What are the PhilHealth benefits? Yes, you might be familiar with PhilHealth because you see this every payday on your payslip along with several deductions. But the actual highlight of being a member is the benefits you can lean on should you need medical care. If you are not a member yet, you can now register online.
READ: PhilHealth Online Membership Registration
4 Basic PhilHealth Benefits
No one will argue that even just a single illness can easily wipe out your savings. Good thing that being a member will give you access to several benefits that can help you during trying times. These benefits can aid you in lowering your hospital bills.
1. Inpatient Benefit
You are entitled to receive this benefit if you are confined in a hospital. The benefit will be directly paid to the accredited Health Care Institution (HCI) depending on the case rate. Upon your discharge, this benefit will be deducted on your total bill inclusive of hospital charges and professional fees.
RequiremEnts:
- 9 months contribution within the 12-month period prior to the first day of confinement
- A copy of Member Data Record or PhilHealth Benefit Eligibility Form (PBEF)
2. Outpatient Benefit
Some medical cases will not require confinement but will still need medical attention. Being a member will cover surgeries, medicines, and other medical tests.
Coverage:
- Day surgeries- minor to major surgeries where patients are safely sent home within the day
- Radiotherapy – Php 2,000 to Php 3,000 per session (maximum of 45 sessions in a year)
- Hemodialysis- Php 2,600 per session (maximum of 90 sessions per year)
- Blood transfusion- Php 3,640 (maximum of 45 times per year)
- Primary care benefit- preventive services, diagnostic examinations, drugs, and medicines.
RequiremEnts:
- 9 months contribution within the 12-month period prior to the first day of confinement
- A copy of Member Data Record and duly accomplished PhilHealth Claim Form 1
3. Z Benefit
The Z Benefit Package is offered by PhilHealth to address serious health conditions like several kinds of cancer. Aiming to lower the ever increasing deaths due to the lack of access to treatment.
Coverage:
- Acute Lymphocytic / Lymphoblastic Leukemia- P500,000
- Breast Cancer- Php100,000
- End-Stage Renal Disease- Php600,000
- Coronary Artery Bypass Graft Surgery- Php550,000
- Surgery for Tetralogy of Fallot in Children- Php320,000
- Cervical Cancer
- Z-MORPH (Mobility, Orthosis, Rehabilitation, Prosthesis Help)
- End-Stage Renal Disease Requiring Peritoneal Dialysis- Php270,000/year
- Colon and Rectum Cancer- Php150,000 to Php300,000
- Premature and Small Newborn Prevention of Preterm Delivery
- Children With Visual Disabilities
- Children With Hearing Impairment
READ: Sun Fit and Well | Most Comprehensive Health Insurance
4. SDG Benefit
If you are suffering from an illness that is part of the Sustainable Development Goals (SDG) then you are eligible for this benefit.
Coverage:
- Outpatient Malaria Package- Php600
- Outpatient HIV-AIDS Package- Php 30,000 per year (P7,500/quarter)
- Anti-Tuberculosis Treatment through Directly (Outpatient)- Observed Treatment Short-course (DOTS) Package Php4,000 (Php2,500 – Intensive phase & Php1,500 – Maintenance Phase)
- Voluntary Surgical Contraception Procedures- Php4,000
- Animal Bite Treatment Package- Php3,000
Final Thoughts:
At some point in your life, you may experience an illness that is not just physically painful but also to your pockets. But being a member of PhilHealth will somehow alleviate the costly medicines and procedures that you may need. However, PhilHealth benefits may not be enough to fully cover the expenses. That’s why having HMO and health insurances will give more confidence to you when illness strikes. So don’t forget to pay your contributions and get a health insurance plan.
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Federico is an electronics engineer, financial blogger, insurance agent, and a certified investment solicitor. A multi-awarded financial advisor with clients ranging from lawyers, doctors, engineers, accountants, business owners, company directors, and OFWs to minimum wage earners had sought advice from him in achieving lifetime financial freedom.
just trying to see if philhealth is any good im a american on medicare is philhealth as good cat ffind aythig on philhealth and what it coves
It only covers up to a certain amount per disease. Usually, it’s not enough to take care of the whole bill that’s why getting an HMO card is still needed.