Philhealth Maternity Benefit — Prenatal Care Worth 1,500 Pesos

November 12, 2011 by Nors | Filed under philhealth.

Philhealth reimburses prenatal care expenses up to 1,500 pesos, as part  of its Philhealth maternity benefit for  Normal Spontaneous Delivery (NSD).

This benefit is attached only to Normal Spontaneous Delivery (NSD) cases, and not to Cesarean Section (CS) cases.

You need to keep your official receipts (ORs) and you need to submit them to the hospital or maternity clinic before discharge so they can attach them to the Philhealth Claim forms. To receive the full 1,500-peso benefit, the total of your official receipts must be equal to or more than 1,500 pesos.

What kind of prenatal expenses are reimbursed?

These prenatal expenses are covered:

- Prenatal consultation

- Drugs and medicines used during prenatal period, such as anti-anemics, anti-infectives, vitamins, minerals and tetanus toxoid or tetanus immunization
Medicines should be in the Philippine National Drug Formulary (PNDF) list.

- Routine care tests, such as CBC, blood typing, urinalysis, glucose test, Hepatitis B surface antigen (HBsAg) test, Venereal Disease Research Laboratory (VDRL) test

- Ultrasound, glucose tolerance test and related tests when they are considered medically necessary

How is Philhealth reimbursement for prenatal costs made?
The reimbursement check from Philhealth is sent to the patient in cases where the patient presented Official Receipts (ORs) in her name.

The reimbursement is sent to the hospital or maternity clinic in cases where prenatal care is provided by the hospital and the patient has signed a certification that prenatal care was provided by the hospital or maternity clinic.

Read more:
Philhealth Maternity Benefits Include Newborn Care
Philhealth Benefits — Medical and Surgical Cases to be Paid on Case Rate Basis
Philhealth Maternity Benefits


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135 Responses to “Philhealth Maternity Benefit — Prenatal Care Worth 1,500 Pesos”

  1. mavic says:

    hi.mam,
    ask q lang po hindi po b pwedeng ire imburse yung prenatal care q before aq manganak.at okey lang po ba kung under 1500 ang reciept q?

    • Nors says:

      Hi mavic, sori hindi, kasi kasabay yan na isa-submit together with the maternity claim for normal delivery. Kung less than 1500 ang receipts, ang marerefund ay less than 1500 din, depende rin kung maconsider lahat ang ORs mo.

  2. march says:

    Im giving birth this coming April 2013
    and I would like to gave birth one of the Lying in near in our area.
    They told me that it will cost P3thou. only.
    If I apply my Maternity benefits it only means that I will not pay for anything.? and can I also avail the pre natal care?

    Thanks

    • Nors says:

      Hi march, ask them first if they’re Philhealth accredited, and if they’re filing maternity claims and prenatal ORs and if they’re performing newborn care procedures. Prenatal care expenses up to 1,500 (submit prenatal ORs worth at least 1,500) may be refunded by Philhealth; should be filed together with the maternity claim. best regards

  3. sheila says:

    hi! i’m currently employed but will be tendering my resignation before february ends. i was just wondering if i could avail of the prenatal care expenses that are not covered by my health card such as laboratory exams? due date will be by april..thanks…

    • Nors says:

      Hi sheila, yes, keep your prenatal ORs (orig and xerox, at least worth 1500) and submit to the hospital together with your maternity claim papers before discharge.

  4. ella says:

    Hi question lang, paano kung ung lying in (kung saan ako manganganak) ung magprocess ng claims/maternity package benefits tapos isasabay ko ung prenatal care dun, so bale kanino mapupunta ung benefits ng prenatal? Sa akin or sa lying in?

  5. Grace says:

    Gods am po gagamitin ko po ang philihealth ng asawa ko…unemployed po ako, may philhealth din me before kaso di na po ako nakakahulog. Anu po ang dapat gawin para po maging dependent ako ng asawa ko? Ano po ang form ang dapat i-fill-up? Sa pre-natal check up po… accredited po e2 ng philihealth…gusto ko rin ma-avail e2ng benefit…paano po ang process? thanks po

    • Nors says:

      Hi Grace, keep your prenatal ORs and submit them to the hospital together with your claim forms. Ask your husband to update his data at Philhealth and write you as his dependent. He brings your marriage certificate (xerox and orig) and your letter asking Philhealth to register you as your husband’s dependent because you have become unemployed and you have stopped paying your contributions.

  6. jhoanna says:

    Helo maam i would like to ask if pwede ko po badmgtifile ang prenatal reimbursement ko aftr discharge? I ask from the iloilo main philhealth branch anthey suggest na ifafile ku daw ito together with the notification letter coming from them. Hindi po ako nakafile Prior to disbharge kase daw di sila naghohonor nun at dapat daw ako mismo mjfafile. di ba lahat ng philhealth accredited hospital same gsistema?

    • Nors says:

      Hi jhoanna, the prenatal receipts should have been filed by the hospital together with the maternity claim.
      But try what Philhealth has suggested — I think they want the papers to be together, so they suggested you wait for their notice or BPN before filing your prenatal receipts.

  7. Bev says:

    Hi, I’m currently unemployed and giving birth on Oct 2013. Do I need to update and pay voluntarily my Philhealth contribution to avail the maternity benefits? Or can I just let my husband add me as his dependent and benefits will be carried over to me?

    Thank you so much!

    • Nors says:

      Hi Bev, you can be a dependent of your husband, and avail of maternity benefit. But make sure your husband’s Philhealth is updated. He also needs to update his MDR and register you as his dependent. If you were a member before, write a letter asking Philhealth to cancel your membership as you’re now unemployed and to register you as your husband’s dependent. Show marriage certificate.

  8. aiz says:

    hi gud pm po. im voluntary philhealth member.meron po akong contribution. Jan-june 2012, july-sept. (wala po). oct 2012- june 2013 meron po. Ang duedate po ng panganganak ko ay july 5, 2013 may makukuha po ba akong benifits? what if mapaaga ang pag anak ko ng last week ng june may benifits pa rin po ba makukuha? thanks

    • Nors says:

      Hi aiz, if your due is July, you’re qualified. But if you give birth in June, you lack 1 monthly payment. I suggest you go to Philhealth and ask about their Individual Policy Contract. You will pay in advance 1 or 2 years; ask if your Jan to June 2013 payment can be included in the IPC so you can avail if you give birth in June.

  9. Zanne says:

    hi! i’d just like to ask, I worked for a year and was being deducted for Philhealth but I already resigned last Dec. when I went to Philhealth to pay for this year’s first quarter they couldn’t see any record of my contributions and was asked to get a certification from my prev employer and register as an individual payer. After that I went to Philhealth to get my MDR, file the certification and pay but then they said the certification was not needed anymore. I’m worried that when my due date comes they won’t approve my maternity benefit since I only have the receipts for 2 quarters. any advice on this please.

    • Nors says:

      Hi Zanne, when are you due? Maybe Philhealth saw that you can accumulate 9 months of payment before your delivery, so they no longer looked at your certification. Or maybe they found your past records.
      But keep that certification from your employer just in case you need it.

  10. Matt says:

    Hi Good,morning i would just like to ask. Me and my girlfriend are not married yet but she is pregnant and im employed and im covered by Maxicare and do have phil health but my girlfriend is a salesgirl working in a small store but she has no philhealth.What do i have to do here? please help ASAP.

    • Nors says:

      Hi Matt, she cannot be your dependent because you have no marriage certificate to present. Is her month of delivery still more than 3 months away? Help her to get an Individual Policy Contract (IPC) from Philhealth. Ask if she can use IPC for her delivery. You may have to pay 1 year in advance.

  11. rachelle says:

    Hi, my husband has an intellicare card and to make it short all the expenses ay sgut ng card nya pero sa accredited hospital and doctors lng. The problem is hindi po accredited yung doctor, can I use my philhealth to pay for her professional fee? Thanks.

    • Nors says:

      Hi rachelle, is your doctor Philhealth-accredited? Does she know you’ll use Philhealth and your HMO? I think HMOs do not pay the costs that should be covered by Philhealth, so you really need to file Philhealth — 2k of the PF will be paid by Philhealth (if the hospital is level 2 to 4).

  12. evelyn says:

    may requirements po sa pgkuha ng ipc test?im giving this month of march what if di ako mkakuha ng ipc test?pwede ko pa rin bang magamit ang philhealth ko?

    • Nors says:

      Hi evelyn, IPC is not a test. It’s a new program in which you pay 1 yr, 2 yr or 3 yrs in advance. I think you can be eligible under IPC if your month of delivery is still about 4 months away, perhaps July onwards.

  13. Zheena says:

    Hi, good day! I planning to give birth at pasig city gen hospital but since it’s public my routine test are made outside the hospital some were taken at hi precision diagnostics. If I’ll be covered by the said 1500 prenatal care can I still submit my receipts at pasig gen even if the lab test are from 3rd party diagnostic lab? Where will it be deducted? Thru my final bill at the hospital or thru check that will be sent thru my address? Thanks

    • Nors says:

      Hi Zheena, the prenatal care refund is given by Philhealth directly to the member in the form of check sent by registered mail. Submit ORs to the hospital so they will be included in the maternity claim.

  14. Shelby says:

    Hi, I gave birth last dec 6, 2012 at metropolitan hosp. I submitted prenatal receipts upon discharge. but until now I haven’t received my 1500 check. I went to philhealth to followup, and was asked to go back to metropolitan so they can submit a waiver. But they don’t know anything about submitting a waiver for prenatal purposes. What do I need to do?

    • Nors says:

      Hi Shelby, I only came to know about this waiver from you. I guess this is not a standard operating procedure for hospitals because Metropolitan does not know it. Have you received your benefit payment notice (BPN) from Philhealth? What I know is that the prenatal check arrives at your address via registered mail together with the BPN.

      • shelby says:

        I went back to philhealth and they said that since this is a hospital claim, meaning the philhealth benefit was already deducted from my bill when I got discharged, a waiver is needed from the hosp. But the hosp said that they only issue a waiver if the benefit was not deducted from the bill yet. I got a copy of the BPN from philhealth, and it says under validation column: 1WP – PRENATAL CARE PART EXCLUDED UNLESS SUPPORTED BY WAIVER. What does it mean?

  15. MHE says:

    hi, lahat po b ng ospital pinapayagan un patient n magsubmit ng claim form 3( prenatal reimbursement)?

    o mas maige po b isubmit mismo lhat ng dokuments sa philhealth?

    • Nors says:

      Hi MHE, all hospitals should accept the prenatal ORs so they can be included in the maternity claim, and so that the prenatal refund check will be sent to you. There are those who have commented here that it’s better to pay the hospital in cash and then file a refund directly with Philhealth. If you do this, you should make sure you get all the claim forms signed before discharge so you don’t have to wait for the doctors for signing later on.

  16. Rowena says:

    Hi,
    I gave birth last April 10th but wasn’t able to give the prenatal check-up receipts to the hospital. Can I still apply for the prenatal care reimbursement? If so, can you give me some guidelines on how to do it? Thanks in advance.More power.

    • Nors says:

      Hi Rowena, you can try asking the hospital if they have not submitted your claim so you can make habol. This is because the receipts should be together with the maternity claim. I’ve read an advice somewhere that said something like — wait for your benefit payment notice from Philhealth, then go to Philhealth with your prenatal receipts. I add that perhaps a letter of request for refund of your prenatal expenses is also adviseable. But I have doubts about the 60-day filing deadline — would they accept even if it’s beyond the 6o-day already? Email actioncenter@philhealth.gov.ph or call 4417442

  17. iris arceo says:

    i have a question, after filling & discharge how & when will i get the worth 1,500php check reimbursement? is it via snail mail where i live? how many calendar days? should i follow up it first or it is automatically sent to my home address even without follow ups? thanks

    • Nors says:

      Hi iris, yes, via snail mail — registered mail delivered to the address you wrote in the claim form in about 2 or 3 or more months even without follow-ups.

  18. Emelson Dela Cruz says:

    Hi this is emelson, my wife was hospitalize last feb this year we already file all the records for refund, till now wala padin po. How will we get the refund?

    Thank you

    • Nors says:

      Hi Emelson, you wait for the benefit payment notice from Philhealth, delivered to your address via registered mail. It may take 3 to 5 months or more. Depending on your payment scheme, the refund could be a check in your name or you could get the refund from the hospital, using your notice, hospital bill and receipt.

  19. Imelda Talinio says:

    Good Afternoon, manganganak po ako sa August 15 sa Clinica Antipolo Hospital, normal with ligation. tanong ko lang po kung magkano mababawas ng Philhealth sa billing ko. Thanks po

    • Nors says:

      Hi Imelda, I’ll check first if ligation and normal delivery are covered separately if they’re done in one setting. CS with ligation and CS only get the same coverage amount, so I have to check first.

  20. rona says:

    gud day! my husband po is seaman, private employd po xa. sumakay xa last oct2012 jan po xa ult ngstart mgbyad til present. hes onboard at present. oct2012~ to may2013 byad n po. due date ko po july 3, mka2avail po b ako ng benefts?.kng sakali po n mbyaran ng company nia ngaung june ang contribution nia at kng sakali po n mapaaga panga2nak ko, qualified po b ako s bnefts?kung sakali po n uuwi husbnd ko ngaung june pwd b ako mg advnce payment.. pls guide n advce.tnx

    • Nors says:

      Hi rona, yes, you are qualified, whether you deliver in June or July. For employed members, payment of 3 of the 6 months BEFORE month of delivery lang ang kelangan. At Philhealth, seamen are considered Employed. Ask for a certificate of premium payments from your husband’s employer. Ask also a signed claim form 1. Get your husband’s updated MDR from Philhealth – bring your ID, marriage certificate, authorization letter and copy of husband’s ID.

  21. charisse says:

    Hi. I gave birth last feb 21,2013 in a tertiary hospital. Normal delivery. I think they have deducted my bills with my philhealth benefits. Can i still claim something? F yes..how?

    • Nors says:

      Hi charisse, if the 5k coverage for maternity and the 1750 coverage for newborn care (depending on what procedures were done) were already deducted, then you already have claimed what’s available. There’s also up to 1,500 pesos for prenatal care (to be refunded by Philhealth) if you have submitted to the hospital ORs of your prenatal care expenses together with your other Philhealth documents before discharge.
      By the way, the deadline for filing claims is within 60 days after discharge.

  22. april says:

    good day!

    i ask po what are the requirements to avail the prenatal care?

    thank you.

    • Nors says:

      Hi april, submit ORs of your prenatal care expenses worth at least 1500 pesos to the hospital, together with your Philhealth documents, so they can file it together with your maternity claim.

  23. wil says:

    Hi, my wife gave birth a week ago. I asked the hospital about the pre-natal care reimbursement which was not showing to had been deducted on our bill, but they said, they don’t have any idea what that is nor they’d been advised by philhealth during their seminar/rollout about the benefits. So I just requested for an Official receipt from the doctor to cover 1500 worth of pre-natal consultations and I’m hoping I could get this honored at the philhealth office. Do you know the process and other requirements I need to bring to file this claim in philhealth? Thank you!

    • Nors says:

      Hi wil, prenatal care ORs should have been submitted to the hospital so that the ORs are filed together with the maternity claim. If you like, you can ask the hospital if they have not yet filed your maternity claim with Philhealth so you can add your prenatal ORs. Or you can go ahead and ask Philhealth if you can file a separate prenatal claim.
      Prenatal care coverage is offered only if it’s normal delivery (not if CS)

  24. Theresa says:

    Hi, my Philhealth payments were continuously paid since 2010 (we pay annually), however we were not aware at first that we have to change our status once become an OFW. Ive been working abroad mid 2010. We only updated it January this year…I gave birth this March. Can I still claim for maternity reimbursements? I was on CS delivery, do you have an idea how much the claim would be? Sorry, I cant find it on the website…Thank you :)

    • Nors says:

      Hi Theresa, you have only 60 days from date of giving birth to file your claim. When did you give birth? CS coverage is 19k (11400 for hospital expenses and 7600 for PF). If you’re still within the filing deadline, you can file as voluntary if you paid as voluntary and you’ve paid 9 of the 12 months BEFORE month of delivery. If not, you can file as OFW if your delivery date is within the validity dates in your receipt; show OEC or other OFW documents.

  25. Jean says:

    Ma’am,
    Good day…I just want to ask, what if the lying-in clinic where I want to give birth is not accredited of philhealth, will I still get the re-imbursement benefit as a member? If yes, what are the document needed for re-imbursement?

    hoping for your kind response.
    thank you

    • Nors says:

      Hi Jean, sorry, you will not be covered by Philhealth so you can’t file for refund. The first requirement is that the clinic or hospital should be Philhealth-accredited.

  26. Jamecel says:

    Hi good pm po. Manganganak po ako september 2013, ngstart aq as philhealth member july 2012 pero d q po nbayarn ung para september to december. And then ngstart ulit aq ng bayd january 2013 untill now. Makakavail p po b ako ng ng prenatal care reimbursement. tsaka makaka avail pa po ba ako sa philhealth benefit kung 9 months palang akong nakakahulog? Tnx

    • Nors says:

      Hi Jamecel, it seems that you lack 1 month. If your due is Sep 2013, dapat paid ang 9 months within Sep 2012 to Aug 2013 (12-month period BEFORE your due).

  27. Red says:

    Hi, Due ko po sa November 2nd week.Nagstart ako sa philhealth August 1,2012 pero nag resign ako March 22,2013 nung nalaman kong buntis ako. I think 8 months lang akong bayad sa philhealth. Is it okay na bayaran ko na lang yung from April hanngang ngayon June? ma aavail ko po ba yung benefits ng philhealth? And baka po may idea din kayo about sa SSS..Same lang din po nahulog ko..Thank you..

    • Nors says:

      Hi Red, dapat bayaran mo na ang Apr to June tomorrow, Sunday — payment deadline Sunday. After Sunday, hindi na puedeng bayaran. Kung November ang due mo, dapat nabayaran mo ang 9 months sa loob ng Nov 2012 to Oct 2013.
      Sa SSS, you’re eligible for maternity benefit, file your maternity notification asap.

  28. ria says:

    hi.. im due on nov 2013.. im currently employed but I checked on my employers record that the last payment they did was Dec 2012 due to insufficient fund and lack of manpower.. im planning to be a voluntary member since I need my philhealth and sss benefits.. am I allowed to? or any better suggestion you can give? thanks!

    • Nors says:

      Hi ria, yes, you can pay as Voluntary for July to Oct 2013 = 4 months. The requirement is payment of 9 of the 12 months BEFORE month of delivery. So ask your employer if you can pay as Employed to Philhealth for Apr to June 2013 (ikaw na ang bahala sa payment and remittance plus penalty, kasi sabi mo can’t afford sila) so you can accumulate 9 months, including Nov and Dec 2012. Ang Employer kasi puedeng magbayad ng late; ang Voluntary hindi puedeng late. Please check my counting.

  29. rose aldeza says:

    . ..hi im rose, may i ask pano yun sa case ko binawi ko po sa lying in na pinagpaanakan ko ung philhealth ko kasi ndi ko po nagustuhan ung service because instead na makatipid ako during ng panganganak ko lalo lang akong napagastos coz i was delivered in hospital. pde bang ako na lang magreimburse sa philhealth ng mga nagastos ko specially sa lying in kasi 6,000 pesos fee nila. and ask ko lang din pde bang pagsamahin ing expenses sa hospital and lying in???>.. include ko sana ung mga resibo ko ng gamot. . thank you

    • Nors says:

      Hi rose, itong hospital ba ay level 1? Kasi ang maternity benefit for level 1 ay pareho ng lying-in na 6500, so kung marefund mo ang 6500 from hospital, hanggang doon lang ang benefit for maternity, so wala ka nang makuha sa lying-in. Kung hospital level 2 to 4, ang maternity benefit ay 5k.

  30. Jhen says:

    good day po, ask ko lng po if qualified ako mag avail ng maternity benefit. Sa sept 2013 po ang due date ko. nag start po ako maghulog ng january 2013. employed po ako sa isang private company.thanks

    • Nors says:

      Hi Jhen, yes, you will be eligible. If employed, the requirement is payment of Philhealth premiums for 3 of the 6 months BEFORE month of delivery.

  31. kate says:

    hi im kate i just want to ask manganganak na po aq ngun before august 2013 ask q lng po pwdi po bng mg direct aq sa philhealth. Macocovered q po kya ang prenatal benefits po pag ngdirect po aq ano pong ang mga requirements. Pwdi po b ung sa ultrasound q khit sa iba q po aq ng pa ultrasound di nmn po lying in ang pupuntahan q hospital government q. Pls reply po tnx

    • Nors says:

      Hi kate, yes, puedeng mag-file with Philhealth directly after discharge within 60 days. Anyway, karamihan din naman ng government hospital ay pinapabili sa labas ang mga supplies and meds. Pero sabihin mo pa rin sa hospital agad about Philhealth because they’re the ones filling-up the claim forms. About prenatal, present ORs of ultrasound and other prenatal care procedures worth at least 1500 pesos.

  32. clarisa solis says:

    hi mam i was admitted and give birth on aug 10 2012 at bayambang district hospital in a nsd procedure.pero until now ay wala pa din ung reimburse ko from phil health i went there para po mgfollow-up pero ang sabi po dun ang andun na nareimburse is aug. 2010.until wen pa po kaya makukuha ung reimburement ko.

  33. Dianne says:

    Goodday!
    pano po ung “medically necessary” for ultrasound, may special form or documentation ba na kailangan ipresent, kc 5-6 wks palang ako e lagi sumasakit tyan ko so nirerequire ng OB-Gyne ko mag ultrasound. At kung sakali, pwede ba na magkaiba ung clinic ng ultrasound sa hospital na pagsa-submittan ng claim?

    • Nors says:

      Hi Dianne, puedeng ibang facility ang ultrasound at yong hospital for delivery, basta merong OR. Doon sa request for ultrasound, merong sinusulat ang OB-Gyne na reason for ultrasound, i-attach na lang sa ultrasound OR.

  34. ricardo says:

    hello maam good day … hmm maam natangap q na po yung bpn nang asawa q … nuung jun 10 2013 .. kaso akala namin ay sulat lng .. yun pala ay refund na nmin un paanu po ba nmin makuha ung refund namin

    • Nors says:

      Hi ricardo, if there’s no check issued to you, xerox your notice and receipts and you go to the hospital and ask for your refund.

  35. Carene says:

    Hi maam,ask ko lang po sana,,panu po ba yong resibo na hinihinging requirements for reimburse..kada prenatal ko kc umaabot ng 1000 or 1500 yong binabayaran ko for check up na yon ksma mga vitamins na binibigay nila.may sarili kasi silang gamot na binibigay sa akin tuwing check up ko.coverd ba yun sa reimbursement?

    • Nors says:

      Hi Carene, up to 1500 lang ang prenatal benefit. Submit ORs of your prenatal care, worth at least 1500, together with your claim form 1.

  36. Jacue says:

    Hi! Pano po ba magclaim ng maternity benefits? What are the procedure. Ill be giving birth this december. May mga kelangan po bang Ifill up? Thannk you!

  37. Rochelle Ann Muncal says:

    Can I separately claim my prenatal care benefit from my actual maternity benefit? I have different doctor/ hospital for my prenatal care with receipt and actual giving birth. How can I claim my pre natal care?

    • Nors says:

      Hi Rochelle, the prenatal care and maternity benefit claims should be submitted together to Philhealth as one claim. You submit your prenatal care ORs (even from other facilities) to the hospital where you’re giving birth.

  38. ocpenia marquez says:

    Hi po ask ko lang bat 3k lang po ang narefund ko sa panganganak ko normal deivery po ako nabasa ko po kc na pag normal delivery ay 6k bale 3k lang binawas sa bill ko bayad na po ako until dec 2013. Voluntary po ako at july 17 po ako nanganak.

    • Nors says:

      Hi ocpenia, sa hospital ka ba nanganak? Kasi pag hospital, ang coverage ay 5k lang (3k for hospital at 2k for doctor). Sad to say, usually, hindi na nagrerefund ang doctor ng 2k. Additional fee na nila.

      • ocpenia says:

        Hi ms nors one thing more, bumalik kc ung claim ko sa nbs stated n denied bcoz of incomplete newborn care service rendered.ndi nailagay ung mga procedure na ginawa sa knya tulad ng bcg, hepa b at hearing test kya denied mali un ng gumawa ng docs nya sa hospital.ask ko lng po pued ko p po bng iapply ule after ko maipalagay ung newborn care screening n ginawa sa kanya.nagbayad po kc ako ng 1600 para sa bcg at hepa b plus 450 sa nb at 700 sa hearing test.

        • Nors says:

          Hi ocpenia, yes puedeng mag-refile; ask Philhealth kung ano yong mga tamang documents para hindi na maibalik uli. Or pa-correct mo na sa pediatrician. Pero ang alam ko meron ding deadline ang re-filing, so tanungin mo na rin.

  39. Mariel says:

    hi mam, just want to ask kasi i’ll be giving birth this november but I stopped paying philhealth last april 2013 because i lost my job but im planning to pay my previous balance this month could it be possible?? and I could still use my benefits by the time I give birth?? thanks.. :)

  40. Nelyn says:

    Hi, in my case, I had my prenatal check ups in a different hospital (Kalibo) and will be giving birth in a different one (Iloilo). Would it still be ok to submit my ORs to the hospital where i will be giving birth? Thanks!

  41. Nelyn says:

    Thanks for your response Ms. Nors, one more thing, I am my husband’s dependent sa Philhealth nya, would there be any additional benefits for me?

  42. Dennis says:

    Hi, ask ko lang, may form bang kailangan s pagreimburse ng prenatal expenses? O kasama na yung mga official receipts ng expenses gaya ng vitamins/glucose test/ultrasound s pagpasa ng cf1? Meron din bang paternity benefit? Magpapakasal pa lang kmi ng girlfriend ko first week ng october at due date ng panganganak nia is last week ng october. Kung matatagalan s pagpasa ng marriage contract, hanggang kailan pwedeng magclaim ng paternity benefit?thanks

    • Nors says:

      Hi Dennis, within 60 days after discharge ang filing period. Sorry walang paternity benefit sa Philhealth. Submit prenatal ORs together with Philhealth docs sa hospital para ma-include sa maternity claim.

  43. cams says:

    Hi mam just want to ask.i follow up my reimbursement to philhealth thru email they told me to coordinate with the hospital for the reimbursement of my son but the hospital didnt know about this one.Diba po dapat i should be receiving the checkthru snail mail?thanks

    • Nors says:

      Hi Hani, yes, wait for the benefit payment notice from Philhealth via snail mail. Just make sure that the hospital filed your claim.

  44. ann says:

    good day po, ask ko lng po dto ako nanganak sa dubai , panu ko isesend yun mg OR’s and ibang expenses ko..kse nabasa ko po article khit sa ibang bansa ka nannganak mayu makukuha din po ko, please san ko pwede isend mga receipt. thanks

    • Nors says:

      Hi ann, nasagot ko ang tanong mo about maternity claim sa isang post. Isama mo ang mga prenatal ORs mo sa maternity claim mo. List your receipts, OR nos and amounts and details in a bond paper and then attach the receipts.

  45. mary says:

    HI.. good day.. this regarding to my or’s… frst receipt ko po from delos santos mega clinic and amnting to 1200 (blood typing, vdrl, and hepa)and i decided manganak po sa san juan de dios which is my 2cd receipt na 300 (tetanus immunization) ay galing nasa hospital … asked ko po how po maifile ung magkaibang or’s kung mag kaiba ng pinangalingan ng receipt?panu po ung claim forms isubmit?..

    • Nors says:

      Hi mary, basta prenatal ORs kahit different issuers, puede. Submit ORs together with your docs for maternity claim para ma-submit at the same time by the hospital to Philhealth.

  46. ocpenia says:

    Hi, ask ko lang po about po sa newborn screening test ng baby ko denied para sa claim ko. Incomplete newborn care service rendered daw sabi ng philhealth.pero na bcg at hepa b vaccine n si baby bfore 1 week nya nun dun din sa hospital kung san ako nanganak may hearing test p nga pong ginawa sa knya at binayaran ko p un ng 700 para sa newborn screening at 450 para sa hearing.ask ko lang pued p po b akong mgclaim at ipasa ule ung docs para sa ns ng baby ko?

  47. ocpenia says:

    Ask ko lang po kung pued p po ule submit ung mga docs para sa newborn screening kc ndi po tama ung pag file up ng hospital kaya incomplete newborn care rendered kaya binalik ung application ko.my bcg,hepa b at hearing test.

  48. Jazz says:

    Helo po ask ko lang,bagong member ako ng philhealth starting july,individually paying and nasa 2nd quarter (6months) pa ako nagbayad ,due ko this january 2013. Kailan ko po maavail ung sa philhealth or ilang months po ako dapat magbayad before i can avail the benefit?

    • Nors says:

      Hi Jazz, kulang ka sa 9-month requirement, so change your category to Informal Sector so you can avail of the 3-month requirement for Informal Sector members. Ask Philhealth too.

  49. Jazz alfad says:

    Ask ko lang po if ung Prenatal benefit ba ay pwede lang ung Prenatal consultation from the OB na ibibigay before checking out sa hosp or lying in? Hnd na kasali ung sa above covered na nakasulat sa taas, or need talaga na andun ung prenatal consultation ORs, medicine ORs (vtamins) at ung ultrasound ORs? Still confused. Thanks!

  50. cindy says:

    Hi ask ko lang po employed ako from oct 2010 – may 2013, wala po akong hulog from May2013-july2013 nagwork ulit ng july 23 2013, due ko po ay Jan 2014, makakaavail pa po ba ko ng mat ben?
    Clarify ko din po, usually po nbs ay ginagawa while nakaconfine pa ang mommies, pwede po ba na isabay na din ito sa pagcclaim ng prenatal ben?

    • Nors says:

      Hi cindy, submit 2 sheets of claim form 1, one for you and one for your baby, so you can avail of nbs. Since you’re employed, you can avail kasi payment of contributions for 3 of the past 6 months lang naman ang requirement for employed members.

  51. bella says:

    hi po. im an ofw. hindi po ako nakapaghulog ng philhealth for the last two years. dito po ko sa Pilipinas manganganak due on Jan 2014. Paano po ako makakaavail ng maternity benefits? Nagpunta po ko sa Philhealth ofc and pinagbayad ako ng dec 2013- dec 2014 premium, enough ba yun so i can avail the benefit sa Jan 2013 panganganak ko?

    • Nors says:

      Hi bella, yes, basta OFW ang category mo sa MDR mo. Pag OFW, dapat yong confinement date ay within the validity dates sa receipt, so in your case, eligible ka, basta OFW.

  52. stephanie says:

    good day po! employed po aq jan sa manila mula feb 2013 at may philhealth, ngresign po aq july 2013 nung nalaman kong buntis aq, jan 2nd week na po due q. inasikaso q po agad philhealth q pag-uwi q dito probinsya. nalaman q po na walang record po ung contributions q mula sa employer q. pero may mga pay slip po aq na hawak. itinuloy q po ung contribution q mula july to dec as indiv payer. nagfile na po aq ng reklamo sa philhealth regarding sa employer q. at nag bayad po aq ulit for the nxt quarter nxt year, ma-aavail q po ba ung maternity benifits sa ganitong kaso? nitong dec 3 lang po bumalik aq sa phihealth office for some inquiries sinabi po nila mula daw nov 5 me bagong patakaran na daw na 3 months nlng ang kailangan para maka-avail ng maternity benifits. tama po ba yon?

    tnx po!more power.

    • Nors says:

      Hi stephanie, yes, you’re right. Update your MDR so your category is Individual Payor — Informal Sector, so you can avail of the 3-month-contribution-payment qualification.

  53. Rico Estrella says:

    We own a small hospital in Cavite, we have had several rejected Philhealth claims for NSD cases because we weren’t able to provide the waiver for prenatal visits. I don’t understand why this is required when the patients did not even have their prenatal care at our hospital and just had their NSD at our hospital.

    • Nors says:

      Hi Rico, yes, I’m puzzled too because waiver of prenatal visits is not in the published list of requirements for NSD. Maybe there’s another list for hospitals? I’m not sure if this will help but I’ve read in one of the Philhealth circulars that a lying-in facility is required to include certification that the patient had at least 4 prenatal visits in their facility before delivery. Would you check if the RVS code 59401 might have been used in the forms? (code for maternity care package in lying-in facilities)

  54. Vanessa says:

    Good day po,,last december po kasi nagpacheck aq sa isang clinic then nagpalaboratory na po aq dun tska transV nmahalan po kase aq sa mga services nila kya i decided na lumipat ng ibang clinic.. ngaun january po nagpacheck ulet aq sa ibang clinic at dun ko na din po balak manganak ..ask ko po sana kung maaavail ko pa din po ba tong prenatal care nagastos ko po sa una kong pinuntahang clinic khit na dun po aq sa bagong clinic manganganak??salamat :)

    • Nors says:

      Hi Vanessa, kausapin mo na lang yong clinic, kasi yong ibang clinic gusto nila sa kanila ang prenatal. Meron kasing requirement ang Philhealth sa maternity clinics na dapat merong prenatal checkups ang member bago sila eligible sa Philhealth.

  55. Teodirico says:

    Hi! tnong q lng po kc lying in clinic lng manga2nak asawa q eh db wla nMn bnbyarang bill dun kc cash donation lng n any amount n kya mo ibigay tpos ung mga gamot at ggmitin nya eh ako ang bbili s labas, confused lng ako qng sknila b mppnta ung maternity benifit since nbsa q n ung 6,500 for normal delivery is for hospital bill at PF lng?!

    • Nors says:

      Hi Teodirico, tama ba ang isip ko na government clinic ang lying-in kasi sabi nio donasyon lang? Philhealth-accredited ba ang clinic? Kung accredited, tanungin nio na lang kung anong policy nila kapag merong Philhealth. Kapag magagamit ang Philhealth, humingi kayo ng ORs ng mga bibilhin niong gamot; ORs in your wife’s name. Irerefund nio na lang sa clinic later on pag meron na kayong natanggap na Philhealth benefit payment notice.

  56. Ohyen Santos says:

    Hello po,seaman po ang husband ko and paid po cya from june2013- sept2013 as voluntary member since hindi cya onboard nung time n un,now,nag join cya ng october & since d aq sure qng nakpagremit ang agency nya for oct,ngbyad po aq s bank last dec 27,for the month of oct only kc sure nmn aq n nadeduct cya for nov and dec,will it still be credited? D dw po kc assured ng bank n pede ung ganun

    • Nors says:

      Hi Ohyen, yes, puede yon, kasi alam naman ng Philhealth na merong months na on vacation ang mga seamen. Yon ding mga nag-le-leave sa work ng more than 1 month, nagbabayad din as Voluntary while on leave.

  57. nicole says:

    hi ask ko lng kc i have contribution from last yr jan- aug may EDD for delivery is on june 2014 can i still pay for may contribution from this month up to june? thank u

    • Nors says:

      Hi nicole, yes, you can pay for Jan to June. Update your member data to Individual Payor-Informal Sector para ma-qualify ka sa new 3-month-contribution na requirement (na hindi na 9-month).

  58. Mary Rose Sampang says:

    Hi, i just give birth last Dec.30,2013 sa isang private lying-in, pero hindi sila nagle-less ng philhealth, i just want to know if i can i still apply for a reimburment to Philhealth?

    • Nors says:

      Hi Mary Rose, baka hindi Philhealth-accredited ang lying-in kaya hindi sila nagdededuct; so hindi puedeng mag-file ng claim. Bukod sa reason na yan, hindi na raw tumatanggap ng direct filing ang Philhealth. Ask others too

  59. Bella says:

    Good day! I’m 7months pregnant now.. And my husband is a seaman.. Pero d kasi kami kasal.. And ala din po ako Phil health.. Ung friend ko po ng seminar sa Phil health isa siyang midwife, she suggested na mag file ako sa Phil health mag advance daw ako ng 1year hulog para magamit ko ang Phil health para makabawas kahit papano sa Bill ko.. Ask ko pwede kaya yun? Na mag advance ako ng 1 year na hulog then magamit ko na siya pag nanganak ako. Thanks

    • Nors says:

      Hi Bella, yes, magregister ka sa Philhealth asap as Individual Payor-Informal Sector. Tama yong friend mo na you pay 1 year in advance so you can qualify. Bring your ID.

      • Bella says:

        Good day! Nakapgfile na po ako sa Phil health imus Cavite and nkpagbayad na din ako ng advance 1 year para magamit ko sa panganganak ko.. Tinanong ko din ung staff ng Phil health if pede ko na siya agad magamit.. They asked me kelan ako manganak sabi ko may 2014.. Sabi nung staff pede dw.. Thank you din sa site mo.. GOD BLESS!! :)

  60. hanzkie says:

    Good Day! just ask if i still avail the new born package worth 1,750 and the prenatal benefits worth 1,500..im 8mos.pregnant and just started paying my philhealth last jan.2014 til now, and want to continue paying this april til june 2014, but my due is this april. i know that i can’t avail the maternity package,coz it needs atleast 9months but how about the prenatal benefits?can i still?

    • Nors says:

      Hi hanzkie, puede na ngayon ang 3 contributions lang for Individual payor-Informal Sector. Have you paid Jan to Mar 2014? If yes, you can avail of the maternity benefit. Submit to the clinic/hospital your prenatal ORs. You can avail of newborn care package if your pedia is Philhealth-accredited.

  61. abby says:

    hi matagal na po akong nagpamember sa philhealth 2007 pa po then from 2008-2013 hindi na po ako nakapaghulog last jan 2014 po nagpunta ako philhealth and binayaan ko na po from jan 2014-dec 2014. I’m due on november cs po ako magagamit ko na po ba yung philhealth ko by that time and how much po ba ang nababawas sa bill if private hospital po. and ano po bang requirements ang kailangan ko sa paggamit ng philhealth I dont have any id kundi yung postal id po.

    • Nors says:

      Hi abby, yes, eligible ka, kasi 3 contributions na lang (paid within the prior 6 months) ngayon ang required sa Individual Payor-Informal Sector. Dapat Indicated CS para ma-cover ng Philhealth, meaning desisyon ng OB kung CS o normal. Ang CS coverage ay 19k (11400 for hospital and 7600 for ob)

  62. Bella says:

    Good day! Nakapgfile na po ako sa Phil health imus Cavite and nkpagbayad na din ako ng advance 1 year para magamit ko sa panganganak ko.. Tinanong ko din ung staff ng Phil health if pede ko na siya agad magamit.. They asked me kelan ako manganak sabi ko may 2014.. Sabi nung staff pede dw.. Thank you din sa site mo.. GOD BLESS!! :)

  63. Nora says:

    Hi Bella, it’s good that you have registered. Thanks for sharing info. God bless din.

  64. girlie pontiga says:

    i just wanna ask marerefund po ba namin yung ga ginastos for hospitalization… yung mga resibo na binili outside the hospital kung may philhealth kami… at ganun po ba tlaga halos kalahati lang angmababawas sa hospital bill namin kahit may philhealth kami

    • Nors says:

      Hi girlie, maternity ba ito? Ang coverage ng maternity ay 5,000 pesos lang (3k for hospital and 2k for PF) pag sa hospital, kahit magkano ang nagasto nio. Kung nagamit na ang 3k for hospital, hindi na marefund yong mga nagasto for gamot na binili sa labas.

  65. jane says:

    Hi my name is an OFW im planning to use his Philhealth for my delivery but I’m anxious baka need pa mag sign ang employer sa papers na ipapas sa Philhelth for benifits which is mahirap na para sa akin.Any suggestion please

    • Nors says:

      Hi jane, sino ang OFW sa inyo? Kapag employed ang husband mo dito sa Phils, kelangan ang signature of the employer on claim form 1. If he is an OFW, yong premium receipt and marriage cert ang kelangan.

  66. dhanz says:

    hi..i juz wanna ask..if maaavail q ang prenatal benefits na 1500… at kung mggamit q ang philhealt q.unemployed n aq last jan.2014.. i hav contri for d period of jun2011-aug12, july2013-nov2013… im 7mos.pregnant.. my due date is may27,2014…. and now. if i’m going to pay my contri from jan-june2014… can i avail philhealth maternity benefits. ?

    • Nors says:

      Hi dhanz, sorry you can no longer pay for Jan to Mar 2014. Go to Philhealth and pay 1 year in advance as Individual Payor-Informal Sector (2400 pesos), so you can avail. Magtanong na rin doon para sure.

  67. Nix says:

    hi po , 7mos. na po ako pregnant now and ngayon lang kame nakapag register sa philhealth at gud for 3mos. lang po yung pnabayaran samin ng philhealth,,, ask ko lang po kung aabot po ba kame sa benefits/reimburse for maternity , prenatalcare and newborn package??3rd week of june po ang duedate ko.thanks in advance po.

    • Nors says:

      Hi Nix, nabayaran mo ang Jan to Mar 2014? Pay also April and May so you can avail in June. Write Individual Payor on the payment form

  68. payi says:

    Hi! My due date is on April 30. I am unemployed but declared philhealth dependent/beneficiary of my husband. He has been working in a private company since October 2, 2013. Assuming his employer is giving updated remittances, can I avail the benefits? And what if his employer is not updated with the remittances (’cause it happened in his SSS, his recorded contribution is only until November 2013, the company said ‘matagal lang talaga minsan pumasok sa system’), can I still avail the benefits?
    Additional Info: He has contribution from June 2009-January 2010 and September 2011-May 2013

    • Nors says:

      Hi payi, you can ask your husband to verify his Philhealth payments at any Philhealth branch at para makakuha na rin siya ng MDR, kasi required doc ito. If there’s only 1 or 2 payments for the past 6 months, mag-member ka na lang agad as Informal Sector/Individual Payor, before April 30; pay 1 year in advance. Ask others too

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