15/02/2025
LAMANG ANG MAY ALAM: PLEASE SHARE!!!!
PHILHEALTH: New and Enhanced benefit packages for 2025:
1) Ischemic Heart Disease – Acute Myocardial Infarction:
• Percutaneous Coronary Intervention (PCI): Coverage increased to ₱524,000 from ₱30,300.
• Fibrinolysis: Coverage increased to ₱133,500 from ₱30,290.
• Emergency Medical Services with Coordinated Referral and Interfacility Transfer: New package at ₱21,900.
• Cardiac Rehabilitation after PCI: New package at ₱66,140. Effective December 21, 2024.
2) Z Package for Peritoneal Dialysis (PD):
• For Adults (Continuous Ambulatory Peritoneal Dialysis - CAPD): Coverage set at ₱389,640 and ₱510,140, depending on the required PD solutions per day.
• For Pediatric Patients:
• CAPD: Coverage at ₱510,000 and ₱765,210.
• Automated Peritoneal Dialysis (APD): Coverage ranges from ₱763,000 to ₱1.2 million.
• Additional Coverage: PhilHealth also pays for exit site infection and peritonitis prevention care. Effective January 1, 2025.
3) Z Package for Kidney Transplantation:
• Living Organ Donor Transplantation: Coverage increased to over ₱1 million from ₱600,000.
• Deceased Organ Donor Transplantation: Coverage set at ₱2.14 million. Effective January 1, 2025.
4) Preventive Oral Health Services:
• Included Services: Mouth examination, dental prophylaxis (cleaning), fluoride varnish application, pit and fissure sealants, Class V restoration procedures (limited to two teeth per year), and emergency tooth extractions when necessary and performed in accredited health facilities. Effective December 28, 2024.
5) Outpatient Emergency Care Benefit (OECB):
• Coverage Includes:
• Facility-Based Emergency: Emergency procedures and services for patients who do not require hospitalization.
• Diagnostic Services: Includes X-rays, CT scans, nebulization, and blood tests.
• Land Ambulance Services: Reimbursement for land ambulance services, with plans to expand coverage to sea and air ambulances. Effective January 11, 2025.
6) Outpatient Therapeutic Care Benefits for Severe Acute Malnutrition (SAM):
• Coverage: Free treatment and care for children 60 months old or younger who have severe acute malnutrition. Effective January 1, 2025.
7) Optometric Services for Children (0 to 15 years):
• Coverage Includes: Vision assessments and prescription glasses for children ages 0 to 15. Effective January 1, 2025.
8) Physical Medicine, Rehabilitation, and Assistive Mobility Services:
• Coverage Includes: Physical medicine, rehabilitation services, and assistive mobility devices. Effective January 1, 2025.
9) 50% Adjustment in Case Rates Packages:
• Examples:
• Moderate-Risk Pneumonia: Increased from ₱19,500 to ₱29,250.
• Caesarean Section: Increased from ₱24,700 to ₱37,050.
• Cholecystectomy: Increased from ₱40,300 to ₱60,450. Effective January 1, 2025.