How to Claim Philhealth Benefit for Overseas Hospitalization
You have 180 calendar days from date of discharge to file your claim for your Philhealth benefit for your hospitalization overseas.
In cases where hospital category or level is considered to calculate benefits, refunds for overseas hospitalization are based on payments made to Level 3 hospitals in the Philippines. For example, the maternity benefit for a normal spontaneous delivery (NSD) in a hospital overseas would be the maternity benefit paid to a Level 3 hospital in the Philippines, which is 5,000 pesos. An additional 1,500 pesos would be reimbursed if Official Receipts of eligible Prenatal Care expenses amounting to at least 1,500 pesos are submitted.
Where to File: File at any Philhealth branch.
Documents to submit:
1. PhilHealth Claim Form 1 (filled-up and signed)
2. Member Data Record (MDR)
- For dependents, show proof of dependency, namely birth certificate or marriage certificate. This is important if name is not yet written as dependent in the MDR
3. Proof of applicable premium payments
- For OFW members, submit a copy of OEC receipt that includes Philhealth premium payment or receipt of Philhealth payment made through accredited overseas collectors of Philhealth (Dates of hospitalization should be within validity dates, as written in the receipt)
- For Individually Paying members, submit receipts of Philhealth premium payments for at least 9 months within the 12-month period prior to hospitalization (for maternity cases and certain surgical cases), or for at least 3 months within the 6-month period prior to hospitalization (for non-maternity cases and regular surgical cases)
- For Employed members, submit employer’s certification of Philhealth premium payments for at least 3 months within the 6-month period prior to hospitalization
Note: For OFWs and Individually Paying members, bring original copy of Philhealth premium receipts in case Philhealth wants to check them.
4. Original official receipt or detailed statement of account (written in English)
5. Medical certificate indicating the final diagnosis, confinement period and services rendered (written in English)
Note: You can download Claim Form 1 from the Philhealth website, or you can ask for it when you go to a Philhealth branch to get your MDR.
Claim Philhealth benefit for overseas hospitalization