Pinalawak na benepisyo para sa operasyon ng katarata ng PhilHealth

ni Fely Ng @Bulgarific | Mar. 8, 2025

Hello, Bulgarians! Simula Enero 30, 2025, ipinatupad ng Philippine Health Insurance Corporation (PhilHealth) ang pinalawak nitong benepisyo para sa operasyon sa katarata kasama ang paglalagay ng intraocular lens (IOL) para sa matatanda at bata.

Ito ay sang-ayon sa direktiba ni Pangulong Ferdinand R. Marcos, Jr. na palawakin pa ang mga serbisyong pangkalusugan ng PhilHealth.

Batay sa PhilHealth Circular 2025-0001 na inilathala noong Enero 15, 2025, ang benepisyo para sa operasyon sa katarata sa mga matatanda ay tumaas nang higit sa apat na beses at nagsisimula sa P20,200. 

Ang benepisyo ay depende sa uri ng lens, kung saan ang mga operasyon na gagamitan ng monofocal IOL o standard lens ay may halagang P28,300 bawat mata. Ang mga premium lens naman tulad ng monofocal toric IOL na nagbibigay ng malinaw na paningin sa isang partikular na distansya habang inaayos ang astigmatism ay sasagutin sa halagang P43,800 bawat mata. 

Samantala, ang multifocal IOL na tumutulong makakita ng malinaw sa malapit at malayo ay may halagang P66,900 bawat mata, habang ang multifocal toric IOL na nag-aayos ng astigmatism at nagbibigay ng malinaw na paningin sa iba’t ibang distansya ay sagot ng ahensya sa halagang P80,900 para sa kanang mata.

Samantala, ang coverage para sa operasyon ng katarata sa mga bata ay umaabot ng hanggang P135,000 bawat mata at P139,050 para sa parehong mata. Kung kasama ang intraocular lens, ang coverage ay nasa P179,000 bawat mata at P187,100 para sa parehong mata.

Dating nagbabayad ang ahensya ng P16,000 bawat mata para sa pagtanggal ng katarata sa matatanda at bata.

Nananawagan ang ahensya sa mga accredited healthcare facilities na panatilihing may sapat na supply ng Intraocular lenses, gamot sa mata, IV fluids, at iba pang mga kagamitan upang masigurong hindi na kailangang gumastos ng pasyente sa pagbili ng gamot sa labas ng pasilidad.

Sa buong 2024, ang PhilHealth ay nakapagbayad ng kabuuang P3.58 bilyon para sa 224,209 na operasyon sa katarata.

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Para sa anumang impormasyon, opinyon, isyu o maging imbitasyon, mag-e-mail sa bulgarific@gmail.com o sumulat kay Ms. Bulgarific at ipadala sa Bulgar Bldg., 538 Quezon Avenue, Quezon City.

New benefit in focus: PhilHealth Outpatient Mental Health Package to support “invisible” pains of Filipinos

by Info @Brand Zone | Mar. 5, 2025

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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.### 

#Rise30

#SamasamangPagangatParaSaBagongPilipinas

PhilHealth expands coverage for heart surgeries up to P1 million

by Info @Brand Zone | Mar. 3, 2025

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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. ###  

https://www.philhealth.gov.ph/circulars/2025/PC2025-0004.pdf 

https://www.philhealth.gov.ph/circulars/2025/PC2025-0005.pdf 

#Rise30 

#SamasamangPagangatParaSaBagongPilipinas