Philhealth Benefits for Selected Outpatient Cases

Here are selected Outpatient Cases covered by Philhealth. These are covered under the Philhealth Case Rate Scheme — meaning the amounts of coverage are fixed rates.

Illness or Treatment Amount of Coverage
in Pesos
Avian Influenza 50,000 – 100,000
Bilateral Tubal Ligation (BTL) 4,000
Cataract 16,000
Influenza A (H1N1) 75,000 – 100,000
Malaria 600
Outpatient Hemodialysis 4,000
Outpatient HIV/AIDS Treatment     30,000
Outpatient Radiotherapy 3,000
SARS Package 50,000 – 100,000
TB-DOTS 4,000
Vasectomy 4,000

For surgeries:
60% of the coverage is for the hospital
40% is for the surgeon or surgeons or for professional fees (PF)

For non-surgical treatments:
70% of the coverage is for the hospital
30% is for professional fees

For hemodialysis:
3,500 pesos is for the medical facility
500 pesos is for the medical professional

Outpatient Radiotherapy and Outpatient Hemodialysis are excluded from the 90-day single-period-of-confinement rule.
They can be availed of on a per session basis, such as twice or thrice a week, up to 45 sessions per year.

Philhealth-Accredited Dialysis Centers in Metro Manila

Other outpatient surgeries are also covered, such as cyst removal, but they are covered under the Fee-for-Service payment scheme. Philhealth pays a portion of the medicines, lab, OR and PF.

For TB-DOTS:
This is Excluded from the 45-day limit per year, but it is covered by the period of confinement rule

If you need Philhealth coverage for a quick surgery, you should talk with your surgeon about Philhealth coverage before scheduling the surgery because there are some busy surgeons who do not have time filling up Philhealth claim forms, specially for quick low-cost surgeries.

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  1. Concepcion U. Mendoza

    Meron po bang bagong directive si President Noynoy na gagawin nang 90 sessions per year ang dialysis? Sana matulungan naman ninyo kami na madagdagan ang sessions up to 90. Malaki po itong tulong sa amin.

    1. Hi Concepcion, sori wala pa naman akong nabasa about that. But that is a good suggestion. Write to your congressman and senator and on the Facebook page of Philhealth. Have you tried asking assistance from PCSO? I know someone supplementing his 45-session coverage by getting guarantees from PCSO. Ask your dialysis provider the documents needed to help guarantees from PCSO. http://www.pcso.gov.ph/imap.html

  2. ung po bang operation sa polyp kasama sa philhealth benefit?

    1. Hi eman, removal of polyps? Yes, covered siya. Talk first with your surgeon about Philhealth coverage para aware siya na you’re using Philhealth.

  3. kailangan daw po operahin ang naimpeksyon na tenga ng anak ko, out patient po siya, hindi naman daw po
    major operation…pwede po ba gamitin ang philhealth ko sa kanya as my benificiaries kahit na
    out patient po siya? thank you.

    1. Hi jinky, puede, pero kausapin nio ang surgeon before the operation kung puedeng magamit ang Philhealth

    2. oo nga po. sana po 90 sessions nalang. malaki po talagang tulong para sa aming mga mahihirap.. :'(

  4. is there a guidelines on how much will go to profesional fee for tb-dots fund?

    is there a guidelines on how much the professional fee should go to health provider out of 4,000 pesos tb-dots pf?

    1. Hi almartires, first time na na-ask ito. I’ll check first the circulars.

    2. Hi almartires, I read the tb-dots circular and there’s no definite PF amount mentioned. It says that the 4k is allotted for “diagnostic work-up, consultation services and anti-TB drugs” at an accredited tb-dots facility.

  5. Tanong lang po kong pwede ba gamitin ang phil health sa vaccination for ani rabies? taga Davao po ako. Salamat po

    1. Hi Lloyd, the animal bite package of Philhealth is for those who have already been bitten by a dog or cat or any other mammal. Treatment should be at a DOH-accredited and/or Philhealth-accredited animal bite center.

  6. My mother underwent catarata surgery/laser on her both eyes 4 years ago. Now, her catarata on her left eye is recurring or bumabalik at malabo na raw paningin nya. Can she use my philhealth card again for the second time surgery/laser of her eye? By the way, am still single and my mother is already 78 years old.

    1. Hi dan, yes, she’s eligible for coverage; I’m just not sure if laser surgery is covered, or only the customary cataract removal process. Find a Philhealth-accredited eye surgeon in an accredited hospital.

  7. Hi poh.. pwede ba mgamit ang philhealth for outpatient like nagpa xray and check-up? tapos yung mama ko dati nagpa remove ng cataract pero outpatient sya.. ano pwede maavail jan?
    Thanks

    1. Hi acel, hindi covered ang outpatient diagnostic procedures like xray or checkup. Ang cataract removal ay covered, pero magpacheckup muna sa accredited opthalmologist kasi kelangan ang pre-approval from Philhealth bago gawin ang procedure.

  8. hi does emergency minor lesion.is covered by philhealth?

    1. Hi dha, some minor outpatient surgeries or treatments are covered, but it usually depends on the doctor/personnel because they’re the ones accomplishing the forms.

  9. Hi!
    Ask ko lang po itanong kung pano po ba ang procedure sa pag avail ng 45 sessions ng pag pa dialysis?tsaka yung sa pcso din po pano din pi process nun?

    1. Hi Cindy, find a Philhealth-accredited dialysis center. Basic docs usually required by dialysis centers are updated MDR, premium ORs, claim form 1, doctor’s prescription for dialysis, medical abstract, hepatitis profile, results of diagnostic exams (orig and copies of these docs). Merong nag-recommend dito ng Genesis, Clinica Antipolo, Hemotek and Nephrology Center Philhealth-accredited dialysis centers in Metro Manila

  10. Tanong lang po yung sa dialysis package po na 3,500 at 500 for doc. fee. san po i avail yung free na epoetin at dialyzer po.tnx po

    1. Hi Leah, puedeng kasama na sa package, depende sa Philhealth-accredited dialysis center. Yong iba, nagrerequest ng meds sa PCSO. Yong iba, bumibili sa NKTI sa Quezon City dahil discounted price daw.

  11. yung leukemia chemotheraphy covered ho ba..

    1. Hi roy, yes, covered, as long as the hospital is accredited and you complete the docs required by the hospital or facility.

  12. impacted tooth for surgery covered ba sya ng Philhealth

    1. Hi may, sori hindi ko makita sa new Case Rate list itong impacted tooth removal. Ang alam ko, hindi covered, pero tanungin mo na lang ang dentist para macheck mo na rin kung Philhealth-accredited siya.

  13. tanong lang po puede ko po ba mareimburse yong bayad ko sa MRI? result po ng MRI nag ka roon po ako ng optic nuiritis.

    1. Hi sherwin, nagawa na ito while confined? Ang alam ko ang mga diagnostic procedures nakakasama lang sa coverage kapag kasama sa treatment while confined. Ask others too

  14. Ask ko up to wat extent ang coverage para s radiotheraphy . And chemotheraphy. Ung sanang 1mrt radiotheraphy ang preferred nmin.

    1. Hi Fanny, doon sa new Case Rate list, merong types of radiation treatments with corresponding coverages. Tanungin nio na lang sa hospital. If you like to see the list, check here: https://sites.google.com/site/informationphilippines/philhealth/case-rate-guidelines-2013
      Click Procedure Case Rates, and then check RVS code nos. 77401 and so on.

  15. hi mam, query ko lang po kng till now itong 4k per session sa outpatient hemodialysis ay continue pa rin ba?

    Salamat po,

    cyril

    1. Hi cyril, yes, pero hindi na direct filing with Philhealth. You need to talk with your dialysis clinic about their Philhealth dialysis package

  16. Hello,

    I am an OFW, and be going home on March 20 this year. I am planning to have a surgical operation kasi may bukol sa right foot ko na sumasakit at minsan nahirapna maglakad dahil nasa natatapakang bahagi ng paa. may philhealth benefit ba kahit outpatient ako?
    Thanks.

    Reuben

    1. Hi Reuben, yes, covered ang outpatient surgery. Look for a Philhealth-accredited surgeon na willing to operate on your foot at willing to let you use your Philhealth coverage.

  17. hi po ask ko sana if covered etong ipapatanggal ko sana na bukol sa talukap ng mata ko kasi kinagat ng insect tas nung tumagal eh may bukol na. malamang po eh outpatient po ako kasi mukhang hindi naman po eto sensitive na case. thanks

    1. Hi abby, yes, covered yan, puedeng excision of eyelid lesion or cyst, pero look for a surgeon who’s willing to accept your Philhealth coverage as part of his payment.

  18. Ask ko lng po kung pwd ang Philhealth sa ECG Test pra sa nanay ko as my dependent..Thnx

    1. Hi Eds, diagnostic ang ECG; ang alam ko hindi covered kapag outpatient. Ask others too.

  19. heloo po, ask ko lang po kung covered ba sa philhealth yong anak ko na confined last month for having extrmeme depression with mixed phsycosis as disgnose by the doctor..

    1. Hi bads, I checked the Case Rate list at meron naman doon different kinds of mental and behavioral disorders na covered. Merong severe depression with psychotic symptoms, recurrent manic-depressive disorder, etc. If your doctor is Philhealth-accredited, you can ask about filing. But ask first Philhealth because they’re now discouraging direct filing with Philhealth.

  20. Maria Sylvia Bernardo

    Good morning po, 3 mos.pa lang nakabayad sister ko sa philhealth,paid nya para sa 1st quarter of 2014, bale continuation ng hulog nya, the last time na nakahulog sya was last 2007, nawalan lang ng job kaya di nakahulog, maco-cover po ba yung excision of breast cysts nya? Marami pong aalisin, kailangan po ba ang confinement? How much po ang pwedeng ma cover kung sakali.? Salamat po.

    1. Hi Maria Sylvia, yes, covered na siya for April. Look for a Philhealth-accredited surgeon willing to accomplish Philhealth papers, kasi yong iba hindi sila available to fill up papers. Usually outpatient procedure ang breast cyst excision. Coverage ranges from 3,640 to 8,020, depende sa specific process.

  21. Hi! Ask ko lng po pano kung may hmo like intellicare and then meron pong coverage na 40k sa dialysis pwede po bang unahin na muna ung sa intellicare at kpag ubos na ung alloted e sa phic namn po ung gagamitin namin, may 45 seasion in a year dw nalibre? Thnk u po!

    1. Hi Jm, yes, puede yang plan ninyo. The Philhealth coverage for hemodialysis is 4k per session, so look for a Philhealth-accredited dialysis center that offers this service with little or no additional cash payment. Take note that the 45 sessions per year is per calendar year and not a per 12-month-cycle.

  22. physio therapy,covered po b ng philhealth ?

    1. Hi merly, sorry, hindi ko makita sa Case Rate lists ang physiotherapy. Ask others too.

  23. sa dialysis concern po ano po ba ibig sabihin ng 45 sessions per yr is per calendar yr & not on per 12 months basis

    1. Hi edmundo, 45 sessions ay per calendar year, hindi per 12 months. 45 sessions for 2014; another 45 sessions in 2015, and so on.

  24. Hi po, inquiry po regarding s case ng mama ko, bale qualified dependent nman po sya ng papa ko n lifetime member n s PhilHealth. Currently, naka-confine mother ko. Naka-3 confinement n po sya starting May 7, una for stroke,diabetes; 2nd- diabetes/pneumonia & now for diabetes complication at nagkidney failure n.
    Nag-dialysis kc sya nung Wed tapos dialysis ulit dis Fri. Sabi po ng dialysis department ng ospital, hindi daw po pwede ma-claim free dialysis ng philhealth while confined ang patient. Ayaw nman po magpacharge ng Binan Doctors ng dialysis, ang gusto nila magbayad kami cash s supplies, pf ng doktor at dialysis itself. I read here n hindi n pwede direct filing ng dialysis. ano po gagawin namin, may iba p po ba n way para ma-reimburse samin cost ng dialysis kc po depleted n rin po resources nmin at umaasa n lang kami s relatives n tumutulong but they can only help as much.
    Thank you in advance for your advise.

    mjn

    1. Hi mjn, that’s because Philhealth deduction will be based on the main diagnosis — kidney failure or diabetes complications, and dialysis is included in the coverage for the main diagnosis. Talk with the collection department so they can help you ask help from PCSO. If possible, ask help from PCSO before discharge.

  25. Nimfa V. Rodulfa

    Is there any benefit for dental procedures?

    1. Hi Nimfa, routine dental procedures are not covered. I can’t even see impacted tooth removal or root canal surgery in the list. Certain diseases involving the tooth, gums, jaw, etc. are the ones covered; ask your dentist

      1. hi po, ask lang po sana.yung patient po kasi nagdialysis po, supposedly outpatient po sna, kaso after po ng dialysis (same day po)nagdecide po yung doctor na iadmit po xa for further management macocover po b pareho ng philhealth yung dialysis and confinement?slamat po

        1. Hi barbie, yes, if the patient was not confined for the same illness within the past 90 days. Ask the billing department.

  26. chita b. mangubat

    Ngpadialysis asawa ko p1500 daw bayad, ang alam ko p4000 ang covered s outpatient bkit pinabili p ako ng injection worth p1500

    1. Hi chita, yes the coverage per session is 4k. Find a hemodialysis center that offers Philhealth packages, and then choose the package that you prefer.

  27. mam pwede po ba mareimburse mga nagastos na medicine out patient po kasi ako?

    1. Hi marlon, sad to say, medicines purchased by outpatients are not covered by Philhealth.

  28. hi! My daughter will undergo minor surgery due to pre auricular sinus sa right ear. It’s congenital. How much is the philhealth deductions for this? Thanks

    1. Hi Grace, sorry I cannot identify the type of minor surgery that will be performed. There are a lot of mentions of sinus in the Procedure list and one mention of a complex middle cranial fossa pre-auricular surgery. To be sure, ask your surgeon about costs with Philhealth coverage so you can prepare.

  29. hello po tatanung ko lang po kc namamaga po paa ko dahil po sa ingrone sa hinlalake gusto ko po sana gamitin ang philhealth ko pwde po ba yun ? anu mga requirement na hihingiin sa ospital?

    1. Hi perl, requirements are here: http://www.healthphilippines.net/2014/06/philhealth-maternity-benefit-individual-payor/. Find a Philhealth-accredited surgeon in a Philhealth-accredited clinic/hospital.

  30. tanong ko lang po kung covered ng philhealth ang chemotheraphy session out patient.

    1. Hi virgilio, yes, find a facility that offers Philhealth packages for outpatient chemo.

  31. tanong ko lang po kung yung pagtanggal/pag-opera ng in-grown s thumb sa paa is covered ng philhealth, namamaga na po kasi xa as in mejo violet na. thanks po.

    1. Hi Jareth, I saw this on the list: Wedge excision of skin of nail fold (ex: for ingrown toenail) 3,640 pesos coverage (840 for PF and 2,800 hospital cost). There are related procedures on the list. Find a Philhealth-accredited surgeon in an accredited facility and ask. Have your big toe treated asap before serious infection sets in. A day or 2 days after failed pedicure, that could have been remedied by a better pedicurist (completion of removal of ingrown plus application of antibiotic cream).

  32. good afternoon po mam. ask lang po regarding sa dialysis package ng philhealth. db po may 4K per session then minus yung 500 for the PF ng doctor. in our institution po kasi 2300 lang per session ng outpatient then 1k po ang epoetin injection nila for a total of 3300 so may remaining pa po na 200. ok lang po ba na icharge yung remaining na 200 for tablets na maintenance ng mga patients?

    1. Hi casper, I’m so glad that you’re thinking of the welfare of patients, and that your facility’s service rate can be fully covered by the Philhealth coverage of 4k. Sorry I’m not sure if you can include the cost of all the tablets. What I know is that only the cost of meds used during the session can be charged. The relevant circular says “Reimbursement shall include payment for use of the dialysis machine and health care institution, drugs and medicines, supplies and others on per session basis.” But I’m not from Philhealth, so ask others too. http://www.healthphilippines.net/2014/08/philhealth-coverage-for-hemodialysis/ If you like, you can mention the name, address, contact nos., services, rates and documentary requirements of your facility here so I can recommend it.

  33. Ate Nora tanung lang po ako…bunt is po ako at ngayung year manganganak na po ako…pwedi nyu po back akong tulungan maghanap ng mag aampon sa baby ko

    1. Hi brenda, I can research for you. Meanwhile, you can approach churches or women’s foundations in your area. Take care. I will add some info later.
      Hi brenda, here’s a list of foundations or centers that you can contact:
      http://www.gmanetwork.com/news/story/307497/lifestyle/peopleandevents/care-during-crisis-a-help-desk-and-resource-list-for-single-moms
      You can also contact 700 Club: prayforme@cbnasia.org / Metro Manila: 810-7176 or 810-7717 /
      Text 0920-222-8373 / 0917-406-5001
      Take care. I’ve prayed for you. I hope you can share later on which foundation or center has helped you.

  34. good day can i reimburse my expenses for my check ups as out patient? I like to use my philhealth for my laser surgery for my eyes. the clinic where i’m having my checkups is not accredited. thank you

    1. Hi helen, sad to say you cannot reimburse outpatient checkups. About your eye surgery, you need to find a Philhealth-accredited clinic and accredited eye doctor. Not all laser procedures are covered, so ask your doctor. If you’re in QC, you can try Novagen at SM Fairview.

  35. Hi, with Philhealth 45/year session on dialysis, what are deducted are the days of confinement not the dialysis sessions during the confinement?
    2nd inquiry po, my father uses my philhealth in his outpatient dialysis as my benificiary, if in case i will use it on my confinement w/ different illness, is the 45 sessions/year reduced?

    1. Hi Ariel, yes, you’re right, it’s the days of confinement that are deducted, regardless of no. of dialysis sessions done during confinement. 2nd question: You have your own allocation of 45 days per year. You can give your father an allocation of 45 days per year, separate from your own 45 days allocation. If you have other dependents, they share in the 45-day allocation, meaning all your dependents divide among them the 45-day allocation for dependents.

  36. Hello there, my father has consumed my sister’s philhealth total allocation of dialysis sessions. Can i use my philhealth to cover his new sessions?

    1. Hi Leslie, sorry your father can use only 1 Philhealth membership, and therefore only 45 dialysis sessions per year. You can go to PCSO and ask for assistance. Here’s good information: http://pinoylifewithpkd.blogspot.com/2014/01/steps-in-getting-pcso-financial.html

  37. hello nors, my child was bitten by a dog. The vaccine used for him — we bought it outside, as it was not available at the hospital. For the next injection, we bought it outside too. For the last injection, we were scheduled at the animal bite center but we were not able to go, so we had to go again to the ER and we again bought the meds outside. can we file our claim with Philhealth?

    1. Hi cynthia, do you mean you had the injections at a hospital and not at an accredited animal bite center? Ask if the hospital is accredited for animal bite treatment, and if yes, then you can file your claim with Philhealth with documents from the hospital. Philhealth’s rule is you should have the treatments at an accredited animal bite center. Ask others too.

  38. Good day! can my sister avail of her philhealth even if she has just paid 3 mos. she’ll have minor surgery to remove her breast cyst. Thank you.

    1. Hi janet, if she paid for July to Sep, yes, she can avail this quarter. If she paid Oct to Dec, she can avail in Jan to Mar 2015.

  39. Ahm tanung lang po sa 45 sessions po ng philhealth sa dialysis ay ilang new dialyzer lng po b ang pwd? Pwd po b kahit ilan bzta papazok sa covered na 3,500..? Db po 4,000 ung cover np philhealth, 500 prof. Fee tpoz ung 3500 sa EPO, DIALYZER, at treatment..so pwd po b kht ilang new dialyzer sa philhealth bzta pzok sa 3500?

    1. Hi ferjenand, yes, you’re right, if 3,500 is enough to cover the cost of a new dialyzer plus epo plus facility, then a new dialyzer, not reuse dialyzer, should be used every session. But this would depend on your facility — there are those that offer no-cash-out or more affordable packages if they use reuse dialyzers some of the time. I’m not sure if this is really what you’re asking, so just comment again.

  40. are endoscopy and colonoscopy philhealth covered? if so, how much? thanks!

    1. Hi amelia, there are several types of those procedures, so i emailed you the case rate lists

      1. Hi, my mom is diagnosed with gastric ulcer and colonic polyp. doctor recommended her for colonoscopy and endoscopy. She is a dependent of my father who is a lifetime member (senior – sss covered/retiree). How much will be covered by philhealth for these two procedures? Hospital quoted more than 40k for this. Thnks.

        1. Hi jp cruz, coverage for colonoscopy and endoscopy ranges from 10k to 18k, depending on specific procedure. You can go to philhealth.gov.ph, then use the Case Rates Search software to find benefit amounts.

  41. How does one know the percentage, phil,health will contribute.towards a minor surgury. example rectum: hospital charge example 50.000.either out patient or few days in hospital.And percentage for medicines, or all payment.We need to know, before we approach the hospital. private,or government.and to choose our budget accordingly thankyou w.m.wood

    1. Hi william, it’s no longer percentage. There’s a fixed coverage for every procedure, regardless of how much you spend and regardless of the type of hospital. You can search the procedure here: Press “Ctrl” and “F” to search. Procedure Case Rate list

  42. HI Nora, my Nanay will have surgery on her cyst/mass near her appendix and the cost of operation is 100K pesos. How much discount can we get from Philhealth?

    1. Hi Don, can you ask the exact term for the surgery so I can check the Case Rate list.

  43. A cat bit my foot. Does philhealth covers the vaccine at san lazaro?

    1. Hi Jasmine, the animal bite package is only 3k. You pay the balance. Ask them about their Philhealth procedure.

  44. Good day! outpatient po anak ko at na blood test siya for 4 days, for platelet count monitoring. covered po ba yun ng philhealth?

    1. Hi rodz, sorry that’s not covered. But ask others too.

  45. hello, my mother needs cataract operation but does not have philhealth. Can she use my philhealth? thanks in advance

    1. Hi kai, is your mother 60 years old? If yes, she can be your dependent. She can also apply for her own free Philhealth card, as she’s already senior. She brings her ID and birth certificate. If not yet 60, she can register to get her own Philhealth and pay for Oct to Dec 2014, and can have the operation in Jan or Feb 2015.

  46. Is endoscopy covered by Philhealth if outpatient?

    1. Hi monet, it might not be if outpatient and if primarily diagnostic. But ask the hospital.

  47. Hello maam Nora, is eye laser treatment covered by philhealth? Thank you

    1. Hi april, ask your eye doctor, as it would depend on what kind of eye illness is the laser treatment used for. Lasik (laser-assisted in situ keratomileusis) is no longer covered, pending review.

  48. Hello I have trigger finger and I need minor surgery. Is this covered by philhealth?

    1. Hi Esmeralda, yes, but find an accredited surgeon who is willing to treat you with Philhealth coverage.

  49. Both my mother and I have philhealth, and she’s also my beneficiary. She’s ready for hemodialysis. Can use both use our Philhealth so she can avail of 90 sessions/year?

    1. Hi criselda, sad to say, no. Your mother can use only 45 days per year. Every member or dependent can use only 45 days per year. Also, a member cannot be at the same time a dependent, although you can write your mother as dependent if she’s 60 or older. By the way, senior citizens now do not have to pay. For additional assistance, you can file at PCSO. I’ve read about some people receiving 10k pesos as aid per approved hemo assistance request from PCSO

  50. As of today, is the proposed 90 free sessions per calendar year for dialysis already approved or it’s still 45 sessions?

    1. Hi anne, it’s still 45 sessions per year.

  51. Hi, is the privilege for senior citizens for dialysis still 45 sessions? She was previously my dependent. But in Nov 25,2014 she registered with philhealth. my mother is 78. Thanks

    1. Hi Pablo, yes, the allotment for every member is still 45 days per year, which means 45 dialysis sessions per year. Your mother is now covered by Philhealth for free since she’s already a senior citizen. Check from time to time if Philhealth is already issuing Philhealth cards for senior citizens. In the meantime, the senior citizen can be used.

  52. One more inquiry senior citizen philhealth privilege refresh every 1st day of new year?example my mother she was started using her philhealth benefit Nov 29 2014 meaning January 01,2015 her privilege for dialysis refresh 45session again?thanks

  53. Hello 🙂 I have thyroid problem. I’m scheduled for radioactive at a private hospital. Is this covered by philhealth? Thank you!

    1. Hi Anelin, yes, radiotherapy is covered. Ask your hospital so you’ll know what to prepare.

  54. Hi, is achilles tendon injury covered? There’s small tear in my achilles tendon (left). Not operated on because the tear is small. Had 2 weeks on cement and now I’m undergoing therapy to get back strength. Can I reimburse my expenses for ultrasound,xray and therapy? Thanks, God bless

    1. Hi Arleen, sorry I’m not sure because it was outpatient treatment, and you said was not surgery. You can ask the facility which treated you, as claim documents are filled up by the doctor and hospital/clinic, and Philhealth now should be deducted from the bill.

  55. does philhealth cover the vaccine for anti rabies if what was bitten was part of the foot

    1. Hi leovy, the coverage for animal bite treatment is 3k, but you have to go to an accredited animal bite center

  56. Is outpatient surgery for cyst or mass covered by philhealth?

    1. Hi let, yes, but talk with your surgeon first about using Philhealth.

  57. Hi!i have kidney stones i have undergone shockwaves for the past 3 years charged to my hmo. Recently i resigned from my work no more hmo.can you advised me where can i have free or even low cost check up using my philhealth. Thanks and more power

    1. Hi may, Philhealth’s coverage for ESWL is 18k. Sorry I don’t know hospitals’ ESWL rates.

  58. Hi po is MRI procedure covered by Philhealth? our budget is not enough. please answer me thank you

    1. Hi rafael, I can’t find MRI or magnetic resonance imaging in their list. What I know is that outpatient diagnostic procedures are not covered. But ask the hospital.

  59. hi po is hand surgery covered? My finger was cut up to the tendon. major operation. my husband is ofw and I’m his beneficiary. Is this covered by philhealth? tnx po

    1. Hi rina, yes, it’s covered. Ask your surgeon if the procedure can be covered fully by Philhealth, and if not, how much you will pay

  60. Is chemotheraphy conducted at a clinic covered?

    1. Hi rebecca, yes, if the clinic is licensed by the DOH to perform chemotherapy and if it’s Philhealth accredited

  61. How do we reimburse animal bite treatment costs? (ex. dog bite)

    1. Hi angelie, your animal bite facility should be accredited as animal bite treatment center. Ask them for Philhealth claim documents

  62. Cover po ba sa philhealth ang ultrasound?

    1. Hi miriam, sorry it’s not covered because it’s outpatient and diagnostic.

  63. Is outpatient endoscopy covered po by philhealth? Can I use the philhealth of my husband? Thanks.

    1. Hi Mariane, endoscopy is covered, but I’m not sure if it’s covered as outpatient. Ask your hospital. If you are not a Philhealth member, you can be your husband’s dependent. Your name should be in his MDR. If not yet, your husband should update his Philhealth data by going to Philhealth with his ID and your marriage certificate and get a new MDR

  64. Romeo E. Ronquillo

    Hello, is gout treatment covered by Philhealth? My last treatment about 3 years ago I spent more than 4 thousand as outpatient. I am a voluntary contributor. thanks

    1. Hi Romeo, Philhealth’s coverage is 7,000 (2,100 for PF and 4,900 for the hospital), but you need to be confined to be covered. I’m not sure if you’ll spend more as confined but covered or as outpatient and not covered.

  65. Hello po, clarify lang po ako if yung 30 sessions ng radiation ng father ko who is a senior citizen covered po ng Philheath? I’ve read Php3000/ session ang coverage. Does that mean 3000 less for all the 30 sessions?

    1. Hi Claire, no. It’s 3,000 per session. The 30 sessions will be deducted from the 45-day allowance of your father per calendar year. 1 session = 1 day

  66. Dental surgery kasali ba s phil health coverage?

    1. Hi gilbert, sorry but in the list, only complex dental surgeries are covered (fractures, jaw injuries), but there’s a list of Philhealth-accredited dentists here. You can ask them if the dental surgery you need is covered.

  67. Hi covered po ba ng Philhealth ang MRI?

    1. Hi Jonathan, sorry, what I know is that MRI as a separate outpatient diagnostic procedure is not covered. It can be included in procedures and treatments covered as a whole when a patient is hospitalized, but basically, because of the high cost of hospitalization, MRI is like it’s not covered at all even if hospitalized.

      1. Thank you, how about x-ray?

  68. Sakop PO ba Ng philhealth ko Ang BETA HCG test Ng aking anak? Outpatient PO ? Please reply! Thank you

    1. Hi Lisa, sorry, hindi covered ang outpatient diagnostic tests. Ask others too.

  69. sagot po ba ng philhealth ang surgery for ingrown? magkno po covered?

    1. Hi Maricel, find a Philhealth-accredited surgeon or clinic who’s willing to do it under Philhealth coverage as day surgery. Wala akong makita na ingrown sa list pero mag-qualify sia siguro under outpatient day surgery.

  70. Ask ko lang po yung minor surgery like boil pwede po ba philhealth yun oit of patient po

    1. Hi Chela, yes, day surgery ang tawag diyan, pero tanungin mo muna yong surgeon before surgery kung puedeng gumamit ng Philhealth kasi siya ang pipirma ng form, para ma-sure na Philhealth-accredited siya at yong hospital.

  71. Pwede po ba gamitin ulit ung philhealth sa pag oil remove sa retina ko. Na surgery na po ako nitong january 11 2018 for retinal detachment then thid coming may 2018 ireremove na po ug oil. Pwede ko po ba ulit magamit ung philhealth?

    1. Hi Michael, yes, puede na uli sa May 2018 kasi lagpas na sa 90 days na rule nila. Ang 90-day rule nila is kapag the same procedure or the same illness within 90 days, yong una lang na na-claim ang puedeng i-cover. Since more than 90 days na since Jan 11, puede na uli i-cover.

  72. Hello po. I am 9 months pregnant and was just waiting for the baby. I have philhealth. Gusto ko lang po malaman if the delivery and ligation will be both covered? Salamat po

    1. Hi Jhoana, yes, merong vaginal delivery with bilateral tubal ligation na 10,500 ang coverage. Ask your OB kung magkano ang package niya para maka-prepare ka.

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