🏥 YAKAP & GAMOT Program Guide
✨ What You Get:
Free health check-ups, cancer screenings, laboratory tests, plus 75 essential medicines worth ₱20,000 per year!
📖 What are YAKAP & GAMOT?
YAKAP (Yaman ng Kalusugan Program) is PhilHealth's enhanced primary care package that replaced the older Konsulta program in July 2025. Instead of just treating illness, YAKAP focuses on preventing sickness through regular check-ups and early detection of health problems.
GAMOT (Guaranteed and Accessible Medications for Outpatient Treatment) is PhilHealth's medicine benefit program launched in August 2025. It provides free essential medicines for common health conditions, so you don't have to spend your own money on prescriptions.
👥 Who Can Join YAKAP?
✅ You CAN join if you are:
- Any Filipino with active PhilHealth membership
- A dependent registered under a PhilHealth member
- A foreign national with valid PhilHealth contributions
Simply put: Every Filipino is welcome in YAKAP!
🎁 What Services Are Covered?
YAKAP Clinic Services
- Routine health check-ups
- Health screenings
- Basic laboratory tests
- Health education and counseling
Cancer Screening Tests
- Mammograms (breast cancer)
- Breast ultrasound
- Liver ultrasound
- Colonoscopy (colon cancer)
- Low-dose chest CT (lung cancer)
GAMOT Medicines
- 75 essential medicines
- ₱20,000 annual limit
- Zero co-payment
- For common conditions
� GAMOT Medicines Coverage
🦠 Infections
Antibiotics and antivirals for respiratory and other infections
🫁 Respiratory
Inhalers and medications for asthma and COPD
🍯 Diabetes
Insulin and oral medications for blood sugar control
❤️ Heart & Blood Pressure
Medications for hypertension and heart conditions
🧠 Neurological
Medicines for nervous system disorders
💊 Others
Cholesterol medications, vitamins, and supportive treatments
📋 Important: Only medicines on PhilHealth's official GAMOT list are covered. Ask your doctor for alternatives if your usual medicine isn't on the list.
💰 GAMOT Annual Benefits
₱20,000 per person per year
- Each PhilHealth member gets ₱20,000
- Each dependent gets their own ₱20,000
- Resets every January 1
- Track your balance through the GAMOT Availment Slip
👨👩👧👦 Family Example:
Family of 4 with PhilHealth = ₱80,000 total in GAMOT benefits per year
- Father: ₱20,000
- Mother: ₱20,000
- Child 1: ₱20,000
- Child 2: ₱20,000
� How to Join YAKAP (Step-by-Step)
1
Register at a YAKAP Clinic
You can register through:
- 🌐 PhilHealth Member Portal online
- 📱 eGovPH mobile app
- 🏢 Any PhilHealth local office
- 🏥 Directly at an accredited YAKAP clinic
Bring: Your PhilHealth ID number and valid ID
2
Schedule Your First Patient Encounter (FPE)
This is your comprehensive health check-up where the doctor will:
- Check your vital signs
- Review your medical history
- Order basic laboratory tests
- Create your personalized health plan
3
Follow Your Doctor's Recommendations
Your doctor may recommend:
- 💊 Medicines (prescribed via GAMOT app)
- 🔬 Additional tests or cancer screenings
- 👨⚕️ Follow-up consultations
- 🏥 Referrals to specialists if needed
💰 How Much Does It Cost?
🆓 Completely FREE at Public Clinics
- All consultations and check-ups
- All laboratory tests
- All cancer screening tests
- No hidden fees or charges
💰 Minimal Fee at Private Clinics
Only ₱900 per year for private YAKAP clinics
This is separate from your GAMOT medicine allowance
📞 Need Help?
📞 PhilHealth Hotline
(02) 866-225-88
📧 Email Support
actioncenter@philhealth.gov.ph
🏢 Local Office
Visit your nearest PhilHealth office
❓ Frequently Asked Questions
PhilHealth YAKAP & GAMOT — Organized Q&A (fact-checked as of August 24, 2025)
1) Program basics
What are YAKAP and GAMOT, in plain words?
YAKAP (Yaman ng Kalusugan) is PhilHealth’s expanded primary-care package (rebranded from Konsulta) that covers clinic consults, basic labs, and selected screenings. GAMOT is the outpatient medicines benefit under YAKAP; PhilHealth pays for a defined list of drugs (75 items) with an annual benefit limit (ABL) of ₱20,000 per beneficiary at accredited facilities.
Who can avail of YAKAP and GAMOT?
Active PhilHealth members and their duly registered dependents (as per PhilHealth membership rules). Registration with an accredited YAKAP clinic is required before using benefits.
When did GAMOT start and when can members begin using it?
PhilHealth announced the expanded GAMOT with a ₱20,000 ABL in August 2025; public guidance and reports state availment began around August 21, 2025.
What medicines are covered?
Only those listed in PhilHealth Circular PC 2025-0013 (Annex A) are covered (75 essential outpatient medicines across common conditions).
2) Eligibility & registration
Do I need to register separately for GAMOT?
No. Enroll in a YAKAP clinic (via Member Portal, eGovPH, LHIO, or at the clinic). If medicines are needed, the doctor issues a GAMOT App prescription.
Should I schedule before going to YAKAP clinics? How?
Scheduling is recommended. Register with an accredited YAKAP clinic through the Member Portal/eGovPH or LHIO, then book your First Patient Encounter (FPE). Some clinics accept walk-ins.
If I haven’t contributed for years and activate now, am I eligible?
Eligibility depends on your membership category and contribution rules. Settle missed payments as required; confirm exact rules with your LHIO.
3) Benefits & coverage
How much does GAMOT cost me? Any co-pay?
Covered medicines have zero co-pay at accredited GAMOT facilities until the ₱20,000 ABL is used; after that, you pay out of pocket.
Will I pay anything at a private YAKAP clinic?
Public clinics are free. Private YAKAP clinics may charge a nominal annual co-payment (commonly ₱900). This is paid out-of-pocket and is not deducted from your ₱20,000 GAMOT allowance.
Does GAMOT cover medicines given during hospital stays (inpatient)?
No. GAMOT is for outpatient prescriptions only. Inpatient drugs are handled under PhilHealth’s inpatient benefits/case rates.
Can children, pregnant women, seniors, and PWDs use GAMOT?
Yes—if they are eligible members or registered dependents, the medicine is on the GAMOT list, and the process is followed.
What if the medicine my doctor orders is not on the GAMOT list?
It is not covered. Ask about an approved alternative, pay out-of-pocket, or consult PhilHealth/LHIO for any case-specific options. (Philippine Information Agency)
4) Process to avail (step-by-step)
YAKAP — what are the steps?
(1) Confirm membership and PhilHealth Identification Number (PIN). (2) Register with an accredited YAKAP clinic. (3) Attend your FPE. (4) Follow your care plan and referrals.
GAMOT — what are the steps?
(1) Get a GAMOT App prescription (with a Unique Prescription Security Code or UPSC). (2) Bring the prescription and a valid ID to an accredited GAMOT facility. (3) The pharmacy validates and dispenses; you sign the GAMOT availment slip; keep your records.
What documents do I need when availing medicines?
Your GAMOT App prescription (printed or digital from the providers only) showing the UPSC, plus a valid government-issued photo ID.
What is the UPSC and why is it important?
The Unique Prescription Security Code is generated by the GAMOT App (this is not an actual public app, it's for the providers' use only) to identify each prescription; facilities validate it to prevent duplicate or fraudulent claims.
How long a supply can be prescribed? (refills/quantities)
Quantities and refill intervals follow GAMOT dispensing rules in PC 2025-0013. Maintenance medicines may be dispensed in multi-month quantities where allowed; short-course drugs follow full-course rules. Check the circular for exact limits. (Philippine Information Agency)
How do I check my remaining ₱20,000 balance?
After each dispense, the facility issues a GAMOT Availment Slip (GAS) showing the amount used and remaining ABL; keep this and your receipts. You may also contact PhilHealth for assistance.
5) Providers & facilities
Where can I get GAMOT medicines?
At PhilHealth-accredited GAMOT Facilities (participating retail pharmacies, hospital pharmacies, or accredited primary-care clinics with dispensing capacity). Look for official signage or check PhilHealth lists (on their fb page or website).
If one GAMOT pharmacy has no stock, can I go to a different one?
Yes. A valid GAMOT prescription may be filled at any accredited GAMOT Facility, subject to validity and dispensing rules.
Can I claim GAMOT without visiting a YAKAP clinic?
No. You need an authorized GAMOT App prescription from an accredited prescriber (usually following a YAKAP consultation).
If the YAKAP clinic refers me for lab tests, where can I do them? What if the referred lab is closed?
Labs covered by YAKAP must be done at PhilHealth-accredited facilities. If the referred lab is closed, you may go to another accredited facility; bring the official referral/order (the clinic can re-issue or update it).
6) Troubleshooting & safeguards
What should I do if a pharmacy refuses to accept my GAMOT prescription?
Ask for a written reason and the facility manager’s contact. If not resolved, report to PhilHealth with your prescription and receipts.
Is there a risk of duplicate/fraudulent dispensing? How is it prevented?
PhilHealth uses the GAMOT App, UPSC, electronic transaction tracking, the GAMOT Availment Slip, and audits. Violations may lead to sanctions.
If I already paid for medicines earlier this year, can I get reimbursed now that GAMOT started?
Retroactive reimbursement is not automatic. Keep receipts and consult your LHIO or PhilHealth for case-specific guidance.
7) Coordination & other
Can private insurers or other programs be coordinated with GAMOT?
Yes. PhilHealth is the primary payer up to the ABL; coordinate with private coverage for any remaining costs.
Who do I contact for help?
PhilHealth Action Center (02) 866-225-88, actioncenter@philhealth.gov.ph; your LHIO/PRO; or the Member Portal/eGovPH.
Where can I read the official rules and the full medicines list?
PhilHealth Circular PC 2025-0013 (GAMOT) and its annexes on the PhilHealth circulars page; see the official YAKAP page for program details and updates. (Philippine Information Agency, PhilHealth)
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