The Philippine Health Insurance Corporation (PhilHealth) has boosted its Z Benefit package for breast cancer to P1.4 million, marking a “1400 percent increase” from the previous package of P100,000, effective March 30, 2024.
Based on PhilHealth Circular 2024-0007, the enhanced Z Benefit package now encompasses stages zero to four of breast cancer.
It also broadens the eligibility criteria for members who can avail, extending coverage even to patients already undergoing treatment.
PhilHealth President and CEO Emmanuel Ledesma Jr. expressed the organization's commitment to delivering responsive benefits to Filipinos, stating, "This significant leap in the Z Benefits package for breast cancer is proof that PhilHealth is committed to delivering our mandate."
He stressed the holistic approach of the package, covering diagnostic tests, breast cancer management, and surveillance for early signs of relapse after surgery.
Ledesma highlighted that the guidelines stipulate varied package rates for mandatory services, depending on the doctor's recommendation and patient needs.
Diagnostic tests and prognostication range from P1,000 to P10,000; surgical procedures range from P30,000 to P140,000; hormonotherapy coverage is set at P2,700 or P18,000; and cytotoxic chemotherapy spans from P43,000 to P185,010.
Ledesma said that the bulk of the package is allocated to targeted therapy, exceeding P1 million, equivalent to P333,336 for 18 maximum cycles.
Surveillance, categorized into basic and specific services, ranges from P5,000 to P9,000.
Meanwhile, he said that to access the enhanced Z Benefit package for breast cancer, members or their qualified dependents are instructed to contact the Z Benefits coordinator of any of the 21 contracted health facilities for guidance on availing procedures.
PhilHealth underscored that “no co-payment” would be charged for services rendered to patients admitted in basic or ward-type accommodation.
Ledesma encouraged qualified health facilities to be contracted to provide this benefit, making it more accessible to patients in need and expressing hope for a positive impact on the country's healthcare system.