The Philippine Health Insurance Corporation (PhilHealth) today announced the granting of provisional contracting for Z Benefits covering selected orthopedic implants, following the devastating magnitude 6.9 earthquake that struck Cebu and nearby provinces on September 30, 2025. This action aligns with the directive of President Ferdinand R. Marcos, Jr., who instructed government agencies to immediately mobilize and extend assistance to the victims of the calamity.
With only one accredited health facility in Cebu currently authorized to provide Z Benefit packages for orthopedic implants, the PhilHealth Board approved and authorized Acting President and CEO Dr. Edwin M. Mercado to effect special policy relaxations to ensure wider access to life-saving orthopedic services for injured patients.
Dr. Mercado, an orthopedic surgeon by training, acted with urgency and compassion, rallying the support of the Philippine Orthopedic Association and his fellow professionals to extend critical assistance to victims requiring surgical procedures. “This is not just a matter of policy, but of timely action to save lives and limbs. By easing restrictions, we are ensuring that those injured in this calamity receive the proper treatment without delay or undue cost,” Dr.
Mercado emphasized.
Under this provisional policy, effective September 30, 2025, until the lifting of the declared state of calamity, the following measures shall apply:
1.Expanded Access: Health care institutions in Cebu are granted provisional accreditation to claim Z Benefit packages for orthopedic implants.
2.No Co-Pay: Victims with eligible orthopedic injuries requiring implants shall be covered at zero co-payment.
3.Flexibility for Professionals: Accredited PhilHealth health care professionals may perform surgeries and be compensated even if not affiliated with the contracted health facility.
4.Exemption from 24-Hour Confinement Rule: Victims needing urgent orthopedic intervention will not be bound by the usual confinement policy.
5.Extended Claims Window: Claims may be filed within 120 calendar days from discharge, including retroactive coverage for admissions up to 60 days before September 30, 2025.
PhilHealth underscored that existing case rates and benefit packages remain applicable for conditions not related to the earthquake. Additional special privileges may be granted after a further impact assessment.
“This proactive move demonstrates the Corporation’s readiness to respond swiftly in times of national emergency,” Dr. Mercado said. “We are loosening policies not to compromise standards, but to maximize access to care at a time when scarcity of accredited providers could mean the difference between recovery and permanent disability.”
PhilHealth assures the public that it remains committed to protecting the health and well- being of Filipinos, particularly in times of crisis, and will continue to work closely with professional societies and health institutions to deliver quality services where they are most needed.
This policy takes effect retroactively on September 30, 2025.