The Philippine Health Insurance Corp. (PhilHealth) has increased its benefit packages for heart disease by up to 1,629%.
Under Circular 2024-0032, released December 21, 2024 and made public January 2, 2025, PhilHealth stated that hospitalized Filipino members with ischemic heart disease and acute myocardial infarction or heart attack will receive increases in two of its benefit packages.
Ischemic heart disease is caused by reduced blood flow to the heart.
The previous coverage of P30,300 for percutaneous coronary intervention, a procedure to remove blockages and plaque in the veins without surgery, has been increased by PhilHealth to P523,853. This is seventeen times higher than the former amount covered by PhilHealth for this procedure.
This can be performed in any of the 70 PhilHealth accredited catheterization laboratories in the country.
The second enhanced package for heart disease is fibrinolysis, a treatment that dissolves blood clots. The former PhilHealth coverage of P30,290 will now be raised to P133,500, an increase of 341% from its previous case rate.
The benefit package for emergency medical services, which includes coordinated referral and inter-facility transfers, has also been raised to P21,900 and cardiac rehabilitation to P66,140.
These benefit packages cover payments to hospitals or healthcare facilities and the attending physician. They also include emergency care, medications, laboratory tests, medical supplies, equipment, and other administrative fees.
These can be implemented in all accredited public and private health facilities at Levels 1, 2, and 3, equipped with the necessary medical apparatus and treatment procedures.
PhilHealth President Emmanuel Ledesma Jr. said this was done with the aid of healthcare facilities, especially as heart disease cases rose during the last Christmas season, according to the Department of Health (DOH).
"There should be no co-payment for inpatient admissions in both public and private hospitals," Ledesma stated, implying that heart disease patients should no longer have to pay additional fees when hospitalized due to the increased rates of the benefit packages.
Ledesma also encouraged PhilHealth members to take advantage of the Consultation services or free consultations to prevent serious illnesses from developing early on.
Consultation services are not only for doctor consultations but also provide assistance with laboratory and diagnostic tests and medication.
