TWENTY-SEVEN medical conditions and health issues have been identified by the Philippine Health Insurance Corporation (PhilHealth) as eligible for coverage under its Outpatient Emergency Care Benefit (OECB) package.
These include changes in vision, changes in hearing, generalized weakness/lethargy, dizziness, palpitations, persistent vomiting, diarrhea, foreign body, difficulty swallowing, fever/chills, burns, rashes, mental health concerns, and non-traumatic bleeding.
Also listed are changes in sensorium, changes in gait, elevated blood pressure, seizures, severe headache, chest pain, difficulty breathing, ingestion/substance abuse, abdominal pain/enlargement, severe pain (others), incessant crying/inconsolable child, obstetric and gynecologic conditions, and sexual assault.
“The following is the list of core presentations covered by the benefit package, which are categorized as potentially emergent to critical by triage level,” said PhilHealth in its Circular No. 2025-0020.
For those availing of the OECB package, the state-run health insurer said more than 300 services can be readily provided in Emergency Rooms (ERs).
A total of 343 services—ranging from laboratory to imaging, therapeutic, and diagnostic procedures—are covered under the benefit package.
“There is a substantial need to support the delivery of acute care for cases not requiring admission or for outpatient services provided in emergency settings,” PhilHealth said.
Among the covered services are nebulization, oxygen administration, vital signs monitoring, CT scan, X-ray, ultrasound, MRI, IV fluid, tetanus toxoid, pregnancy test, and blood transfusion, among others.
PhilHealth first introduced the OECB package in February 2025 to bridge the gap in financial coverage for patients requiring urgent or emergent care. (Anton Banal/SunStar Philippines)