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How to Claim PhilHealth Benefits and Coverages


Getting sick is really expensive not to mention the hospitalization cost that a patient may incur. If a patient doesn’t have insurance, there’s no other option but to shell out the amount from your own pocket.

Good thing is that the government created an agency that can help Filipinos to avail benefits in case of medical urgencies. PhilHealth offers medical assistance including outpatient and inpatient services in any accredited facilities.

Guide on How to Claim Your PhilHealth Benefits

  1. Conditions

To qualify for the benefits of PhilHealth, the member should meet the following conditions;

  • The member should pay three monthly contributions prior to the period of the confinement. Other cases like pregnancies, newborn screening package, radiotherapy, chemotherapy, dialysis and specific surgical procedures require 9 months of contributions within the 12 months’ period.
  • Confinement due to illness should be 24 hours in an accredited facility and the attending physician should be accredited by PhilHealth.
  • Other conditions that are excluded in the PhilHealth benefits claim are cosmetic surgery, optometric services, treatment for alcohol dependency as well as fifth and ensuing normal deliveries.
  1. Requirements

Before the discharge from the hospital, the member should submit the necessary documents including;

  • Updated copy of MDR
  • Original copy of PhilHealth Claim Form 1 signed by the employer
  • Official receipts of monthly premium
  • PhilHealth ID of the member and another valid ID

If the member is unable to submit the claim form, he or she can ask for a representative provided with an authorization letter and valid ID.

  1. Claiming of benefits

The documents should be submitted before the patient is discharge so that your hospitalization allowance or benefits will be deducted from the total bill.

It is important to be a member of PhilHealth to help financial problems in times you or any family member gets sick. Also if you are single parent it is a big help isn’t? Likewise, make sure to pay your monthly premium diligently so that you’ll be qualified to avail for all the benefits.




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