Updated June 4, 2016
Philhealth Requirements for Employees on Leave
I’ll give birth this December. I have a difficult pregnancy, so I’ve been on leave since July, and so I have not paid my Philhealth contributions. Can I avail of Philhealth maternity coverage in December?
You’re on leave for more than 3 months, so you will not be able to file your Philhealth claim as Employed. For Employed members, the requirement is payment of 3 of the 6 months immediately BEFORE your month of delivery.
What you can do is to file your claim as Individual Payor.
Go to the nearest Philhealth branch with your ID and a copy of your accomplished leave form (or any proof you are on leave) and pay for at least 3 months of the time you are on leave. Make sure you will be paying at least 3 months of the 6 months prior to your month of delivery. Your month of delivery is included in the 6-month count.
Bring also your latest pay slip, as they might want to know if your monthly gross income is more than 25,000 pesos. If your gross monthly income is more than 25,000 pesos, your quarterly payment is 900 pesos. If it’s 25,000 or less, your quarterly payment is 600 pesos.
Ask for a new MDR (Member Data Record). Keep your payment receipt. You’ll need your MDR and your receipt plus copies at the hospital.
When you get back to work, after your leave, your Philhealth status will automatically revert back to “Employed” after your premium payment as Employed is posted.