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by Info @Brand Zone | Mar. 14, 2025



Council Members consist of Dr. Tessa Tan-Torres Edejer, health economist who served as  the Coordinator of the Unit on Costs, Effectiveness, Expenditure and Priority Setting in the  Department of Health Financing and Governance (HGF), WHO in Geneva; Dr. Carlo Irwin  A. Panelo, health systems, policy and financing expert; Honesto A. Nuqui, Jr., actuary,  mathematician, and seasoned insurance executive; Dr. Michael L. Tee, university professor,  scientist, and chancellor; Dr. Valerie Gilbert T. Ulep, health economist and well-published  senior research fellow; Dr. Vivencio Jose Villaflor, a practicing surgeon and seasoned  hospital administrator; and Henry Aguda, information technology and digital transformation  expert.

.PhilHealth PR No. 2025-15 | March 13, 2025 | Reference:  Dr. Israel Francis A. Pargas


The PCEO Mercado convened the Technical Advisory Council (TAC) for its second meeting  on March 10, 2025. The session focused on improving actuarial assumptions and refining  the disease coverage selection process. 


During the meeting, experts discussed practical ways to strengthen actuarial projections that  will directly benefit PhilHealth members. The council emphasized the need for more detailed,  market-based assumptions that assess whether current healthcare providers can actually  deliver the covered services.  


"By improving our actuarial assumptions, we can better predict healthcare costs and  utilization patterns," explained the PCEO Mercado. "This means we can expand benefits in a  sustainable way while ensuring members can actually access the care we're promising." 


The TAC supported the President and CEO's direction to expand coverage for high-cost,  high-burden diseases to increase access to critical services. For members, this translates to  greater financial protection against catastrophic health expenses that previously caused  significant hardship for many Filipino families. 


"Going granular means understanding if our current healthcare infrastructure can deliver the  services we're covering, and developing strategies to create robust markets where they don't  exist. Ang ibig sabihin po nito, alam natin hindi lang kung nasaan ang mga doktor at iba pang  mga propesyonal, ngunit alam din natin kung ilang pasyente ang kaya nilang tingnan sa  isang araw nang hindi bumababa ang kalidad ng serbisyong pang-medikal," added the  PhilHealth President and CEO. "When we promise coverage for a condition, we want to  ensure our members can find qualified providers to deliver that care without excessive out of-pocket expenses or long travel times." 


Council members committed to developing a practical framework that will guide this  expansion while ensuring service delivery capability.



 
 

by Info @Brand Zone | Mar. 5, 2025



PhilHealth PR No. 2025-11 March 4, 2025


PhilHealth is committed to holistically addressing the healthcare needs of every Filipino. 

“Nais naming ipaabot na kahit hindi nakikita ang inyong daing, may PhilHealth na magbibigay ng suporta at alaga sa inyo. Ito po ay alinsunod sa mga prayoridad ng ating Pangulong Marcos,” said Dr. Edwin M. Mercado, PhilHealth Acting President and CEO.


Through the PhilHealth's Outpatient Benefits Package for Mental Health [PhilHealth Circular 2023-0018], members and dependents aged 10 and above, can now access services encompassing initial assessments, follow-up consultations, diagnostic tests, and psychosocial support. It covers conditions such as depression, psychosis, epilepsy, child and adolescent mental and behavioral disorders, dementia, and self-harm or suicide risks, among others. 


As such, those requiring specialized care are provided with access to interventions from psychiatrists, neurologists, and psychologists. PhilHealth provides annual coverage of Php 9,000 for general mental health services and Php 16,000 for specialized care. 


Members can access these benefits at any accredited facility that provides general mental health services. These facilities include rural health units (RHUs), city or municipal health offices, level 1 and 2 hospitals, Department of Health (DOH) Medicine Access Program-mental health access sites, and stand alone mental health clinics. 


On the other hand, specialized mental health services can be accessed at accredited Level 2 and 3 hospitals with specialized staff, custodial care facilities, and national specialty centers identified by DOH. 


"We recognize the importance of accessible mental health services for every Filipino. Kaya naman, katuwang din natin ang Kagawaran ng Kalusugan sa patuloy pang pagpapalawig ng ating mga serbisyo para sa kalusugang pangkaisipan. We are calling for more providers to participate and make these services within reach of Filipinos with mental health struggles," added Dr. Mercado. 


Beyond the Mental Health package, PhilHealth encourages individuals experiencing suicidal thoughts or mental health distress to utilize readily available 24/7 crisis hotlines, including the National Center for Mental Health hotline at 0917-899 8727 or 989-8727, for immediate counseling. 


PhilHealth remains committed to strengthening the nation's mental health service infrastructure and ensuring that quality care is accessible to all Filipinos needing them. For more questions on the MH benefit package and other benefits, members can call the following 24/7 touch points: (02) 866-225-88; mobile numbers 0998-857-2957, 0968-865-4670, 0917-1275987 or 0917-1109812.### 


 
 

by Info @Brand Zone | Mar. 3, 2025



PhilHealth PR No. 2025-10 March 1, 2025



Effective today, March 1, 2025, the Philippine Health Insurance Corporation’s (PhilHealth’s) significantly expanded Z Benefits Package for open heart surgeries and newly developed package for heart valve repair and replacement reaffirm the social health insurance’s commitment to provide financial protection for cardiovascular health 

Cardiovascular disease (CVD) is the number one cause of mortality in the Philippines.  Globally, 32% of deaths were reported to be due to CVDs (WHO). In response to this growing health concern, PhilHealth substantially increased the packages for the following open-heart surgeries: 


1. Coronary Artery Bypass Graft (CABG) ranging from P660,000 to P960,000 (previously  at P550,000) 

2. Closure of Ventricular Septal Defect (VSD) from P498,000 to P614,000 (previously at  P250,000) 

3. Total Correction of Tetralogy of Fallot (TOF) up to P614,000 (previously at P320,000) 


Additionally, PhilHealth has launched its new Z Benefits Package for Heart Valve Repair and Replacement ranging from P642,000 to P810,000. It also includes cardiac rehabilitation packages at P15,000 and P6,500 for adult and pediatric cases, respectively. 


Meanwhile, patients with rheumatic fever/ rheumatic heart disease undergoing these  treatments may be enrolled in the outpatient benefit package for secondary prevention in  accordance with PhilHealth Circular 2019-0005. 


Qualified PhilHealth members and dependents can avail of these benefits without co payments if admitted in ward accommodations of PhilHealth contracted facilities nationwide. 


These initiatives reinforce PhilHealth’s commitment to making essential healthcare services  more accessible to all Filipinos, in support of President Ferdinand R. Marcos Jr.’s thrust to  expand access to medical care for all communities. In his first State of the Nation Address,  PBBM stated that “We must bring medical services to the people and not wait for them to  come to our hospitals and health care centers.” 


As of December 2023, there are 131 specialty centers established nationwide.

"Kaisa ni Pangulong Ferdinand R. Marcos, Jr. ang PhilHealth sa layuning mailapit ang mga  benepisyo, lalo na ang mga specialty services sa mga Pilipino sa lahat ng rehiyon,” said  PhilHealth President and CEO, Dr. Edwin M. Mercado. “Ito ay naaayon sa layunin ng  Department of Health na pagbutihin ang antas ng mga ospital sa buong bansa.”, he added. 

For further inquiries on benefits and services, members may call PhilHealth’s 24/7 hotline at  (02) 866-225-88 or at mobile numbers (Smart) 0998-857-2957, 0968-865-4670, (Globe)  0917-1275987 or 0917-1109812. ###  


  



 
 
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