PhilHealth members and their eligible dependents can access up to Php 20,000 worth of prescribed medicines every year through the Yaman ng Kalusugan Program (YAKAP) and its Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) benefit.
The program covers 75 medicine categories, including treatments for high blood pressure, diabetes, high cholesterol, and certain infections.
However, beneficiaries must first register with a participating YAKAP clinic and undergo a medical assessment before claiming their medicines.
Php 20,000 Medicine Benefit Covers 75 Categories
According to PhilHealth, the GAMOT benefit provides an annual medicine coverage limit of Php 20,000 per eligible beneficiary.
Of the 75 covered medicine categories, 21 essential medicines are available through YAKAP clinics, while 54 additional categories are available through accredited partner pharmacies.
The benefit is not a cash allowance.
Patients receive medicines based on their doctor’s prescription, covered prices, and remaining annual benefit balance.
For more information, read our complete PhilHealth YAKAP benefits guide.
How to Register and Claim Covered Medicines
Members can enroll through the PhilHealth Member Portal, eGovPH app, participating YAKAP clinics, or PhilHealth offices.
After registering, beneficiaries must visit their chosen clinic for a First Patient Encounter (FPE).
A doctor will assess their health and prescribe medicines when needed.
To claim covered medicines:
- Obtain a GAMOT prescription or Unique Prescription Security Code (UPSC) from your YAKAP doctor.
- Visit an accredited GAMOT pharmacy.
- Present the prescription or UPSC and a valid ID.
- Complete the required pharmacy verification and sign the GAMOT Availment Slip.
Patients should confirm medicine availability before visiting the pharmacy.
Are Checkups and Laboratory Tests Also Free?
YAKAP also covers primary care consultations, 13 laboratory tests, and selected cancer screenings when medically necessary.
Contrary to claims that patients can receive only one consultation yearly, PhilHealth allows follow-up care based on medical needs.
Covered primary care services at public YAKAP clinics are free.
However, private accredited clinics may charge a co-payment of up to Php 900 per beneficiary per year.
This annual cap applies to covered and medically necessary YAKAP primary care services.
What If Your Medicine Is Out of Stock?
Medicine availability may vary between participating facilities.
PhilHealth allows patients to obtain eligible prescribed medicines from other accredited GAMOT providers, subject to program rules.
Patients should keep their UPSC code and ask the dispensing pharmacist how to claim any remaining prescribed supply.
If a medicine is unavailable, they should consult their doctor or pharmacist about suitable alternatives rather than changing medication themselves.
What PhilHealth Members Should Do Next
Members who have not registered should check the availability of accredited YAKAP clinics in their area.
Those already enrolled can schedule consultations, ask about covered medicines, and follow their doctor’s recommended appointments.
YAKAP focuses on outpatient care and prevention.
For eligible patients needing hospital care, other assistance may also be available through programs such as the DOH Zero Balance Billing initiative.
For questions or complaints about YAKAP services, contact PhilHealth at (02) 8662-2588 or visit philhealth.gov.ph.
