Health Philippines Net

Philhealth Maternity Benefits Requirements for Voluntary Members or Individually Paying Members and their Dependents

Ito ang mga documents na ibigay mo sa hospital or maternity clinic bago ma-compute ang bill mo, or bago ka ma-discharge para maibawas agad ang Philhealth maternity benefit mo sa total bill.

Mas maganda na maibawas agad ang Philhealth maternity benefit mo sa total bill mo, kasi matagal ang processing ng Philhealth refund. Pareho lang ang amount ng benefit ng nagpa-deduct agad at yong nagpa-refund.

1.   Clear copy of  Member Data Record (MDR) — Kunin mo ito from Philhealth

2.  Philhealth Claim Form 1 — You can also get this form from Philhealth or from some hospitals or clinics.   Fill this up and sign.  Ganito ang itsura ng form:  https://sites.google.com/site/informationphilippines/philhealth/philhealth-claim-form-1

3.   Clear copies of Official Receipts of Philhealth contribution payments  

Dapat merong 9 monthly payments.  Dapat itong 9 months na ito ay nasa loob ng 12-month period bago buwan ng panganganak. Puedeng merong gap, basta merong 9 months na nabayaran sa loob ng 12-month period.

Example:  Kung September 2012  ang buwan ng panganganak, dapat merong 9 months na nabayaran sa loob ng 12-month period mula September 2011 to August 2012.

4.  If you are a dependent of your husband, at hindi pa nakasulat ang pangalan mo as dependent sa MDR, submit a copy of your marriage certificate from NSO or from local civil registrar

5.  Official receipts of Prenatal Care Payments — Puede lang ang benefit na ito sa Normal Delivery. Wala ito sa Cesarean Section o CS.

Submit at least 1,500 pesos worth of receipts, kasi 1,500 ang prenatal care  benefit.  Anong prenatal care ang puede? Merong list dito:  http://www.healthphilippines.net/2011/11/philhealth-maternity-benefit-prenatal-care/

6.  Hindi naman sinabi ng Philhealth, pero dalhin mo na rin ang Philhealth ID mo or any other ID, just in case hanapin sa iyo.  Pero hindi ito dahilan para hindi mabawas agad ang Philhealth benefit.

Additional Information: 

1.  Dapat Philhealth-accredited ang hospital o clinic at ang doctor.

2.   Merong 1,750 pesos worth of Newborn Care — Dapat Philhealth-accredited ang pediatrician.  Puede ang benefit na ito sa Normal Delivery at sa CS. Ano itong newborn care?  Ito ang listahan: http://www.healthphilippines.net/2011/08/philhealth-maternity-benefits-newborn-care/

3.  How much is Philhealth maternity benefit?

Kapag Normal Delivery:

– 6,500 pesos pag maternity o lying-in clinic o Level 1 or small hospital

(2,600 pesos for doctor at 3,900 pesos for hospital)

– 5,000 pesos pag Level 2 to 4 or bigger hospital

(2,000 pesos for doctor at 3,000 pesos for hospital)

Ang 1,500 pesos ay marerefund lang kapag merong mai-submit na Official Receipts of Prenatal Care Payments.

Kapag Indicated Cesarean Section o CS:

19,000 pesos — Dapat sa Level 2 to 4 hospital.  7,600 pesos for doctor at 11,400 for hospital

Philhealth Maternity Benefit for OFW Members and Dependents

How to Claim Philhealth Refunds