The Philippine Health Insurance Corporation (PhilHealth) is expanding access to selected first-line anti-tuberculosis (TB) medicines through its Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) program, giving eligible members and their dependents an additional access point for prescribed medicines starting November 1, 2026.
Under PhilHealth Circular No. 2026-0018, eligible patients with confirmed drug-susceptible tuberculosis (DS-TB) may obtain covered medicines from PhilHealth-accredited GAMOT Facilities through prescriptions issued by YAKAP physicians.
The policy advances PhilHealth’s commitment to strengthening comprehensive primary care through the Yaman ng Kalusugan Program or YAKAP and supports the Unified National Agenda for Health, particularly its pillar on a functional primary care system. By connecting primary care consultations with access to prescribed medicines, PhilHealth aims to help bridge gaps in treatment, promote continuity of care, and make health benefits more accessible and responsive to patients’ needs.
Importantly, covered anti-TB medicines will not be deducted from the member’s ₱20,000 annual GAMOT benefit limit, preserving this allocation for other covered outpatient medicines.
Up to a one-month supply of first-line anti-TB medications may be prescribed per transaction, and the accredited GAMOT Facility must dispense the complete prescribed quantity within two (2) days from the date of GAMOT prescription issuance. Patients must claim their medicines within the prescribed period; otherwise, they may still obtain them but must pay out of pocket or secure an updated prescription. YAKAP accredited physicians must issue prescriptions through the GAMOT Application in accordance with the Department of Health- National TB Control Program (DOH-NTP) treatment protocols.
To facilitate timely access, accredited GAMOT Facilities must submit an updated Certification of Availability to their PhilHealth Regional Office (PRO) before dispensing anti-TB medicines. PhilHealth will directly reimburse participating GAMOT facilities based on the fixed fees schedule specified in the circular.
The expanded benefit complements—not replaces—the Outpatient TB-DOTS Package, which remains PhilHealth’s primary benefit for comprehensive outpatient TB care. Meanwhile, TB-DOTS facilities shall continue providing comprehensive care and dispensing medicines when supplies are available and sufficient. If first-line anti-TB drugs are dispensed through a GAMOT facility instead of the TB-DOTS facility, an automatic 50% deduction will apply to the TB-DOTS package claim for each treatment phase.
Members are encouraged to consult their YAKAP Authorized Physician or TB-DOTS provider to determine the appropriate treatment arrangements and how to access the benefit.
For PhilHealth, strengthening primary care means turning health coverage into meaningful access to care. Through YAKAP and complementary benefits such as GAMOT, PhilHealth continues to advance the national health agenda by helping Filipinos access essential medicines and services, supporting continuity of treatment, and reducing financial barriers to healthcare.
For questions on registration, YAKAP selection and location of YAKAP Clinics, members may call the PhilHealth Corporate Action Center at (02) 8662-2588 or visit www.philhealth.gov.ph.
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