PHILHEALTH EXPANDS COVERAGE FOR HEART SURGERIES UP TO P1 MILLION

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.