PhilHealth


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Members

availment procedures

Outright/automatic deduction of benefits

1. Present your valid PhilHealth Card to the admitting/billing section.

2. Submit the following prior to discharge from the hospital:

  • Duly accomplished PhilHealth Claim Form
  • Copy of valid Family Health Card
  • Clear copy of Member Data Record (MDR)

    If qualified dependent is not listed in MDR, submit applicable proof of dependency.

3. Agree with your attending physicians on how much is left to be paid for their services over the professional fee (PF) benefit.

4. Upon submission of all applicable documents, the billing section will compute and deduct your benefits from your total hospital bill. For confinements in DOH-retained hospitals, Sponsored Members will no longer have to pay anything.

Direct Filing/reimbursement

Submit the following to PhilHealth or through the hospital in addition to the documents mentioned earlier within 60 calendar days after discharge:

  • PhilHealth Claim Form 2 filled up by the hospital and attending physicians
  • Official receipts or hospital and doctor's waiver
  • Operative record for surgical procedures performed
Confinements abroad

Submit the following within 180 days after discharge. Overseas confinements shall be paid based on Level 3 hospital benefit rates.

  • PhilHealth Claim Form 1
  • MDR or supporting documents
  • Proof of applicable premium payments