THE Philippine Health Insurance Corporation (PhilHealth) has created a benefit package for its members set to undergo open heart surgery.
In its Circular No. 2025-0004, PhilHealth assured its members and their dependents that open heart surgeries will now be covered up to P960,000.
The circular takes effect on March 1 after its publication in the Official Gazette or a newspaper of general circulation.
“This PhilHealth Circular aims to expand the coverage for open heart surgeries and ensure equitable access to quality healthcare services and financial risk protection,” said PhilHealth.
“All patients, who meet the clinical criteria, shall be eligible to avail of the Z Benefits package for open heart surgeries,” it added.
Under the benefit package, Coronary Artery Bypass Graft (CABG) Surgery – Expanded Risk will have a P960,000 package rate while Coronary Artery Bypass Graft Surgery – Standard Risk will have a P660,000 medical coverage.
PhilHealth said other related benefit packages include Closure of Ventricular Septal Defect (VSD) with or without Associated Special Conditions (P498,000); Closure of VSD with Severe Pulmonary Stenosis (P614,000); and Total Correction of Tetralogy of Fallot (P614,000).
For post-cardiac surgery benefits, there will be coverages for Cardiac Rehabilitation for post-CABG surgery (P54,000 for six sessions); Ancillary Services for post-CABG surgery: Laboratory/Diagnostic Tests (P12,140); and Cardiac Rehabilitation Services for post-VSD or TOF surgery (P6,500 for four sessions).
According to PhilHealth, cardiovascular diseases (CVDs) are the leading causes of death globally, with an estimated 32 percent of deaths due to CVDs in 2019.
In the Philippines, heart disease is the leading cause of death, accounting for 19.1 percent of all fatalities in 2023.
