What is the Philhealth category for a Seaman?
Is it OFW or Employed?
According to Philhealth, a SEAMAN is considered an EMPLOYED member. He is not OFW.
Philhealth says that all SEA-based OFWs are EMPLOYED members. This is because seamen receive their salaries through allotments facilitated by their maritime manning agencies based in the Philippines.
Because the Philhealth category of a SEAMAN is EMPLOYED, his Philhealth eligibility requirement for Philhealth benefits is the same as the eligibility requirement for Employed members working in the Philippines.
For EMPLOYED members, they are eligible for Philhealth benefits if they have paid at least 3 monthly premiums within the 6-month period immediately prior to month of hospitalization.
Count 6 months immediately before month of hospitalization. Within these six months, have you paid for at least 3 months? If yes, then you are eligible for Philhealth coverage.
There are some healthcare providers that require payment of 6 months or 9 months. They’re sigurista or not updated. Call Philhealth Call Center 441-7442 and ask for help.
Prepare your Philhealth documents and submit to the hospital one day before discharge. Why one day before? So you’ll have time to remedy in case there’s a problem with your documents. Some hospitals also require submission 1 day before discharge.
Remember: Filing for refund directly with Philhealth is NO longer allowed. So submit your Philhealth papers to the hospital upon admission or 1 day before discharge.
Documents to submit to the hospital:
1. Philhealth Claim Form 1 — filled-up, signed by you (Philhealth member) and your company. Prepare 2 sheets if it’s for maternity coverage (one for the mother and one for the baby).
2. Member Data Form (MDR) — Get this from Philhealth
If the patient is the seaman’s dependent and his or her name is not yet written in the MDR as dependent, submit birth certificate (if child or parent) or marriage certificate (if spouse) to the hospital. Many hospitals require the MDR to be updated, so update your MDR.
3. For Maternity Patients, submit official receipts of prenatal care (total is at least 1,500 pesos) to get reimbursement of up to 1,500 pesos. This is optional and this is only for normal delivery cases.
4. Bring your Philhealth ID or Philhealth card or any valid ID, in case the hospital requires your ID.
If the SEAMAN is not in the Philippines to process Philhealth papers, he can email an authorization letter authorizing his wife or family member to process all Philhealth documents needed for Philhealth coverage, including a photo or scan of his ID.
If the SEAMAN is on VACATION or ON LEAVE WITHOUT PAY for more than 2 or 3 months, he should pay his Philhealth premiums as Individual Payor.
Philhealth for Seaman — Employed Category, Not OFW
Why is the bill for a newborn separate from the mother? Can the newborn be covered as dependent?
Hi jesus, yes, the newborn can avail of Philhealth coverage because he’s a dependent of the father or mother (Philhealth member). Usually the hospital-issued birth cert can be used for Philhealth documentation. Some hospitals require birth cert from city hall/local registrar. Ask for deduction; direct filing with Philhealth is no longer allowed
I’m a dependent of my seaman husband who started working last Dec … I’ll give birth this may …Can I avail of philhealth if the company pays Dec to April?
Hi cristine, yes, you can avail. Ask for signed claim form 1 and cert of premium payment with OR nos. from your husband’s company plus MDR from Philhealth.
good day. I’m a seaman, on vacation since since last month. Would like to pay for may-july. I’ll be leaving in august..How much will I pay? Should I pay as individual payor? I ask the bayad center teller last week and they don’t know what to say. Thanks..godbless
Hi alvin, yes, if you’re on vacation, pay your premium as Individual Payor. Philhealth gives the same advice to local employees on long leaves. Rate is 200 pesos per month.
Hi! Ask ko lang if maka benefit naba ako even my husband last March pa sya nakasakay ng barko ulit? Gusto ko sana magpacheck.up as out patient lang, this month sana ako plano magpa check.up dahil sa lungs ko. Pwede naba akong maka benefit sa PHILHEALTH? Magkano po ba ma benefit sa TB na case po? Salamat!!!
Hi Charlotte, if his agency paid for Apr May June, you can avail. Find a hospital that offers TB DOTS package. The coverage for the 6-month treatment program is 4k pesos. In some hospitals, 4k might be enough; in others, you pay the balance.
Hi po gud pm..!!dependent po ako.,seaman po asawa ko.!naka Sampa po sya nung April 2014.,manganganak po ako this coming sept..!!3months po naging bakasyon nya..ma kaka avail po na ako sa philhealth..April ulit nag simula ang hulog ng company nila hanggang ngayon..?
Hi melody, yes you can avail.
Good day! I’m a seaman. Can we avail of Philhealth benefits if we pay for 3rd quarter this year? My wife’s due date is October. Thanks!
Hi Rolly, yes, she can avail.
Gud pm po.!!tanong ko lang po.,ano po ba ang requirements ng benificiary.?at saan po ba kukuha ng MDR..?sa agency po ba o Sa philhealth office..!thank you po and Godbless
Can I use my philhealth and how much will be the coverage for my medical operation for gallstone. almost tree months I’m on vacation and I need to have the operation
Hi teodel, if your procedure is cholecystectomy, the coverage is 31k pesos. If your operation is this month of Feb, you should have paid 3 months within Sep 2014 to Feb 2015. If your surgery is in March, pay Jan to March asap.
Are you open on Saturdays. I’ll be paying.
Hi Lilibeth, many branches are not open on Saturdays. Check Philhealth branches at some Robinson malls.
Good day! My brother is seaman his dependent is my mother 49years old admitted to hospital for cerebrovascular infarct can my mother avail assistance?
Thank you
Hi Dianne, sorry your mother is not yet qualified as Philhealth dependent because she is not yet 60 years old. If you have an AMOSUP medical ID at malapit kayo sa Seaman Hospital, tingnan nio kung puedeng ma-transfer.
Hi po, kasasakay lang po ulit nang husband ko last week of october. Makaka-avail po ba ako nang philhealth? February po ako manganganak.. thanks po
Hi Rea, yes, kung yong agency ng husband mo is makabayad for your husband for Nov, Dec 2016 and Jan 2017 or Dec 2017, Jan and Feb 2017. Dapat 3 months. Kung hindi, dapat mga middle of December, mag-register ka na sa Philhealth and pay for Oct, Nov and Dec para magamit mo ito for your Feb delivery.