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PhilHealth Expands Heart Disease Coverage to Reduce Patient Costs

Krystal by Krystal
13/02/2025
in News
PhilHealth Expands Heart Disease Coverage to Reduce Patient Costs

The Philippine Health Insurance Corporation (PhilHealth) has announced an expansion of its benefit packages for heart disease treatments, aiming to alleviate the financial burden on patients and improve access to critical medical care.

The new coverage, which specifically addresses Ischemic Heart Disease-Acute Myocardial Infarction (IHD-AMI), was detailed by Janette Manaois, Chief of the Benefits Administration Section of PhilHealth Ilocos, during the Kapihan sa Bagong Pilipinas event on February 11 in San Fernando City, La Union.

“The newly introduced PhilHealth benefit for IHD-AMI offers coverage ranging from P21,900 to P523,853, depending on the medical services required,” Manaois explained.

PhilHealth’s move to expand coverage comes in response to the high financial burden posed by IHD-AMI, a condition recognized for its significant impact on public health. The expanded package is designed to ensure that patients can access life-saving treatments without facing excessive out-of-pocket costs.

Expanded Coverage Details

The expanded IHD-AMI benefit package, which became effective on December 21, 2024, includes a variety of services aimed at supporting patients through critical stages of heart disease treatment. The covered services are as follows:

  • Emergency Medical Services with Coordinated Referral and Interfacility Transfer (P21,900)
  • Cardiac Rehabilitation (P66,140)
  • Fibrinolysis (P133,500)
  • Percutaneous Coronary Intervention (PCI) (P523,853)

Manaois emphasized that these services are available at PhilHealth-accredited Level 1 to Level 3 hospitals, both public and private, provided the facilities are equipped to handle the necessary procedures. A full list of accredited health facilities can be found on PhilHealth’s official website at https://www.philhealth.gov.ph/partners/providers/facilities/accredited/.

Under Republic Act No. 11223, also known as the Universal Health Care Act, all Filipino citizens are automatically enrolled in the National Health Insurance Program (NHIP), making them eligible for the newly expanded IHD-AMI benefits.

Streamlined Claims Process

PhilHealth has also simplified the claims process. The requirement for a printed copy of the Member Data Record (MDR) has been eliminated, and accredited health facilities are now required to apply PhilHealth benefits at the time of patient discharge, regardless of the day of the week.

As February marks Philippine Heart Month, PhilHealth’s expansion of coverage aligns with the observance by ensuring that more Filipinos have access to affordable heart disease treatments.

By reducing financial barriers and improving claims efficiency, PhilHealth underscores its commitment to enhancing the health and well-being of Filipinos. In critical moments, where every second and every peso counts, this move provides essential support to those battling heart disease.

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Krystal

Krystal

Krystal is a Registered Nutritional Therapist. She is passionate about all things gut-related and her master's thesis examined the role of the microbiome in cardiovascular outcomes. Krystal has over 7 years of experience working at leading nutrition schools in the United States and Canada.

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