PhilHealth offers kids optometry package
The Philippine Health Insurance Corp. (PhilHealth) now covers annual optometry services including prescription eyeglasses for children aged 15 and younger.
Under PhilHealth Circular No. 2025-0002, the new optometry benefit package worth P2,500 includes vision assessment, eyeglasses (including frames and lenses) and follow-up consultation for children patients.
They may avail themselves of that benefit once a year, subject to the evaluation of health-care providers.
The new circular was signed by PhilHealth president Emmanuel Ledesma Jr. on Jan. 15 and took effect upon publication on Jan. 18.
“While the current vision screening of the government is only focused on kindergarten pupils, other children with error of refraction and other eye problems need early intervention to improve their vision,” PhilHealth said in the circular.
‘First patient encounter’
Those who can avail themselves of the new benefit package are children aged 0 to 15 years old, who have been assessed and diagnosed by qualified health professionals to have errors of refraction and other eye conditions that can be corrected by prescription glasses.
Children whose vision cannot be corrected to 20/20 despite the lenses and those with other vision or eye problems shall be referred first to ophthalmologists for further examination.
Before they can obtain their glasses, patients shall first undergo a vision screening in an accredited facility as part of the “first patient encounter.” The screening is covered under PhilHealth’s Konsulta outpatient package.
There will be a follow-up for the fitting of eyeglasses, and advice for eye care and eyeglasses care.
Schools conducting vision screening under Republic Act No. 11358, or the National Vision Screening Act of 2019, and other PhilHealth-accredited health facilities may refer patients to optometrist clinics also accredited by the agency.
The patient shall not be charged for the services provided in the package, including regular frames and appropriate lenses, regardless of the materials used in the eyeglasses.
However, the use of “designer frames” is subject to out-of-pocket expense, provided that the beneficiaries are properly informed and have consented.
Risk factors
According to the 2018 Philippine Eye Disease Study of the Philippine Eye Research Institute (Peri), 9 percent of children in kindergarten are affected with visual impairments.
The figure doubles when they reach adolescence, with 16 percent of high-school students found to have visual impairment. Ninety percent of these cases are myopia or nearsightedness.
Dr. Leo Cubillian, ophthalmologist and director of Peri, said while genetics is mostly blamed for the high cases of myopia, recent studies pointed to the lack of exposure to natural light as a risk factor.
