07 - 05

The rainy season has officially begun in our country!  And along with the unpredictable changes in weather (warm and sunny in the morning, cold and wet in the afternoon) come different types of bacteria and viruses that cause infections and ailments among kids and adults.  Visiting your doctor’s clinic, or worse, the Emergency Room, could be inevitable during these wet season.

Good thing we have Philhealth to help us cover the unexpected expenses of getting medical treatment!

This week, we will dedicate a blog series on the different benefits that we can avail as Philhealth members, starting off with INPATIENT BENEFITS.  Share this with your friends and family!

Read on!

Inpatient Benefits

  • These benefits are paid to the accredited Health Care Institution (HCI) through All Case Rates.
  • The case rate amount shall be deducted by the HCI from the member’s total bill, which shall include professional fees of attending physicians, prior to discharge.
  • The case rate amount is inclusive of hospital charges and professional fees of attending physician.
  • Availment condition: Member must have at least three (3) months’ premium contributions within the immediate six months prior to the month of availment.
  • Documents needed are:
    • Copy of Member Data Record or
    • Philhealth Benefit Eligibility Form (PBEF)
    • Duly accomplished Philhealth Claim Form 1
  • These benefits can be obtained at all accredited HCIs.  Different case rate amounts for selected medical conditions are being implemented when done in Primary Care facilities.
  • Only admissible cases shall be reimbursed.

Tomorrow we will feature the Outpatient Benefits offered by Philhealth to contributing members.  Meantime, you may send us your questions about Philhealth coverage and we will try our best to look for the answers for you.

See you tomorrow!

Source: https://www.philhealth.gov.ph/benefits/

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