The Philippine Health Insurance Corp. (PhilHealth) 6 (Western Visayas) has disbursed about PHP14.81 billion, while more than PHP2.44 billion are being processed for the 1,356,020 claims in the region as of the end of December 2025.
PhilHealth-6 acting Vice President Lazaro Tabsing, during the Kapihan sa Western Visayas on Tuesday afternoon, said topping the medical claims is moderate risk pneumonia, with PhilHealth disbursing more than PHP1 billion for 41,306 cases.
Topping the list for procedural claims is hemodialysis, with more than PHP3.62 billion paid out by the state health insurer, he said.
Other top medical claims are acute gastroenteritis, hypertensive (emergency urgency), urinary tract infection, chronic kidney disease, stroke infarction, upper respiratory tract infection, and fluid and electrolyte disturbances.
“These conditions are not only among the most frequently claimed. They are also the very illnesses that PhilHealth aims to prevent and manage early through our YAKAP (Yaman ng Kalusugan Program) services,” Tabsing said.
He said that through YAKAP, there is a shift from a system that focuses solely on treatment to one that emphasizes prevention, early detection, and continuous care.
Meanwhile, he said the number of claims for hemodialysis reflects the increasing number of Filipinos requiring regular kidney treatment.
Other top paid procedures are expanded newborn care packages, routine obstetric care, chemotherapy, facility-based emergency, outpatient human immunodeficiency virus/acquired immunodeficiency syndrome packages, and polymerase chain reaction testing.
“Although it did not enter the Top 10 list, it is worth highlighting that TB-DOTS, a key program aligned with the Sustainable Development Goals, registered at 8,518 claims, with PhilHealth paying more than PHP18 million to support tuberculosis treatment and control,” Tabsing said.
Field Operations Division Chief Junie Sabusap, meanwhile, said that as of Dec. 31, 2025, a total of 3,084,541 of the more than 8 million population of Western Visayas have enrolled in YAKAP.
Of the total, nearly 1 million had their first patient encounter.
He said they are counting on the successful implementation of the Guaranteed Access Medication to Outpatient Treatment (GAMOT) program, which provides 54 medicines on top of the 21 basic medications, to encourage more PhilHealth members to enroll in YAKAP.
As of the end of November last year, 96.74 percent of the 8.09 million projected population of Western Visayas are registered with the state health insurer. (PNA)