PhilHealth boosts breast cancer benefit to P1.4M

THE Philippine Health Insurance Corp. (PhilHealth) has increased the benefit package for breast cancer to P1.4 million from the previous P100,000.

This will go a long way in helping the numerous Filipinos of both sexes who are fighting the disease.

According to the Department of Health, citing the Philippine Cancer Society, the breast is the top cancer site for both men and women, with a whopping 65 percent of breast cancer cases diagnosed already at the advanced stage.

However, the state insurer announced Monday, April 8, 2024, that under PhilHealth Circular 2024-0007, the enhanced Z Benefit Package now covers Stages 0 to 4 of breast cancer as well as expanded the eligibility of members who can avail themselves of the benefit to include patients already undergoing treatment for this illness.

The increased benefits took effect on March 30, 2024.

In a statement, PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. said the breast cancer treatment package covers “diagnostic tests, breast cancer management up to surveillance or assessment for early signs of relapse after the surgery.”

The package rates for diagnostic tests and prognostication range from P1,000 to P10,000; surgical procedures from partial mastectomy to modified radical mastectomy range from P30,000 to P140,000; hormono-therapy, P2,700 or P18,000; cytotoxic chemotherapy, P43,000 to P185,010.

“The bulk of the package goes to targeted therapy amounting to more than P1 million coverage, which translates to P333,336 for 18 maximum cycles,” the insurer said.

The package for surveillance ranges from P5,000 to P9,000.

Those wishing to avail themselves of the enhanced Z Benefit Package for breast cancer were advised to contact the Z Benefits coordinator of any of the 21 contracted health facilities for guidance on pre-authorization procedures up to the cost-sharing aspect of the treatment, if any.

However, the insurer emphasized that for patients admitted in basic or ward-type accommodation, no co-payment shall be charged for the services provided to them.

The state insurer is still encouraging more health facilities capable of rendering specialized care to enter into a contract with PhilHealth to provide the specialized care for the Z Benefits, to make it more accessible to patients needing the treatment.

According to the Philippine Statistics Authority, citing the World Health Organization, cancer was the second leading cause of deaths in the Philippines in 2022. The majority of those who died of cancer suffered from lung, breast and liver cancers.