As we all know, being a member of PhilHealth has its benefits . But have you every laid a thought on how much PhilHealth will put out for a specific illness? If not, then this article is perfect for you. This post is featuring a comprehensive list of how much you can get out of being a member of PhilHealth. This will also include eligibility, coverage, and guidelines for a specific disease.
1. The member must have at least three (3) months’ premium contributions within the immediate six (6) months before the month of availment.
2. An aspiring member also needs to submit:
Read: How to get PhilHealth Member Data Record (MDR)
For more information regarding the requirements, you can go to the PhilHealth website. Alternatively, you can contact them at:
Trunkline (02) 441-7444 Call Center (02) 441-7442 Php2, 600.00 per session
Php3, 640.00 (one or more units)
Php31, 000.00
Php23, 300.00
Moderate Risk Pneumonia: Php15, 000.00High Risk Pneumonia: Php32, 00.00Primary Care Moderate Risk Pneumonia: Php10, 500.00 Php18, 000.00
Lying in: Php6, 500Hospitals: Php5, 000.00Pre-Natal: Php 1, 500.00 Php4, 000.00
For IN PATIENTS benefits:
Benefits are paid ONLY to accredited Health Care Institutions (HCI)
The case rate amount is to be deducted by the Institution (HCI) from the member’s total bill. Inclusive of professional fees of physicians BEFORE your discharge Member must have at least three (3) months’ premium contributions within the immediate six (6) months prior to the event The case rate amount is inclusive of hospital charges and professional fees of attending physician/s Php2,000
Php4,000
Php11,800
Php10,100
Php2, 000
Breech Extraction Php12, 120
Php24, 000
Php28, 000
Php9, 500
Php9, 600
Php16, 000
Php31, 000
Php11, 300
Php19, 000
Php15, 200
Php1, 750
Php11, 400
Hospitals: Php4, 000Primary Care Facilities: Php2, 800 Dengue Fever: Php10, 000Severe Case of Dengue: Php16, 000 Php12, 200
Php12, 800
**With complications other than Coma and Ketosis: Php12, 600
Asthma in acute exacerbation for hospitals: Php9, 000 In primary care facilities: Php6, 300 Php9, 900
So if there are benefits to the diseases mentioned above, PhilHealth extends its help furthermore. The Z Benefit Package is a program of PhilHealth to its members to address health conditions that trigger expensive treatments. In addition to that, it also aids illnesses and diseases that promote prolonged hospitalization.
The conditions under type Z are the farthest end of the spectrum. Moreover, these are the cases “perceived as economically and medically catastrophic” due to the seriousness of each.
Z001 Acute lymphocytic leukemia, standard risk (for children) Z002 Early breast cancer, stage 0 to IIIA Z003 Prostate cancer, low to intermediate risk Z004 Kidney transplantation for end stage kidney disease, standard risk Z005 Coronary artery bypass graft surgery, standard risk Z006 Total correction of Tetralogy of Fallot (for children) Z007 Closure of ventricular septal defect (for children) Z008 Cervical Cancer, stage I to IV Z009 The Z MORPH (Mobility, Orthosis, Rehabilitation and Prosthesis Help)
Members covered are all eligible PhilHealth members whether:
Employed Individually paying (Voluntary) Lifetime member program Sponsored program Overseas worker program In addition to that, their dependents are also entitled of the package.
Furthermore to the list of illnesses in the ‘Z” category, PhilHealth will cover:
Operating Room Drugs and Laboratory exams Hospital room and Board fees Professional fees for the entire course of the treatment (Mandatory, *Other services required per ailment) For the partner hospitals, you can refer to the image here to know where you can go. To make it simpler, you can just type PhilHealth Z Benefit in Google Maps and it will automatically give you a list of partner hospitals.
For the illnesses in the Z package, a member can go to any contracted hospitals and have themselves check if they are eligible to be part of the or the Z Package .
Refer to this list:
If you are indeed qualified, PhilHealth will receive documents and endorsements from the hospital/s. If you want to know documentation requirements and checklists, you can find them here:
Wow, who knew that PhilHealth really aims to support the whole country? With these in mind, I can say that it’s a pretty fair deal, after all.
Do you have diseases in which you would need financial assistance from government organization/s? Or do you know someone who dreadfully needs this? Spread the word now and save a life.
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Source: PhilHealth
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