MANILA, January 7, 2026 — The Philippine Health Insurance Corporation (PhilHealth) has issued a public advisory reminding members of the reinstated ₱20,000 annual Guaranteed Medicines Access Program (GAMOT) benefit, effective January 1, 2026.

The GAMOT program provides financial support for eligible outpatient medicines, helping reduce out-of-pocket expenses for millions of Filipinos. Each member and their dependents are entitled to a maximum of ₱20,000 worth of medicines per calendar year.

PhilHealth clarified that the benefit is strictly non-cumulative, “Any unused GAMOT benefit from the previous year will not be carried over to the current year,” the agency emphasized.

PhilHealth explained that the ₱20,000 GAMOT benefit applies to outpatient medicines listed under the program package, with each member and their dependents entitled to a maximum of ₱20,000 worth of medicines per calendar year. 

The benefit resets every January 1 and expires on December 31, making it essential for members to maximize their entitlement within the year. Importantly, any unused amount cannot be transferred or added to the following year, reinforcing the need for timely utilization.

The GAMOT program is part of the PhilHealth YAKAP initiative, which aims to expand access to essential healthcare services. Launched in 2025, YAKAP includes enhanced outpatient medication coverage and partnerships with pharmacies nationwide.

Health Secretary Teodoro Herbosa previously highlighted the program’s importance, noting that it covers up to 75 types of medicines for conditions such as hypertension, diabetes, and asthma.

PhilHealth encourages members to maximize the benefit within the year to avoid losing unused amounts, check accredited pharmacies and clinics for eligible medicines, and keep receipts and documentation for reimbursement or direct coverage.

GAMOT Helps, Yet Out-of-Pocket Pain Remains

PhilHealth’s reinstated ₱20,000 GAMOT benefit is a welcome reminder that outpatient medicine support exists. For many Filipinos managing hypertension, diabetes, or asthma, any help matters. Access to listed medicines can ease daily costs and reduce skipped doses. That value is real.

Still, the math deserves scrutiny.

Chronic illness is not seasonal. Medicines are monthly, sometimes lifelong. Prices rise. Prescriptions change. A ₱20,000 annual cap can disappear fast, especially for patients with multiple conditions or brand-dependent therapies. When the limit is reached, the burden returns to pockets already stretched thin.

The non-cumulative rule adds pressure. Miss the window, lose the benefit. For workers juggling jobs, caregiving, and transport, timing is not simple. The reset favors the informed and the organized. The sickest often struggle the most to keep pace.

GAMOT under the YAKAP initiative signals intent. Intent alone does not refill prescriptions in August or November. Coverage breadth matters. Pharmacy reach matters. Continuity matters.

Public health gains come from sustained access, not short ceilings. If chronic care is the goal, caps should reflect chronic reality.

So here’s the question that matters most: does ₱20,000 truly cover a year of chronic care, or does it just delay the next out-of-pocket shock?

 Image from Ted Herbosa Facebook