The Philippine Health Insurance Corporation (PhilHealth) has boosted its Z Benefits Package for open heart surgeries and introduced a new package for heart valve repair and replacement, aiming to provide greater financial protection against cardiovascular diseases (CVDs), starting March 1.
This expansion comes as CVDs remain the leading cause of death in the Philippines, mirroring a global trend where 32% of deaths are attributed to these conditions, according to the World Health Organization (WHO).
PhilHealth has substantially increased coverage for key open heart procedures: Coronary Artery Bypass Graft (CABG) now ranges from P660,000 to P960,000, up from the previous P550,000; Closure of Ventricular Septal Defect (VSD) coverage has risen from P250,000 to between P498,000 and P614,000; and Total Correction of Tetralogy of Fallot (TOF) is now covered up to P614,000, which was increased from P320,000.
In addition, PhilHealth has launched a new Z Benefits Package for Heart Valve Repair and Replacement, offering coverage between P642,000 and P810,000. The agency has also introduced cardiac rehabilitation packages, providing P15,000 for adult cases and P6,500 for pediatric cases.
Patients with rheumatic fever or rheumatic heart disease undergoing these treatments can also access outpatient benefit packages for secondary prevention, as outlined in PhilHealth Circular 2019-0005.
Qualified PhilHealth members and their dependents can avail of these benefits without co-payments when admitted to ward accommodations in PhilHealth-contracted facilities nationwide.
These initiatives align with President Ferdinand R. Marcos Jr.’s directive to expand access to medical care for all Filipinos. “We must bring medical services to the people and not wait for them to come to our hospitals and health care centers,” the President stated in his first State of the Nation Address.
As of December 2023, 131 specialty centers have been established across the country.
“PhilHealth, under President Ferdinand R. Marcos Jr., is committed to bringing benefits, especially specialty services, closer to Filipinos in all regions,” said PhilHealth President and CEO, Dr. Edwin M. Mercado. “This aligns with the Department of Health’s goal to improve hospital standards nationwide.”