PhilHealth Expands Oral Health Benefits for Filipinos

The Philippine Health Insurance Corp. (PhilHealth) has approved an expanded primary care package for oral health services, according to a recent article published on NewsInfo.inquirer.net. The new benefit aims to provide comprehensive preventive dental care for Filipino citizens, aligning with the Department of Health’s (DOH) “Ngiting 70-20” vision.

Coverage and Services

The approved package will cover a range of preventive oral health services, including:

• Annual mouth examinations
• Dental prophylaxis (cleaning)
• Fluoride varnish application
• Pit and fissure sealant for up to two teeth
• Emergency tooth extractions
• Dental consultations

Health Secretary Teodoro Herbosa, who chairs the PhilHealth board, emphasized the importance of this initiative, stating, “Universal Health Care (UHC) must have oral health care, and the best way to make it sustainable and felt by all Filipinos is through primary care.”

Financial Details and Implementation

PhilHealth will provide a maximum payment of P1,000 per patient annually, structured as follows:

• P300 for the first visit (covering initial examination and cleaning)
• P300 for a second visit at least four months later
• P200 per tooth for sealant procedures (maximum two teeth)

Private dentists will be permitted to charge a maximum copayment of:

• P1,500 for mouth examination and oral prophylaxis
• P600 for pit and fissure sealant
• P600 for emergency tooth extraction

Future Steps and Context

The dental care package is expected to be rolled out early next year, coinciding with the Philippines’ participation in the World Health Organization’s first Global Oral Health Meeting in Bangkok, Thailand.

DOH spokesperson Albert Domingo reflected on the significance of this development, noting, “The Philippine journey for oral health care has been like a roller coaster with ups and downs in implementation. Under the administration of President Marcos and Secretary Herbosa, we are now rising again to fulfill the mandate of Universal Health Care that includes oral health.”

The next steps involve PhilHealth publishing detailed package information in a circular and developing IT systems to facilitate data capture and payments.