The Philippine Health Insurance Corp. (PhilHealth) said on Tuesday that only health facilities accredited under the Yaman ng Kalusugan (YAKAP) program that have complied with the requirements are eligible for the rollout of the Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program this year.
During a Kapihan forum here, Ferlyn Catacutan, social insurance officer of PhilHealth-Dumaguete, said not all YAKAP facilities have complied with the requirements for the GAMOT program.
“Only compliant YAKAP-accredited facilities can start the GAMOT implementation once this is rolled out in the province soon,” Catacutan said in Cebuano.
According to her, the implementation of GAMOT will be done in phases, as their regional office still has to engage with accredited facilities, such as hospitals and clinics, and with physicians identified for the YAKAP program.
Physicians and pharmacies participating in the GAMOT program also have to apply for an online app, she added.
Catacutan did not give a specific date for the official rollout of the GAMOT this year, but as promised during its launch late last year, it would be during the early part of 2026.
Some of the private accredited YAKAP facilities here are Diagcare, Health Care Diagnostic, Negros Polymedic Hospital, ACE Medical Center in Bayawan City, ACE Dumaguete Doctors Hospital in Dumaguete City, and Futalan Medical Clinic in Siaton.
The GAMOT program provides a qualified PhilHealth member who has signed up with YAKAP a total of PHP20,000 in medication and/or laboratory examinations for a year.
Negros Oriental constituents who are PhilHealth members were urged to register with YAKAP so they can avail of the GAMOT program once it is fully operational.
Only those registered with PhilHealth can become YAKAP members.
Meanwhile, Shiela Marie Bacalso, social insurance officer of PhilHealth-Dumaguete, said they have yet to contract a health facility in Negros Oriental for cardiovascular cases under the Z Benefit Package.
The closest contracted health facilities are in Cebu City, and one in Bohol that caters only to newborns suffering from heart diseases, she said.
Despite this, Bacalso said, PhilHealth covers various heart diseases through higher package rates as of 2025.
She cited as an example Percutaneous Coronary Intervention, formerly known as angioplasty, with a PhilHealth coverage of PHP523,000.
Pre-screening, evaluation, and communication with the accredited health facility for Z-Ben are required before a patient can be accommodated, she added. (PNA)