By SwiftClaims
MANILA, Philippines — In a groundbreaking move set to brighten the future for Filipino families, the Philippine Health Insurance Corporation (PhilHealth) has launched its Optometry Benefit Package for children aged 0 to 15 years old. This new program, detailed in a recent PhilHealth Circular, promises free vision assessments, prescription lenses, and more—ensuring that no Filipino child is left behind when it comes to healthy eyesight.
Tackling Vision Challenges Early
According to the 2018 Philippine Eye Disease Study, about 1.98% of Filipinos suffer from various visual impairments—often due to uncorrected refractive errors, cataracts, glaucoma, and more. For children, even mild vision problems can significantly affect learning, confidence, and overall well-being.
With this new benefit, PhilHealth beneficiaries aged 0 to 15 identified with errors of refraction or other conditions that can be managed with prescription eyeglasses will receive a comprehensive suite of services:
- Vision Assessment (including refraction tests)
- Prescription Eyeglasses (covering basic lenses and frames)
- Follow-up Care
Php 2,500 Coverage Per Child
PhilHealth will provide Php 2,500 worth of coverage per year for each eligible child. This amount is inclusive of facility fees, professional fees, regular frames, and lenses—meaning families will not have to pay any co-payments for standard eyeglasses. Designer frames remain optional and come at an additional cost if chosen.
Crucially, this coverage also includes follow-up consultations. Should a child’s vision prove more complex than simple refractive correction, an ophthalmologist will be consulted for specialized care.
Complementing Universal Health Care
In keeping with the Universal Health Care Act (R.A. No. 11223), PhilHealth’s initiative aims to provide equitable health services for Filipinos nationwide. By focusing on children’s eye health, the institution furthers its goal of ensuring every Filipino enjoys quality medical attention—particularly in the crucial developmental years.
This program also aligns with the National Vision Screening Act (R.A. No. 11358), which mandates vision screening among kindergarten pupils. Now, children beyond kindergarten age can benefit from earlier and more accessible interventions to correct vision issues, thus improving academic performance and social development.
How to Avail the Benefit
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Initial Screening at a PhilHealth Konsulta Provider
- Accredited healthcare facilities will perform a basic vision check as part of the First Patient Encounter or during follow-up appointments.
- Children who fail this screening will be referred to a PhilHealth-accredited optometric clinic for more comprehensive testing.
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Comprehensive Eye Examination
- Qualified optometrists or ophthalmologists assess the child’s eyes and recommend prescription lenses if needed.
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Free Prescription Eyeglasses
- Lenses and regular frames (basic frames) come at no extra cost. Designer frames are out-of-pocket if chosen.
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Follow-Up Visits
- Health professionals will check the fit of the eyeglasses and ensure the child’s vision is responding well to treatment.
- Children needing further care will be referred to ophthalmologists for conditions beyond refractive error.
Simplified Claims and Provider Payments
PhilHealth guarantees it will process legitimate claims within 60 days of receipt. Accredited facilities must keep detailed patient records and submit claims via PhilHealth’s certified systems. By streamlining the claims process, PhilHealth aims to encourage more providers to join the program and expand coverage nationwide.
Seeing a Brighter Tomorrow
For many Filipino families, corrective eyewear can open up a world of possibilities for their children—boosting their academic success, self-confidence, and everyday quality of life. Through the Optometry Benefit Package, PhilHealth underscores its commitment to leaving no Filipino child behind in the pursuit of clear and healthy vision.
Key Takeaways for Parents
- Who’s Eligible? Children 0 to 15 years old enrolled in PhilHealth.
- What’s Covered? Eye assessments, basic frames, lenses, and follow-up visits.
- Cost? Up to Php 2,500 per child per year, with no co-pay for standard frames and lenses.
- Next Steps? Consult a PhilHealth Konsulta Provider or accredited clinic for initial vision screening.
For More Information
Visit the official PhilHealth website or inquire at your nearest PhilHealth office to learn more about how the Optometry Benefit Package can help your family. Let’s make healthy vision a reality for every Filipino child—starting today!