P16,000 per eye for cataract extraction, with no distinction between adult and pediatric cases. To prevent out-of-pocket expenses and ensure uninterrupted medical services, PhilHealth has directed all accredited healthcare facilities to maintain minimum stock levels of intraocular lenses, essential eye medications, life-saving drugs, IV fluids, and other necessary medical supplies.
The expanded coverage for cataract surgery is expected to significantly reduce preventable blindness in the country and improve the quality of life for thousands of Filipinos. In 2024 alone, PhilHealth disbursed P3.58 billion for 224,209 cataract removal procedures, demonstrating the high demand for this essential eye surgery.
/ CAV.
