PhilHealth expands coverage for heart surgeries up to P1M

EFFECTIVE March 1, 2025, the Philippine Health Insurance Corp. (PhilHealth) is expanding its Z Benefits Package for open heart surgeries and introducing a new package for heart valve repair and replacement, reinforcing its commitment to cardiovascular health.

Cardiovascular disease (CVD) is the leading cause of mortality in the Philippines, with 32 percent of global deaths attributed to CVDs. In response, PhilHealth has significantly increased coverage for key open-heart surgeries: Coronary Artery Bypass Graft (CABG) now ranges from P660,000 to P960,000 (previously P550,000); Closure of Ventricular Septal Defect (VSD) from P498,000 to P614,000 (previously P250,000); and Total Correction of Tetralogy of Fallot (TOF) up to P614,000 (previously P320,000).

PhilHealth also launched a new Z Benefits Package for Heart Valve Repair and Replacement, covering P642,000 to P810,000, along with cardiac rehabilitation at P15,000 (adult) and P6,500 (pediatric). Patients with rheumatic fever/heart disease undergoing these treatments may enroll in the outpatient benefit package for secondary prevention.

BETTER BENEFITS PhilHealth has significantly increased coverage for key open-heart surgeries. IMAGE FROM PHILHEALTH

Qualified members and dependents can avail of these benefits without co-payments in ward accommodations at PhilHealth-contracted facilities. These initiatives support President Ferdinand Marcos Jr.'s goal of expanding health care access nationwide. As of December 2023, 131 specialty centers have been established.