Special benefit package
Coverage for normal spontaneous deliveries
PhilHealth provides compensation for uncomplicated normal spontaneous delivery or NSD of the first four births done either in hospital or non-hospital settings.
For deliveries in hospital facilities - subsidy shall be broken down as follows:
Services |
Coverage |
| Hospital charges which includes room and board; drugs and medicines; laboratory, supplies and other ancillary procedures; labor room, delivery room and recovery rooms; other medically-necessary charges for delivery and postpartum care. | Php 2,500 |
| Professional fees for delivery services, immediate post-partum care and counseling for reproductive health, breastfeeding and newborn care. | Php 2,500 |
| Prenatal services for reimbursement of member’s prenatal expenses prior to confinement which may include drugs and medicines, laboratory tests and ancillary procedures, tetanus immunization, and consultations supported by official receipts. | Php 1,500 |
|
Total |
Php 6,500 |
For deliveries in non-hospital facilities a comprehensive package consisting of maternal and childcare services are offered under the Maternity Care Package.
Details of coverage:
Services |
Coverage |
| Facility and professional fees which cover charges for PF (delivery, postpartum care, and counseling for reproductive health, breast feeding and newborn screening); room and board; drugs and medicines; laboratory, supplies and other ancillary procedures; labor, delivery and recovery rooms; and other medically necessary charges for delivery and postpartum care. | Php 5,000 |
| Prenatal services to be reimbursed to the member for prenatal expenses prior to confinement. May cover essential drugs and medicines, laboratory tests and ancillary procedures, tetanus immunization, and PF for consultations supported by official receipts. | Php 1,500 |
|
Total |
Php 6,500 |
Additional information:
Providers |
Duly accredited lying-in clinics, birthing homes or midwife-managed clinics. |
Eligibility |
No premium payments required. |
Exclusions |
• NSD of the fifth
and subsequent births. • Maternal age of less than 19 years. • First pregnancy of patients aged 35 years and older. • Multiple pregnancies • Ovarian abnormalities (ovarian cyst) • Uterine abnormalities (myoma uteri) • Placental abnormalities (placenta previa) • Abnormal fetal presentations (breech) • History of three or more miscarriages/abortions • History of one stillbirth • History of major obstetric and/or gynecologic operation (cesarian section, uterine myomectomy). • History of medical conditions such as hypertension, pre-eclampsia, eclampsia, heart disease, diabetes, thyroid disorder, morbid obesity, moderate to severe asthma, epilepsy, renal disease, bleeding disorders. • Other risk factors that may arise during present pregnancy (e.g. premature contractions and vaginal bleeding) that warrants a referral for further management. |
Other conditions |
Pregnancies resulting to abortion are not covered by the limitation of coverage of vaginal deliveries of the first four births. |
