MANILA -- PhilHealth President and CEO Emmanuel Ledesma Jr. on Friday announced that the enhanced Z Benefits Package for breast cancer--from P100,000 to the current P1.4 million--has been effective since March 30, 2024.

This is the first time that the said benefits for breast cancer have been increased since 2012.

"Iyong pinaka-mandato kasi namin is to really increase the benefit packages of the people to make it easier for them with regards to their medical expenses, to make their out of pocket expenses as low as possible... Talagang gagastusin namin ang pera ng PhilHealth, we will put it to good use," Ledesma said in a press conference.

He added that males can also get breast cancer--and they are also covered by the enhanced package.

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Exequiel Sy from the Special Benefits Team of PhilHealth's Benefits and Development Research Department explained that the previous benefits only included surgery, chemotherapy, and diagnostics up to breast cancer Stage 3A.

Now, the enhanced benefits cover diagnostics up to surveillance for all breast cancer stages (Stage 0 to 4). 

Rey Baleña, acting vice president of PhilHealth's Corporate Affairs Group, said benefits also include mammogram and ultrasound. 

"Para ma-avail itong mammogram tsaka breast ultrasound, pinakamaganda na ito ay i-avail na po sa mga contracted hospitals ng PhilHealth. Pagka doon kasi nila in-avail at - sabi nga kanina - kapag sa biopsy ay na-determine na kung anong stage ng kanilang breast cancer ay tuloy tuloy na silang ia-assist noong contracted hospital hanggang sa tuluyan nilang ma-avail iyong kabuuan ng pakete," he told reporters at the sidelines of the press conference. 

CONTRACTED HOSPITALS 

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Sy said there are currently 21 contracted health facilities, including East Avenue Medical Center in Quezon City and the Philippine General Hospital (PGH) in Manila. 

Region 8 and BARMM do not have contracted hospitals. 

Contracted hospitals are the accredited facilities that can deliver the benefit package being offered-- this case, breast cancer. 

Dr. Francisco Soria Jr., vice president of Quality Assurance Group, explained hospitals who want to be contracted for a certain benefit package should be accredited hospitals and must pay a "small accreditation fee". 

These should also have the capability to deliver facilities, the multi-disciplinary team to manage patients, along with a Z Benefits Package coordinator. 

Ledesma said, as much as they want more hospitals to immediately become contracted, they have "deliverables" that should be shown. 

He also asked the public to "give us a little more time" to address the lack of contracted hospitals in the regions and - even - nationwide. 

"Now that it's (benefits package) increased from P100,000 to P1.4 million, marami ng interest iyan, sigurado. It's just a matter of spreading it," he said. 

Baleña assured they are improving efforts to entice more hospitals to become contracted. 

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"Pinapaigting po natin iyong ating marketing efforts para mas marami pang ospital at pasilidad na magpa-contract with PhilHealth. Siyempre, iyong mga facilities na ito ay accredited na sa PhilHealth. Pero ibang level itong engagement na ito kaya tayo ay nakikipag-contract sa mga pasilidad," he said.

"So nag-aanyaya tayo sa mga public and private facilities na qualified at capable na magpa-contract na po sa PhilHealth, nang sa gayon maging accessible sa mas maraming mga kababayan natin itong pinagbuting Z Benefit Package ng PhilHealth," he added. 

But why did it take 12 years to enhance benefits for breast cancer coverage? 

Merla Rose Reyes, head of PhilHealth's Special Benefits Team, shared this has been in the works since 2014, but it all boiled down to "priorities". 

"It's not really only now. We tried to adjust the package rates. As early as 2014, nag-propose na po kami ng increase in the package rates kasi nakita na kulang. Pero hindi po kasi na-prioritize at that time. Depende po sa priorities ng management, so we're really glad and fortunate to have supportive management ngayong taon na ito," she said during the press conference. 

Interested patients or their families may call PhilHealth's 24/7 hotlines at (02) 8662-2588 and mobile numbers 09988572957, 09688654670, 09171275987, and 0917-1109812. They may also speak with their respective hospitals' designated PhilHealth benefits coordinator. 

This year, PhilHealth is also looking into enhancing the Z Benefits Package for cervical cancer, and the chemotherapy coverage for lung, liver, ovarian, and prostate cancers.