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Nakaseguro
pati kalusugan ng iyong pamilya…
Kasamang makikinabang kaagad sa iyong PhilHealth membership ang mga sumusunod:
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Legal na asawa na hindi miyembro |
• |
Mga anak (legitimate, illegitimate, legitimated, adopted o step children) na mababa sa 21 taon gulang, walang asawa at hindi nagtatrabaho. Kung 21 taon na o pataas ngunit may kapansanan (pisikal o sa pag-iisip) o congenital illness ay kasama ring makikinabang. |
| • |
Mga magulang 60 taon gulang o pataas na hindi miyembro. Kasama ang step parents (kung patay na ang tunay na magulang) at adoptive parents (kung may adoption papers). |
Mga benepisyo sa ilalim ng OWP
ng PhilHealth
| Out-patient
Care |
• |
Enhanced Outpatient Benefit Package - sa pakikipag-tulungan ng DOH hospitals kung saan madaling maa-avail ng mga OFW-OWP members at ng kanilang qualified dependents ang mga serbisyo na nakapaloob sa package na ito. (sa Pilipinas lamang) |
• |
Day surgeries, dialysis at cancer treatment
procedures tulad ng chemotherapy at radiotherapy
sa mga accredited free-standing clinics at
ospital. |
| Special
Benefit Packages |
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Maternity Care Package
- P4,500 para sa Normal Spontaneous Delivery
(NSD) ng unang tatlong panganganak sa mga
accredited hospitals; - Kung nanganak naman
sa isang accredited non-hospital facility
(lying-in clinics) - covered ang prenatal
at postnatal care pati na ang family planning
services. (sa Pilipinas lamang) |
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Newborn Care Package - kung saan covered ang eye prophylaxis, umbilical cord care, Vitamin K, thermal care, unang bakuna para sa Hepatitis B, at Newborn Screening Test (P1,000) sa hospital at non-hospital facilities. (sa Pilipinas lamang) |
• |
TB-DOTS (Directly
Observed Treatment Shortcourse) Package - P4,000 para sa gamutan ng pulmonary at extra pulmonary tuberculosis sa mga accredited TB-DOTS Centers. (sa Pilipinas lamang)
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SARS Package na aabot sa P50,000 para sa miyembro at dependents, at P100,000 kung health worker ang miyembro. |
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Avian Influenza / Influenza
Pandemic o Bird Flu na aabot sa P50,000 |
In-patient Care
Ang mga sumusunod ay ang iyong benepisyo sa bawat single period of confinement o serye ng confinements sa Pilipinas at abroad sanhi ng iisang sakit sa loob ng 90 araw.
Mga dapat tandaan sa pagkamit ng
benepisyo
| Local
confinement |
| Outright
deduction: |
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Upang makamit kaagad ang PhilHealth benefits
bago lumabas ng ospital, isumite sa Billing
Section ng ospital ang mga sumusunod: |
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Original PhilHealth Claim
Form 1* |
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Valid Enhanced Member
Data Record (MDR), o PhilHealth Premium
Payment Receipt (i.e. E-receipt, PhilHealth
Official Receipt, MI-5) |
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Kung dependent ang na-confine
at wala ang pangalan nito sa Enhanced
MDR, maglakip ng kopya ng dokumentong
magpapatunay sa relasyon ng legal na
dependent sa miyembro |
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| Direct
Reimbursement: |
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Isumite ang mga sumusunod sa PhilHealth
sa loob ng 60 araw pagkalabas ng ospital: |
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Original PhilHealth Claim
Form 1* |
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Original PhilHealth Claim
Form 2 |
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Original PhilHealth Claim
Form 3 (para lamang sa
na confine sa level 1 hospital (primary)
o naospital ng mababa 24 oras). |
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Valid Enhanced member
Data Record (MDR), o PhilHealth Premium
Payment Receipt (i.e. E-receipt, PhilHealth
Official Receipt, MI-5) |
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Original Official Receipt
(OR); o Waiver na galing
sa ospital at duktor na nagpapatunay
na walang naibawas na PhilHealth benefits
sa kabuuang binayaran. |
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Hospital Operative Record
(kung may surgical procedure) |
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SPA or Letter of Authorization
for spouse/dependent to claim in behalf
of the member abroad. |
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| Confinement
abroad (sa ibang bansa) |
| Isumite ang mga
sumusunod sa PhilHealth sa loob ng 180 araw
pagkaraang lumabas ng ospital: |
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Original PhilHealth Claim Form
1* |
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Valid Enhanced Member Data Record (MDR),
o PhilHealth Premium Payment Receipt (i.e.
E-receipt, PhilHealth Official Receipt, MI-5) |
| •
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Kung dependent ang na-confine at wala ang
pangalan nito sa Enhanced MDR, magsumite ng
kopya ng dokumentong magpapatunay sa relasyon
ng legal na dependent sa miyembro |
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Official Receipt ng binayarang bill sa ospital
at duktor |
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Statement of account (may kaukulang singil
para sa
kwarto, gamot, X-ray at iba pang laboratory
examinations, operating room at bayad sa duktor). |
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Medical Certificate mula sa attending physician
kung
saan nakasaad ang final diagnosis, petsa ng
pagkakaospital at iba pang serbisyong isinagawa. |
Note: Dapat nakasalin sa English
ang mga dokumentong nakasulat sa ibang wika.
* Maaaring pirmahan ng itinalagang
kinatawan ng miyembro ang PhilHealth Claim Form
1 kung ang member ay nasa abroad. Mahihingi ang
nasabing form sa ospital, PhilHealth Office o
mag-download sa Forms
page ng website na ito.
| Bumisita
o tumawag sa: |
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Overseas Workers Program
(OWP) office |
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11th Flr. Citystate Centre
709 Shaw Blvd., Pasig City |
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Contact Nos. |
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(02) 637-37-54
(02) 637-99-99 locals 1122 & 1124
(Cel) - 0918-963-5396
e-mail -
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OWP Operations Center
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OWP Operations Center |
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POEA Ortigas Ave. cor EDSA, Mandaluyong
City |
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Contact Nos. |
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(02) 724-9414; 725-51-78 |
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Premium payments
Ituloy ang pagbabayad ng iyong kontribusyon
upang masiguro ang tuloy-tuloy na benepisyo
mula sa PhilHealth! Maaaring bayaran ang
taunang kontribusyon na P900 sa mga sumusunod:
Sa abroad
Ang katumbas ng halagang P900 sa bansang
pinagta-trabahuan ay maaaring bayaran sa:
- Phil. Overseas Labor Office (POLO) in
Toronto, Canada - I-remit Centers in Taiwan,
Hongkong, U.K., Singapore, & Australia.
Sa Pilipinas
Maaaring ang kamag-anak o sinumang kinatawan
ang magbayad sa alinmang tanggapan ng PhilHealth
o sa PhilHealth OWP Operations Center na
nasa Philippine Overseas Employment Administration
(POEA), Mandaluyong City. Magpakita lamang
ng dokumento (tulad ng employment contract)
na magpapatunay na ikaw ay aktibong OFW. |
Tuloy-tuloy na coverage
• Kung sakaling ikaw ay hindi na OFW,
ituloy ang iyong PhilHealth coverage bilang
Individually Paying Member upang maiseguro
ang iyong kalusugan pati na ng iyong pamilya.
• Kung ikaw naman ay 60 taon gulang
na at pataas, at nakapaghulog na ng 120
buwan na kontribusyon o higit pa sa PhilHealth
at hindi na nagtatrabaho, ikaw ay maaari
nang maging Non-Paying Member kung saan
habang buhay ka nang covered ng PhilHealth
nang wala nang babayaran pang kontribusyon. |
Enhanced
Outpatient Benefit Package for Overseas
Workers Program Members
and their Families |
Per PhilHealth Board
Resolution No 992 s. 2007 effective July
01, 2007.
| A. |
Consultation |
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| B. |
Diagnostic Services |
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•Complete blood count (CBC) |
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•Routine urinalysis |
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•Fecalysis |
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•Fasting Blood Sugar |
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•Blood Typing |
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•Hemoglobin/ Hematocrit |
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•Electrocardiogram(ECG) |
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•Anti-streptolysin O (ASO-Titer) |
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•Hepatitis B Screening Test |
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•Treponema pallidum
hemaglutination assay (TPHA) |
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•Potassium hydroxide (KOH) |
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•Erythrocyte sedementation
rate (ESR) |
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•Pregnancy test |
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•X-ray (Skull, Chest Lower and
Upper Extremities) |
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•Sputum Microscopy |
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•Pap Smear |
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| C. |
Promotive/ Preventive and
Curative Health Services: |
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•Visual acetic acid screening
for cervical cancer |
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•Periodic digital rectal
examination |
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•Periodic clinical breast
examination (CBE) |
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•Counseling for cessation on
smoking |
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•Lifestyle modification (regular
blood pressure measurement and nutritional
or dietary counseling) |
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•Counseling for reproductive
health particularly breastfeeding |
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•Nutritional or dietary counseling |
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| D. |
Visual Acuity examination |
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| E. |
Psychological evaluation
and debriefing |
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| F. |
Auditory evaluation |
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| G. |
Drugs and Medicines (based
on PhilHealth adopted Clinical
Practice Guidelines) |
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•Treatment for urinary tract
infection |
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•Treatment for upper respiratory
tract infection |
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•Care for acute gastroenteritis
(AGE) |
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AVAILMENT
MADE EASY: |
Here are two simple steps for you to
avail of your Enhanced Outpatient benefit
package:
| 1. |
Present clear copy of Member
Data Record or MDR to the
receiving clerk of the hospital: |
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•If qualified dependent is not
listed in the MDR- submit valid
ID and proof of dependency. |
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•If MDR is not available -
present valid official receipt of
premium payment and proof of
dependency. |
2. After verification, availee may
now proceed to the doctor for
consultation.
Availment of this package shall not be
deducted from the 45-day allowance for room
and board benefit for the member and from
the separate 45-day allowance for the member’s
dependents |
DIRECTORY
of
Participating DOH Hospitals
for the Enhanced OPB Package
|
| National
Capital Region |
| 1. |
Jose Reyes Memorial Medical Center
Rizal Ave., Sta. Cruz, Manila |
| 2. |
San Lazaro Hospital
Quiricada St. Sta. Cruz, Manila |
| 3. |
Tondo Medical Center
Balut, Tondo, Manila |
| 4. |
Dr. Jose Fabella Memorial Hospital
Lope de Vega, Sta. Cruz, Mla. |
| 5. |
East Avenue Medical Center East Ave.,
Quezon City |
| 6. |
Quirino Memorial Medical Center
Proj. 4, Quezon City |
| 7. |
Philippine Orthopedic Center
Banawe, Quezon City |
| 8. |
National Children’s Hospital
E. Rodriguez Sr., Ave., Quezon City |
| 9. |
National Center for Mental Health
Nueve de Febrero St., Mandaluyong City |
| 10. |
Amang Rodriguez Medical Center
Marikina City |
| 11. |
Rizal Medical Center
Pasig City |
| 12. |
Valenzuela General Hospital
Valenzuela City |
| 13. |
Research Institute for Tropical Medicine
Alabang, Muntinlupa City |
| 14. |
Las Piñas General Hospital
Satellite Trauma Center, Las Piñas
City |
| CAR |
| 1. |
Baguio General Hospital and Medical
Center, Baguio City |
| Region I |
| 1. |
Region 1 Medical Center
Dagupan, Pangasinan |
| 2. |
Ilocos Training Regional Medical Center,
San Fernando, La Union |
| 3. |
Mariano Marcos Memorial Medical Center,
Batac, Ilocos Norte |
| Region II |
| 1. |
Cagayan Valley Medical Center
Tuguegarao City, Cagayan Valley |
| 2. |
Vetetans Regional Hospital
Bayombong, Nueva Vizcaya |
| 3. |
Southern Isabela General Hospital
Santiago City, Isabela |
| Region III |
| 1. |
Paulino J. Garcia Memorial Research
& Medical Center Cabanatuan City,
Nueva Ecija |
| 2. |
Jose B. Lingad Memorial Regional Hospital,
San Fernando, Pampanga |
| 3. |
Bataan Provincial Hospital
Balanga, Bataan |
| Region IV |
| 1. |
Batangas Regional Hospital
Batangas City |
| 2. |
Ospital ng Palawan
Puerto Princesa City, Palawan |
| Region V |
| 1. |
Bicol Regional Training and Teaching
Hospital, Legazpi City |
| 2. |
Bicol Medical Center, Naga City |
| Region VI |
| 1. |
Western Visayas Medical Hospital
Iloilo City |
| 2. |
Corazon Locsin Montelibano Memorial
Hospital, Bacolod City |
| Region VII |
| 1. |
Vicente Sotto Memorial Medical Center,
Cebu City |
| 2. |
Gov. Celestino Gallares Memorial Hospital,
Tagbilaran City, Bohol |
| 3. |
St. Anthony Mother and Child Hospital,
Basak, San Nicolas
Cebu City |
| Region VIII |
| 1. |
Eastern Visayas Regional Medical Center,
Tacloban City |
| Region IX |
| 1. |
Zamboanga City Medical Center
Zamboanga City |
| Region X |
| 1. |
Northern Mindanao Medical Center Cagayan
de Oro City |
| 2. |
Mayor Hilarion A. Ramiro Memorial
Regional Training and Teaching Hospital
Ozamis City |
| 3. |
Amai Pakpak Medical Center
Marawi City |
| Region XI |
| 1. |
Davao Medical Center
Davao City |
| 2. |
Davao Regional Hospital
Tagum City |
| Region XII |
| 1. |
Cotabato Regional and Medical Center
Cotabato City |
| CARAGA |
| 1. |
Caraga Regional Hospital Surigao City |
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