PhilHealth benefit for heart disease up by over fifteen-fold

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As Filipinos celebrate the holiday season, the Department of Health (DOH) recently called on people to prioritize their well-being by practicing moderation in their food intake and maintaining an active lifestyle. This is particularly important given that cardio-vascular diseases, specifically ischemic heart disease (IHD), remain the leading cause of death in the Philippines. 

To provide expanded financial coverage associated with heart disease treatment, the Philippine Health Insurance Corporation (PhilHealth) significantly increased its benefits coverage for Ischemic Heart Disease-Acute Myocardial Infarction (IHD-AMI) or “heart attack” for all inpatient admissions effective December 21, 2024. 

PhilHealth Circular No. 2024-0032 published on the same date provides coverage for (1) Percutaneous Coronary Intervention (PCI) at P524,000 from P30,300, an increase of 1,629 percent; (2) Fibrinolysis at P133,500 from P30,290 or a 900% increase; (3) Emergency Medical Services with Coordinated Referral and Interfacility Transfer at P21,900; and (4) Cardiac Rehabilitation after PCI at P66,140.

The expanded PhilHealth benefits packages for heart attack ensure that patients receive timely medical treatment by including emergency medical transport services to a capable health facility and all the medical interventions needed to ensure survival and good patient outcomes. 

“We understand the significant financial burden that heart disease can place on families,” said PhilHealth President and Chief Executive Officer Emmanuel R. Ledesma, Jr. “We have listened to the patients and their families, and with the cooperation of our partner health facilities, we have been able to determine the prevailing costs that led us to adjust and substantially increase our financial support in these life-saving treatments,” he added. 

The enhanced heart packages support a comprehensive range of services that include emergency medical services, medicines, laboratory and diagnostic tests, medical supplies, use of equipment, and pertinent administrative fees. In the case of percutaneous coronary intervention, the procedure can be availed of at any of the 70 accredited Cath Labs nationwide. 

The PhilHealth Chief reminded the members that there should be no co-payment for inpatient admissions in basic or ward accommodations in both public and private health facilities nationwide. 

“But we should not forget, heart ailments can be prevented. To support our members in their journey towards better health especially in the coming new year, we encourage everyone to avail of our primary care benefits under Konsulta,” urged Ledesma, specifying consultations with primary care physician, laboratory tests for early detection as well as medicines to support those that already have heart conditions, all for free. 

“Through the Konsulta, we can identify potential health risks early on, including family history of heart disease, allowing for timely interventions such as medication for cholesterol management and lifestyle advice, to prevent or mitigate the development of heart disease,”. He asked Filipinos to register to their Konsulta provider of choice at any of the local health insurance offices nationwide or through their own account in the PhilHealth Member Portal. 

By embracing a healthy lifestyle and by utilizing the Konsulta, Filipinos can better protect themselves from heart diseases for a healthier and productive future, he added.

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