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Manila Bulletin devider Philippines devider National devider PhilHealth raises heart surgery coverage to P1M effective this month

PhilHealth raises heart surgery coverage to P1M effective this month

Published Mar 4, 2025 09:03 am

Reinforcing its commitment to providing financial protection for cardiovascular health, the Philippine Health Insurance Corporation (PhilHealth) announced that it is implementing a significantly expanded Z Benefits Package for open-heart surgeries and a newly developed package for heart valve repair and replacement.

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(PhilHealth / Manila Bulletin) 

PhilHealth said the expanded package is effective March 1, 2025.

PhilHealth President and Chief Executive Officer (CEO) Dr. Edwin M. Mercado said President Marcos and PhilHealth share the goal of bringing benefits—especially specialty services—closer to Filipinos in all regions.

This, Mercado added, also aligns with the objective of the Department of Health (DOH) to improve hospital standards nationwide.

Expanded package for cardiovascular disease

PhilHealth noted that cardiovascular disease (CVD) is the leading cause of mortality in the Philippines.

Globally, PhilHealth cited data from the World Health Organization (WHO) indicating that 32 percent of deaths are attributed to CVDs.

In response to this growing health concern, PhilHealth has substantially increased the packages for open-heart surgeries, including:

Coronary Artery Bypass Graft (CABG): From P550,000 to a range of P660,000 to P960,000
Closure of Ventricular Septal Defect (VSD): From P250,000 to P498,000 to P614,000
Total correction of Tetralogy of Fallot (TOF): From P320,000 to up to P614,000
Additionally, PhilHealth said it has launched a new Z Benefits Package for heart valve repair and replacement, ranging from P642,000 to P810,000. This also includes cardiac rehabilitation packages at P15,000 for adult cases and P6,500 for pediatric cases.

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

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

These initiatives, PhilHealth said, reinforce its commitment to making essential healthcare services more accessible to all Filipinos, supporting President Marcos’ thrust to expand access to medical care for all communities.

In his first State of the Nation Address (SONA), the President said: “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, PhilHealth reported the establishment of 131 specialty centers nationwide.

Related Tags

PHILHEALTH CEO Cardiovascular disease President Marcos Philhealth coverage DOH
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