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PhilHealth expands coverage for heart surgeries up to P1 million

  • BULGAR
  • Mar 3, 2025

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. ###  


  



 
 

PhilHealth reinforces support for Filipinos living with HIV/AIDS

  • BULGAR
  • Feb 27, 2025

by Info @Brand Zone | Feb. 27, 2025



PhilHealth PR No. 2025-09 / February 27, 2025 


PhilHealth reaffirmed its commitment to supporting people living with HIV (PLHIV) by  providing increased financial access to essential healthcare through its comprehensive  outpatient HIV/AIDS treatment coverage. 


The enhanced Outpatient HIV Treatment (OHAT) Package now provides P58,500 in annual  benefit, a 95% increase from the previous P30,000. The package includes antiretroviral  therapy (ART) for all individuals with confirmed positive HIV test results confirmed by certified  institutions, regardless of their clinical or immunologic status. It also ensures access to all  minimum essential services necessary for effective HIV management. 


This enhancement is aligned with President Ferdinand R. Marcos, Jr.’s directive to  continually improve and sustain health insurer’s healthcare benefits by ensuring adequate  financial support to patients seeking medical treatment. In his second State of the Nation  Address, the President emphasized that “The whole of society must exert efforts to suppress  the alarming rise of tuberculosis and HIV/AIDS. To stem the tide, the strategic plan is to  ensure early diagnosis and treatment, and ample testing sites and medications.” 


The OHAT Package can be accessed through any of the 234 PhilHealth-accredited DOH designated HIV Treatment facilities nationwide. With this improved OHAT Package,  PhilHealth not only hopes to support PLHIV members to seek appropriate management but  also to reassure and encourage other PhilHealth members to sign up for regular testing.  


The state-insurer also emphasized that a separate package for TB-DOTS may be  reimbursed at accredited TB-DOTS facilities. Members may avail of both the OHAT and TB DOTS packages simultaneously. 


In 2024, PhilHealth disbursed a total of P1.66 billion for 176,819 Outpatient HIV/AIDS  Package benefit claims. 


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.




 
 

PhilHealth chief meets with hospital groups to increase access points and address provider concerns

  • BULGAR
  • Feb 20, 2025

by Info @Brand Zone | Feb. 20, 2025



PhilHealth PR No. 2025-08 | February 20, 2025 | Reference:  Dr. Israel Francis A. Pargas


Pasig City, Philippines – The Philippine Health Insurance Corporation (PhilHealth), under the leadership of Acting President and CEO, Dr. Edwin M. Mercado, held a consultation meeting with the country’s leading private hospital groups and national associations. The brief meeting focused on PhilHealth’s commitment to improving its efficiency, addressing wastage, and optimizing processes to ensure that hospitals receive timely payments for their claims.


Attendees included heads and representatives from the Metro Pacific Health Corporation, Mount Grace Hospital Group, Unilab Foundation, AC Health, St. Luke’s Medical Center, The Medical City, Private Hospitals Association of the Philippines, Inc., and Philippine Hospital Association. 


Dr. Mercado and the hospital executives also mutually agreed to take on the challenge of increasing access points for primary care. The hospitals taking on primary care will facilitate the completion of Health Care Provider Networks (HCPNs) which will bring us closer to achieving Universal Health Care for every Filipino. 


“We recognize the significant role that private hospitals play in delivering quality healthcare services to Filipinos. We can only leverage their capacities when we build a sphere of trust and effective coordination”, said Dr. Mercado.


Next on his priority list to meet are the government hospitals, both DOH and LGU-managed. With continued stakeholder engagement across the public health community, we are creating a strengthened PhilHealth that can uplift healthcare financing in the Philippines.



 
 
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