When PhilHealth Dies: The Benefits You Need To Pay Out Of Your Own Pocket

It's not a lot, but qualified PhilHealth members get to save some money from medical bills.

If your salary is Php10,000, your Philippine Health Insurance Corporation's (PhilHealth) monthly contribution is Php300. If you have been regularly contributing, Philhealth will cover at least Php10,000 of your hospital bill. For many Filipinos, this the only financial lifeline they have if they get hospitalized.

So when news that PhilHealth could cease to exist next year, the reaction was shock and then anger, especially when the alleged corruption in the company came to light.  

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What does it mean when they say “wala nang PhilHealth?”

If you have a job that includes health maintenance organization (HMO) coverage or can afford to pay for a family medical insurance, that’s great. But for many, PhilHealth may be the only relief from paying medical expenses. If there’s no PhilHealth, you have to pay for your medical bills in full. 

Can you imagine the financial burden it will give Filipinos if “wala nang PhilHealth.” It’s the hardworking people’s money, and they should still be able to benefit from it. Here are some of the packages the insurance company has been offering. 

Maternity Care Package (MCP)

This includes prenatal care includes checkups to screen and manage complications of pregnancy, maternal nutrition, immunization, and counseling for a healthy lifestyle. Postpartum includes follow up visits within 72 hours and seven days after childbirth. Philhealth's Maternity Care Package also covers a portion of all kinds of labor and delivery, and even miscarriage and pregnancy loss, including part of your attending doctor’s professional fees (PF). Here’s how much preggos will have to pay out of pocket:

  • Php3,900 for women who gave birth via normal spontaneous delivery (NSD) in non-hospital facilities and Php3,000 in a hospitals. For doctor’s PF, Php2,600 for those who gave birth in non-hospital facilities and Php2,000 for those who gave birth in hospitals.
  • Php19,000 for women who gave birth via C-section. Of that total amount, Php11,000 goes to the hospital and Php7,600 to the attending physician.
  • Php9,700 for women who gave birth via complicated vaginal delivery
  • Php12,120 for women who gave birth via breech extraction
  • Php12,120 for women who gave birth via vaginal birth after C-section (VBAC)
  • Php11,000 for women women who had a miscarriage or pregnancy loss who undergo dilatation and curettage (D&C), locally known as raspa. Of that total amount, Php6,600 to the hospital and Php4,400 to the attending physician

Newborn Care Package

The Philippines’ Newborn Screening Act of 2004 requires all newborns to undergo tests to detect disorders that warrant early intervention. PhilHealth's Enhanced Newborn Care Package covers Php2,950, which includes the original and expanded Newborn Screening (NBS) and hearing tests, BCG and Hepatitis B vaccinations, eye prophylaxis, weighing, and essential newborn care (ENC) or Unang Yakap protocol. 

Z Benefits for premature and small infants

If you give birth earlier than expected, your PhilHealth membership can spare you from paying Php600 to Php4,000. The benefits package for premature infants also pays from Php24,00 to Php135,000 for the care of premature babies born at 24 weeks to less than 32 weeks, and infants who have low birth weight or weigh less than 2,500 grams. 

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Z Benefit Package for children with special needs 

Children 0 to 17 years old who have special needs, whether physical, cognitive, behavioral, etc. can also enjoy PhilHealth coverage via benefits for children with special needs. These include:

  • Php3,626 to Php5,726 for assessments, tests and plans 
  • Php5,000 per set for rehabilitation therapy 
  • Php13,110 to Php163,540 for children requiring assistive devices for upper and lower extremity prosthesis, lower extremity orthosis, and spinal bracing or orthosis
  • Php12,730 to Php29,450 for children requiring seating devices, and basic and intermediate wheelchairs

Kasambahay medical fees

If you have helpers at home, paying for your kasambahay's PhilHealth monthly contribution is their right and your responsibility as their employer. It’s certainly better than paying for their medical bills if they get sick. 

Contraceptive Implant Package

Philhealth members can avail of Subdermal Contraceptive Implant Package, for Php3,000 in fees per case. Of that amount, Php1,200 goes to professional fees and Php1,800 to health care institution fees. The implant is inserted via a minor procedure and is effective for two years.

COVID-19 Packages

In the unfortunate event that you get sick with COVID-19, PhilHealth covers testing and hosptialization. That’s about Php2,170 to Php8,150 for swab tests and Php43,997 to Php786,384 for hospitalization bills depending if you have a mild or critical case. 

These are just some of the benefits PhilHealth offers. They have packages for out-patient procedures, animal bites, dialysis, etc. It’s not a lot, but it’s a couple of thousands you need not worry about if you or your family get sick.


This story originally appeared on edits have been made by the editors.

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