MANILA — The Philippine Health Insurance Corp. is set to significantly expand its benefit package for children with developmental disabilities, following President Ferdinand Marcos Jr.'s announcement during his fifth State of the Nation Address.
Marcos Jr. said the government would double PhilHealth's benefit package for consultations and therapy, while increasing the number of therapy sessions covered to 150 from 90.
PhilHealth President and CEO Edwin Mercado said the enhanced package will also increase coverage for a patient's initial developmental assessment to P8,000 from P3,700.
The expanded package will cover four major developmental disabilities: Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Cerebral Palsy, and Global Developmental Delay.
PhilHealth estimates around 1.6 million Filipinos aged 19 years and below are living with developmental disabilities.
For parents raising children with developmental disabilities, the expanded PhilHealth coverage could ease the financial burden of long-term therapy.
Lee Javate-Gatlabay, whose child is on the autism spectrum, said therapy alone can cost families more than P10,000 a month.
"Depende sa kung ano yung binibigay ni doctor na kailangan niya. Kung kailangan niya ng occupational therapy, speech therapy, or behavioral therapy yun," she said, adding children may need therapy as often as four times a week.
(It depends on what the doctor recommends. The child may need occupational, speech or behavioral therapy.)
While she welcomed the government's plan, she said many families will still need sustained support because developmental disabilities require continuous intervention.
"Hindi naman siya natatapos ng araw ng one session lang, two session."
(It's not a matter of one or two sessions.)
Beyond financial assistance, PhilHealth also acknowledged the country has few developmental pediatricians qualified to diagnose children with developmental disabilities.
Mercado said the agency is exploring ways to expand the pool of professionals who can be certified to conduct initial assessments.
Among those being considered are occupational therapists, child psychologists and general pediatricians.
He said PhilHealth is working to expand the number of healthcare facilities accredited to provide developmental services and "making sure that every region is covered."
PhilHealth is also consulting medical societies and healthcare providers and studying the actuarial requirements to implement the enhanced benefits nationwide.
The state insurer expects to roll out the updated developmental disability benefit package in the fourth quarter of 2026.