PhilHealth pushes wider YAKAP enrollment as preventable diseases claims rise

By Mariela Angella Oladive

The Philippine Health Insurance Corp. is urging members in Western Visayas to actively enroll in and use the YAKAP (Yaman ng Kalusugan) primary care package as data show that the region’s most paid illnesses are largely preventable.

In a media forum on Tuesday, PhilHealth Western Visayas Public Affairs Unit head Janimhe Jalbuna reported that Region 6, including Negros Occidental, has achieved 95.25 percent PhilHealth membership coverage, representing 7.7 million registered members and dependents.

She said only 36.50 percent of the population, or 2.95 million individuals out of the region’s projected 8.09 million population, is registered with a YAKAP Package Provider as of Oct. 31, 2025.

YAKAP enrollment rates by province are as follows:

• Aklan: 60.77%
• Antique: 64.25%
• Capiz: 44.81%
• Guimaras: 61.50%
• Iloilo province: 24.88%
• Negros Occidental: 32.15%

Jalbuna stressed that increasing YAKAP registration is essential because the program provides free outpatient consultations, laboratory tests and medicines.

She said strengthening YAKAP participation is critical since the top illnesses paid by PhilHealth—including pneumonia, acute gastroenteritis, hypertensive emergency, dengue fever, urinary tract infections and peptic ulcer disease—are mostly preventable through timely primary care.

Pneumonia remained the costliest condition in the region, with PHP 790.6 million paid for 31,457 cases.

“The symptoms could have been treated before they became aggravated. Take note that low-risk pneumonia can be addressed in our YAKAP. But when it becomes moderate risk, it is already high risk, so it needs admissions in hospitals,” she said, adding that early detection through YAKAP significantly reduces out-of-pocket expenses and prevents complications.

She said 772,739 members and dependents have completed their first patient encounter under the program, representing 56.28 percent of the 1.37 million target for 2025.

Iloilo recorded the highest number of first patient encounters at 171,688, followed by Capiz with 169,361.

PhilHealth said PHP 416.33 million has been disbursed for YAKAP claims this year, with Capiz and Iloilo receiving the largest shares at PHP 103.67 million and PHP 102.34 million, respectively.

Formerly known as Konsultasyong Sulit at Tama (Konsulta), YAKAP aims to keep Filipinos healthy through preventive and primary care.

The benefit includes the enhanced PhilHealth Guaranteed and Accessible Medications for Outpatient Treatment, or GAMOT, a comprehensive outpatient drug benefit covering 75 types of medicines with an annual limit of PHP 20,000 per member and dependent.