Core benefit
The Yaman ng Kalusugan Program — PhilHealth's primary care benefit, launched in 2025, focused on consultations, health screenings, diagnostic tests, and continuity of care.
Universal Healthcare
The promise of the Universal Health Care Act
Republic Act No. 11223
Equitable access without financial hardship
Under Republic Act No. 11223, all Filipinos shall have equitable access to quality health services without suffering financial hardship. RxSolutions supports the implementation of this Act and PhilHealth's transformation toward a proactive, primary care-driven health system.
Aligned programs
- Republic Act No. 11223
- PhilHealth YAKAP
- PhilHealth GAMOT
- PhilHealth Cancer Screening
- Primary Care Provider Network
- Financial Risk Protection
Coverage
Coverage under Universal Health Care
What eligible members can reach through coordinated pharmacy and network pathways.
- 01
Population Coverage
Helping more Filipinos connect to the benefits they are entitled to under national health insurance.
- 02
Service Coverage
Improving access to essential medicines, primary care, and coordinated healthcare services.
- 03
Financial Risk Protection
Reducing financial and access-related barriers throughout the healthcare journey.
PhilHealth Transformation
From reactive treatment to proactive, primary care
PhilHealth's Yaman ng Kalusugan Program (YAKAP) represents a shift toward a proactive, primary care-driven health system focused on prevention, continuity, and long-term wellness.
- 01
Reactive → Proactive Care
- 02
Hospital-Centric → Primary Care-Driven
- 03
Treatment → Prevention and Early Detection
- 04
Episodic Care → Continuous Care
PhilHealth Programs
PhilHealth Programs
Core benefit
Guaranteed and Accessible Medications for Outpatient Treatment — up to ₱20,000 per year across a 75-medicine outpatient formulary for enrolled members and qualified dependents, per PhilHealth Circular No. 2025-0013.
Also aligned
Cancer Screening Benefits
Outpatient cancer screening benefits under YAKAP, supporting early detection and continuity of care.
Outpatient Emergency Care Benefit
PhilHealth's Outpatient Emergency Care Benefit, supporting access to appropriate emergency outpatient services.
Other Applicable Benefits
Other applicable outpatient and inpatient PhilHealth benefits that support the patient's coordinated care.
The GAMOT formulary and coverage details are set by PhilHealth and may be updated over time. Public Yaman ng Kalusugan Program clinics provide services at no cost; private providers may apply an annual co-payment. Members should confirm current eligibility, covered medicines, and any applicable co-payment with their accredited provider.
Care continuum
The 4Cs of Care
First Contact · Coordinated Care · Continuous Care · Comprehensive Care — a connected model of coordinated care spanning pharmacy, diagnostics, imaging, dialysis, oncology, and assistance pathways.
01 First Contact
An accessible community entry point for medicines, guidance, and benefit navigation.
02 Coordinated Care
Connecting patients to the right medicines, benefits, providers, and services.
03 Continuous Care
Supporting patients throughout the healthcare journey, not only at the point of dispensing.
04 Comprehensive Care
Spanning pharmacy, diagnostics, imaging, dialysis, oncology, and patient assistance pathways.
Why Primary Care Matters
Healthcare begins in the community
For every one Filipino hospitalized, many more seek care in the community — and many others never receive the care they need. This underscores the importance of primary care, community pharmacies, and accessible healthcare pathways.
1
hospitalized
14
consulted in the community
40
needed but forewent care
Adapted from primary care utilization frameworks used in Universal Health Care and primary care advocacy materials. Illustrative; not intended to represent current Philippine national statistics. Consistent with the "Ecology of Medical Care" evidence base (New England Journal of Medicine, 2001; 2016).
How we contribute
How RxSolutions Advances Universal Health Care
Universal Health Care is a shared responsibility among government, healthcare providers, and private sector partners. RxSolutions helps make healthcare benefits real by improving access to medicines, services, and coordinated care.
- 01Improving access to essential medicines.
- 02Supporting primary care and continuity of care.
- 03Helping eligible patients access available healthcare benefits and government medical assistance programs.
- 04Reducing financial and access-related barriers throughout the healthcare journey.
- 05Strengthening partnerships across the Philippine health system.
Next step
Continue the care continuum
Explore the patient journey, connect with Kaagapay, or partner with us on Universal Health Care pathways.