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PhilHealth Announces Z Benefit Packages for
Colon and Rectum Cancers November 6, 2015

TO achieve better health outcomes for patients with colon and rectum cancers, the Philippine Health Insurance Corporation (PhilHealth) announces its coverage rates for both diseases.

Through the Z Benefit Package, expenses for the treatment and management of colon and rectum cancers are now covered for members who pass the selections criteria. These are based on current standards validated by experts in colon and rectum cancers and are adopted by PhilHealth during benefits development.

Addressing representatives of contracted health care facilities at the Z Benefits Summit held recently at the Marco Polo Hotel in Ortigas, PhilHealth President and CEO Alexander A. Padilla said that “we are definitely not stopping at having 11 Z benefit packages” and that “the quest to introduce more relevant, responsive packages continues” with the publication of PhilHealth’s issuance detailing the inclusions under the Z Benefit Package for Colon and Rectum Cancers.

Earlier researches have shown that colon and rectum cancers in the country are now the 3rd among males and 4th among females, and that the incidence rates rise starting at 50 years old for both sexes. “Like other forms of cancer, treating colon and rectum cancers requires a multi-disciplinary team of experts, and through the Z Benefit Packages, we are offering state-of-the-art treatment for Early Stage up to Stage III to increase chances of survival from these diseases,” Padilla said.

The Z package rate for the entire course of treatment of colon cancer, Stages I to II (low risk) is P 150,000.00, while package rate for Stages II (high risk) to III is P 300,000.00.

On the other hand, the Z package for the entire course of treatment for rectum cancer, Stage I (clinical and pathologic) is P 150,000.00.

PhilHealth will also pay P400,000.00 for pre-operative clinical stage I, but with post-operative pathologic Stages II-III using linear accelerator as mode of radiotherapy. Coverage for the same stages but using cobalt as mode of radiotherapy is P320,000.00.

Rectum cancer with clinical stages II-III, using linear accelerator as mode of radiotherapy is also covered at P400,000.00, and using cobalt as mode of radiotherapy is covered at P 320,000.00.

Stressing that PhilHealth aims to see its ailing members go back to society as productive citizens and to contribute to the economic growth of the country, Padilla said that “nais naming ipadama sa ating mga miyembro na ang PhilHealth ay lagi nilang kaagapay sa oras ng pangangailangan. Batid namin na ang ganitong mga sakit ay nangangailangan ng matagalan at mahal na gamutan, kung kaya’t kami ay gumawa ng paraan upang sila ay matulungan at maibsan ang kanilang mga pag-aalala sa buhay.”

The Z benefit packages for colon and rectum cancers will soon be made available in contracted public and private health care institutions. “We are now evaluating the capabilities of some accredited facilities that have expressed their intentions to become our contracted facilities for the said package. We are optimistic that before the year ends, there will be members who will be availing themselves of the package already,” he said.

Padilla added that “our challenge now is to bring in more facilities to be our contracted partners for the Z Packages. Let us not take that ‘wait and see’ attitude but rather, let us grab the opportunity to be part of this noble program.”

Health care institutions that intend to become contracted facilities for these packages must adhere to the No Balance Billing Policy or the “Walang Dagdag Bayad” policy for indigent and sponsored members who will avail themselves of the Z packages. On the other hand, the negotiated fixed co-pay shall be applied for all eligible non-sponsored members and their qualified dependents. However, the co-pay scheme shall be reflected in the individual contracts and shall cover for additional services rendered by the contracted HCI in relation to the Z benefits for colon and rectum cancers.

HCIs may apply for contracting by submitting a Letter of Intent (LOI) signed by the Medical Director indicating that their facility is capable of providing the said services.

Members who avail of this Z benefit for colon and rectum cancers shall be deducted a maximum of five (5) days from the 45 days annual limit regardless of the actual length of stay in the contracted HCI in a calendar year.

Coverage for colon and rectum cancers took effect on October 15 of this year (Emy Retuta)

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PhilHealth Announces Z Benefit Packages for Colon and Rectum Cancers