QUEUE FOR BENEFITS Members of PhilHealth visit the state insurer’s office in Quezon City, shown in this 2023 photo, to inquire about their benefits. —Grig C. Montegrande
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) has substantially increased the benefit packages for members who get confined for heart ailments to up to P500,000 in some cases.
Circular No. 2024-0032 signed by PhilHealth president Emmanuel Ledesma Jr. on Dec. 18 raised the health packages for ischemic heart disease-acute myocardial infarction (IHD-AMI), which were previously at P18,900.
For patients admitted for IHD-AMI and needing percutaneous coronary intervention (PCI), the reimbursement rate is now P523,853. The PCI is a nonsurgical, minimally invasive procedure to relieve the narrowing of the coronary artery, usually by ballooning the narrow segment or deploying a stent to keep the artery open. It is a combination of coronary angioplasty with stenting.
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On the other hand, the case rate for those who need fibrinolysis—treatment to break up the blood clots in the coronary artery to restore blood flow—has been raised to P133,500; while those who need emergency medical services with coordinated referral and interfacility transfer can avail themselves of a package worth P21,900.
Benefit package
Those needing cardiac rehabilitation are entitled to a package totaling P66,140. The medically supervised program is designed to improve the cardiovascular health of those recovering from a heart attack, heart failure, or other heart problem that required surgery or medical care. This includes exercise counseling and training, education for heart-healthy living and counseling to reduce stress.
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The new IHD-AMI packages took effect on Dec. 21.
“PhilHealth identified IHD-AMI as one of the priority conditions for improving financial coverage and protection against catastrophic health-care expenditure during illness,” the state health insurer said.
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The average cost of treatment for heart attack is around P1 million—around P100,000 for the initial diagnosis; P500,000 for treatment and procedures upon hospital admission; and P400,000 for postsurgery rehabilitation. The IHDs refer to heart damage caused by narrowed or blocked arteries, usually due to a buildup of fat, cholesterol and other substances.
When arteries narrow, less blood and oxygen reach the heart muscle, which can lead to acute myocardial infarction or a heart attack. Prompt treatment is needed to prevent death.