Philhealth Coverage for Myoma Removal or Myomectomy

Here are the Philhealth Case Rate coverage amounts for Myoma Removal or Myomectomy:

A myoma is a fibroid tumor or a non-cancerous tumor.

Myomectomy is a surgical procedure to remove myomas or fibroid tumors from the uterus.   The uterus is not removed.

Coverage amounts for Myoma Removal or Myomectomy:

Code 58545
Laparoscopy, surgical, myomectomy, excision;  intramural myomas and/or removal of surfaces myomas

Coverage for Professional Fee (PF):  12,600 pesos
Coverage for Hospital Expenses:  10,700 pesos
Total Coverage:  23,300 pesos

Code 58561
Hysterescopy, surgical;  with removal of leiomyomata

Coverage for PF:  12,600
Coverage for Hospital Expenses:  10,700
Total Coverage:  23,300

Code 45108
Anorectal myomectomy
Coverage for PF:  16,800
Coverage for Hospital Expenses:  13,500
Total Coverage:  30,300

Code 58140
Myomectomy, excision of fibroid tumor of uterus, single or multiple; abdominal approach

Coverage for PF:  12,600
Coverage for Hospital Expenses:  10,700
Total Coverage:  23,300

Code 58145
Myomectomy, excision of fibroid tumor of uterus, single or multiple; vaginal approach

Coverage for PF:  8,400
Coverage for Hospital Expenses:  9,600
Total Coverage:  18,000 

Source:  

Philhealth Circular No. 35 s. 2013,  effective January 1, 2014
Annex 2.  List of Procedure Case Rates

Disclaimer:  This blog is a personal blog.  It is not administered by Philhealth.

22 Comments

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  1. hi tanong ko lang po.. kailangan kasi operahan ang birthmark ng anak ko yung tinatawag na strawberry human juma.. magkano kaya ma avail ko sa philhealth? ako po ay isang ofw!

    1. Hi jennifer, that could be covered as outpatient day surgery. Find a surgeon that accepts Philhealth coverage for day surgery. Sorry I can’t find in the Case Rate list that specific type of surgery so I can’t give the amount of coverage.

  2. My ob-gyne was advice me to undergo hysteroscopy myomectomy procedure at may iinject sia skin n para hindi ako magregla for almost 2 months that be covered by philhealth?
    How much?

    1. Hi joy, the procedure is covered, but I’m not sure if the medication to be injected can be covered because that’s outpatient medication. Ask your ob-gyne.

  3. Hi Ms. Nora, my mom is admitted due to her myoma and anemia. She was transfused 3 bags of blood. Now she will be scheduled for an operation for her myoma, is it still covers the philhealth benefits? How much?

    1. Hi juliet, Philhealth says that only one illness will be covered — the one that will use more hospital resources — will expand my response later

    1. Hi malou, the usual coverage is 12,600. See above for coverages for other types. Talk to your surgeon about costs so you can prepare.

  4. good day. just want to ask. my mom had myoma when she gave birth to my kuya (1993). and then, 5 months ago, she said her myoma returned after many years as she noticed her bleeding is continuous. she’s now so thin. is my mom’s case severe? Is surgery the option? What’s the preferred type? vaginal or abdominal? want less risk. I’m afraid for her. please help. any recommendations who can i ask about this situation. Thank you and Godbless.

    1. Hi jeanette, your mom should go to a good OB-gyne asap. An ultrasound might be performed. The cause might be or not be myoma. It will be the doctor who can decide which is better, vaginal or abdominal. I hope she has Philhealth so you can get deductions when she’ll be treated. God bless too

    1. Hi Floralyn, yes, both are covered. If not contrary to doctor’s advice and if not more costly, have them treated separately, as usually only one case will be covered if treated together in one confinement. Obviously, of course, have the more serious one treated first.
      We can use Philhealth as many times as needed, up to these limits: only 45 days of confinement allowance per year; another set of 45 days per year for all dependents; if the same illness for the same patient within 90 days, only one confinement is covered. Exceptions to the 90-day rule are hemodialysis and chemotherapy.

  5. Hi my mother was confine last jan 15 2015 with anemia and we used her philhealth. Now after the ultrasound we found out that she had myoma. Her ob said she should undergo surgery asap. So could we use her philhealth again?

  6. Hi! just wanna ask if I will undergo ovary removal during my cesarean section, what case rate will be covered? or will it be 2 case rates?!

    1. Hi Chona, there’s a case rate for Subtotal or total hysterectomy after CS, and the coverage is 30k. If ovary removal and not hysterectomy, I’m not sure, as ovary removal is not a second-case, based on the Second-Case list, so only 1 case will be covered, but ask your OB too

  7. hi, may i just ask if how much is the estimated cost of mayoma surgery? cause i think the doctor who will perform the operation charges my sister too much.. without philhealth is 90k and if philhealth will be applied it will cost her 60k…. thanks

    1. Hi ed, your sister can consult with other OBs in other hospitals if it’s not emergency and if not yet scheduled. You can ask around for referrals.

  8. Hello, last Feb po I underwent myomectomy but before the procedure I asked my OB how much will it cost. As per her computation for her PF less Philhealth daw na 7500 kasi same lng naman daw sa CS. Ngayon ko lng nalaman na 12,600 ang cover ng Philhealth sa PF nya. Then less 10K for the hospital bill. Meron ba ako habol pag ganitong case? Nasaaki parin po yung computation nya, wla po binigay sakin na OR for her PF yung hospital bill lng po ang my OR. Thank u

    1. Hi meg, baka yong myomectomy na 18k coverage ang naperform sa iyo, kasi ang sabi niya same as CS. You can see how much Philhealth really paid the hospital in your benefit payment notice that will be mailed to you by Philhealth. Or you can ask at any Philhealth branch maybe after a month. Pero kung anuman, usual practice na nila na bukod sa cash na ibinibigay sa OB as PF without OR, kukunin pa nila yong PF from Philhealth. Para daw sa assistants, etc. or other costs. Hindi kasi regulated ang PFs, so kahit ano ang idictate ng doctor, yon ang masusunod, wala silang limit, which is so frustrating. Pero you can try to ask for refund from the hospital if you have your notice.

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