Expanded benefits greet PhilHealth members for 2025

The Philippine Health Insurance Corporation (PhilHealth) announced the launch of new and expanded health benefit packages on Friday, aiming to provide enhanced support for its members beginning this year. 

PhilHealth President and CEO Emmanuel Ledesma Jr. stated that the necessary policy instruments and circulars for these benefits have already been issued. 

The new packages include coverage for ischemic heart disease-acute myocardial infarction, Z Packages for peritoneal dialysis and kidney transplantation, preventive oral health services, outpatient emergency care, and a 50% increase in case rate packages.

Ledesma emphasized that these initiatives aim to ease the financial burden on Filipino patients and ensure timely access to essential medical services such as hospitalization, diagnostic tests, procedures like angioplasty, and critical medications. 

The ischemic heart disease-acute myocardial infarction package now offers expanded coverage, including percutaneous coronary intervention or coronary angioplasty, which has increased from P30,000 to P524,000. 

Other components include fibrinolysis treatment, now raised to P133,500; emergency medical services with interfacility transfer, valued at P21,900; and cardiac rehabilitation following PCI, with coverage set at P66,140.

PhilHealth is also advocating for the use of peritoneal dialysis (PD) as a primary treatment option for end-stage renal disease, citing its flexibility and potential to improve patients’ quality of life. 

The Z Package for PD now includes continuous ambulatory peritoneal dialysis (CAPD), with coverage increasing by up to 89%, depending on the required solutions. Pediatric patients can now access CAPD and automated peritoneal dialysis (APD) packages, with coverage ranging from P510,000 to P1.2 million. 

Members are also eligible for infection prevention care at 51 accredited PD providers nationwide. 

Additionally, the Z Package for kidney transplantation has been expanded to include living organ donor procedures, with coverage exceeding P1 million, and deceased organ donor transplantation is now set at P2.14 million.

Preventive oral health services have also been integrated into primary care, offering dental check-ups, cleaning, fluoride varnish application, sealants, minor restorations, and emergency tooth extractions. 

Furthermore, the new outpatient emergency care benefit will cover urgent treatments that do not require hospitalization, including life-threatening medical emergencies.