Unexpected expenses, like sudden hospitalization, can put a huge dent in your savings. Serious medical conditions can even drain your wallet and force you to sell some assets.
Fortunately, there’s a government agency that helps Filipinos deal with medical expenses—PhilHealth. You may be a member, but are you familiar with the PhilHealth benefits?
Read on to learn more.
Established in 1995, PhilHealth aims to financially help Filipinos with medical expenses. The agency can help cover medical bills or part of it. It works like an insurance company,[1] except that it’s mandated by the government.
Member contributions and funding from both local and national governments enable PhilHealth to operate and aid its members. The government requires all employees to become PhilHealth members. Self-employed individuals (also called voluntary members) can also apply.
Read more: What is Universal Healthcare Act and How Will It Benefit Us?
To avail of PhilHealth coverage this 2024, you need to pay your contributions. If you’re employed, your contributions are already part of your mandatory government deductions. But if you’re a voluntary member, you can settle your contributions via PhilHealth offices, accredited banks, and select online platforms.
The cost of your contribution will depend on your salary. For 2024 to 2025, the contribution rate is 5%. Check out this table to see how much you’re supposed to cover:
Mainly, you get subsidies for your hospital bills. In other words, you can get a deduction in your hospital bill with PhilHealth.
Take note, though, that the agency implements a case rate payment system. With the said system, PhilHealth reimburses a fixed amount for a specific condition or procedure. The case rate amount is inclusive of hospital charges and the attending physician’s professional fees.
Use the following benefits of being a PhilHealth member in case of hospitalization or other medical procedures:
If you are admitted to a hospital to receive care, you can get PhilHealth benefits. Part of your total bill will be shouldered by the agency, as long as the hospital you were admitted to is a PhilHealth partner.
If you need medical care but do not need to be admitted, you can still enjoy PhilHealth benefits. The agency can cover part or the entire cost of the following procedures:
Launched during the term of President Benigno Aquino III, Z Benefits are designed for patients with serious medical conditions. You can avail of this benefit if your illness is covered by PhilHealth and you pass PhilHealth’s pre-authorization procedure.[2]
The amount will depend on your condition. To give you an idea, here are some of the illnesses and the respective amounts covered by this benefit:
Benefits under this category are in line with the United Nations Sustainable Development Goals (SDG). Here are some of the benefit packages:
Expectant mothers can avail of PhilHealth’s maternity benefits, which include the following packages:
Read more: PhilHealth and SSS Maternity Benefits Every Parent Needs to Know
PhilHealth’s mental health benefits cover the following outpatient services: consultations, diagnostic follow-ups, psychoeducation, and psychosocial support.[3]
The subsidy for this benefit is categorized into two:
Important note: This isn’t the complete list of covered procedures. Check PhilHealth’s official website for the complete list of accepted diseases and procedures. Take note that certain conditions apply when availing of each benefit.
To apply for the benefits of PhilHealth, take note of the following:
You need to meet certain conditions to avail of your PhilHealth benefits. These include the following:
Read more: How to Check If Your PhilHealth and Pag-IBIG Contributions are Posted
The documents needed will depend on the benefit you’re availing of. But generally, you have to prepare the following:
On the day of your discharge, submit all the required documents to the hospital. The benefits will be deducted from your total hospital bill. Once you receive the final bill, settle it at the hospital’s cashier.
Still have questions about the benefits of PhilHealth? Check out the following to find answers:
You can avail of PhilHealth benefits any time during the year as long as you fulfill the contribution requirements. However, note that certain procedures have benefit limits.
For instance, radiotherapy and outpatient blood transfusion have a 45-day benefit limit. Hemodialysis, meanwhile, has a 90-day benefit limit. One session is equal to a one-day deduction from the allowable days per year.
The agency covers part or all of your medical costs, but it depends on the medical case. Check out this list[4] of medical rates covered by PhilHealth.
Related: Government Social Media Accounts Filipinos Need to Follow
The following PhilHealth dependents can avail of benefits without additional premiums:
Unfortunately, diagnostic procedures like x–ray, MRI, CT scan, 2D echo, and ultrasound aren’t covered by PhilHealth if they’re undertaken as outpatient services.
PhilHealth automatically covers all senior citizens aged 60 and above. Those who want to enroll can visit their local office for senior citizens affairs or health insurance office.[5]
Read more: Are Your Parents Enjoying These Benefits for Senior Citizens?
Now that you know the benefits you can get by being a PhilHealth member, you can minimize your medical expenses. Your qualified dependents can also enjoy the same PhilHealth benefits. Make sure to stay on top of your contribution to avoid any inconveniences when claiming your benefits.
With a credit card, you can pay in installments, get rebates, and more. Compare your options via Moneymax:
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