benefit availment conditions

Eligibility Requirements

The following must first be met to avail of your PhilHealth benefits:

• Payment of at least three (3) monthly premiums within six (6) months prior to the month of confinement.
• Confinement in an accredited hospital for at least 24 hours (except when availing of outpatient care and special packages) due to illness or injury requiring hospitalization.
• Attending physicians must also be PhilHealth-accredited.
• The 45 days allowance for hospital room and board is not consumed yet.

Post Availment Reminders

After the automatic deduction or reimbursement of your benefits, PhilHealth will send the Benefit Payment Notice or BPN to the address indicated in the member’s claim form. The BPN is a report of actual payments made by PhilHealth relative to member’s the confinement/availment.

Should there be discrepancies between the amounts reflected in the BPN and in the member’s final billing statement issued by the hospital, or if the member has other concerns pertaining to benefit availment, he may contact PhilHealth or the health care provider. The member must bring the BPN as reference document.