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PhilHealth Z benefits: Saving lives, ensuring futures

QUEZON CITY, Philippines – Coronary heart disease is the most common heart ailment and remains as one of the top causes of mortality in the country. This condition could be remedied by performing a Coronary Artery Bypass Graft (CABG) procedure on the individual suffering from this situation. The procedure, of course, comes at a dear price. It costs hundreds of thousands of pesos, if not millions.
Imagine the pain and suffering that this predicament will bring to a family should one of their loved ones have to endure this unbearable situation. This medical condition and the surgery it requires will almost always guarantee exhaustion of financial resources, not to mention the emotional and mental strains that come with it.
How could we honestly expect someone to carry this kind of burden in an economically-challenged nation? Where could this someone run to during these tough times? Is there someone to lend a caring hand?
The answer is yes.
PhilHealth never tires of providing viable solutions to every health condition that the sick citizens of our proud Republic have to put up with as they struggle to be freed from what ails them.
We came across Cristina Santiago whose husband suffered a heart disease that required CABG to treat his medical state. She was very willing to share the ordeal that her family had to go through and how PhilHealth came to their assistance in their time of need.
At 59, Cristina’s husband, Pablo Santiago Jr, an industrial engineer, had to undergo CABG in order to treat his heart ailment. Without him knowing, his wife researched online through the PhilHealth website in order to find a satisfactory and a more than adequate coverage from the only government health care insurer in the country, and find the suitable assistance she did.
Cristina learned that PhilHealth provides coverage for CABG under the Z-Benefit packages that the Corporation implemented in 2012. The benefit entitled to members who will go through this surgery amounts to P550,000.00, inclusive of professional fees of attending physicians.
Upon knowing that PhilHealth presents a caring solution to her husband’s dire circumstance, Cristina did not waste another second in expressing their intent to avail of the Z-Benefit for CABG. She notified the hospital, the Philippine Heart Center, of their interest in the life-saving package and the facility responded by taking charge of the dispensation of the benefit.
The hospital is to handle the pre-authorization checks needed by PhilHealth to classify cases which should be compensated by Z-Benefits, in this case, CABG. Once the pre-authorization is completed, the results are passed over to PhilHealth for evaluation. If PhilHealth deemed that the patient is qualified to receive this enormous coverage, the Corporation will in turn notify the contracted facility that they can proceed with the operation.
“Nakakatuwang isipin na may PhilHealth na handang tumulong sa mga nangangailangan. Fair ang treatment na ipinakita sa amin ng ospital, regardless kung may ibabayad kami o may tulong na nakuha galing PhilHealth,” was Cristina’s sentiment during the interview with the PhilHealth team recently. “Outstanding,” was the one word with which she summed up PhilHealth’s service to its members.
Pablo’s operation was performed in October 2014. The surgery did not only save his life, it also provided him with a future full of promises. Pablo turned 60 this June with a clear outlook in life and in what is still to come after the ordeal that almost took his life. He now resides in Bohol in the hope of securing an employment with the local airport.

Criselda Cabangon David, a happy mother of two kids, is a full-time Sociologist at the City Government of Lucena, Quezon Province. She is currently the Managing Editor of Ang Diaryo Natin Sunday News, a weekly local community newspaper in the Philippines and an active member of the National Union of Journalists of the Philippines.