How To Use Your PhilHealth Benefits During Hospitalization

If you have not tried using or claiming your PhilHealth benefits in a hospital, you need to read this.

Medical emergencies can happen to us anytime. That is why it is important that we know how to tap on our resources when the need arises. When you find yourself admitted in a hospital, you not only start thinking about your well-being, you also ponder on the expenses that your hospital confinement will entail. Without an insurance to cushion the blow, healing and recuperating from your illness might prove to be difficult.

As PhilHealth members, we are assured of financial assistance if and when we get confined in a hospital. Here’s how you can easily and efficiently file your claim so that you do not have to shoulder all your hospital expenses on your own.

Requirements when filing PhilHealth claims during hospitalization:

  • Updated copy of your PhilHealth Member Data Record. You may download your copy online; read my blog on this topic here: How To Get A Copy Of Your PhilHealth Member Data Record Online.
  • Duly accomplished and original copy of PhilHealth Claim Form 1.
  • Your PhilHealth ID and one valid ID.
  • The hospital where you are confined must be PhilHealth-accredited.
  • You must have paid at least 3 months worth of premiums within the last 6 months of your confinement.
  • You must have been confined at the hospital for at least 24 hours.

How to claim your PhilHealth Hospitalization Benefits:

  1. You must have informed the Emergency Room or admitting department that you are a bona fide PhilHealth member. Present your PhilHealth ID.
  2. Fill out a copy of the PhilHealth Claim Form 1 and hand this to your nurse or the billing section (usually, a nurse assists you with the documents you need for discharge). Include a copy of your MDR.
  3. The billing section will provide you a breakdown of the charges and fees; review the document to be sure that the necessary PhilHealth coverage is reflected on your bill.
  4. The PhilHealth coverage should be automatically deducted from your total hospital bill.

Hospitals also have a helpdesk where a PhilHealth representative is available to answer your questions and clarifications. Have your watcher coordinate with them in advance to give you enough time to complete your requirements.

If you have questions about your PhilHealth coverage and other claims, you may call their hotline at 02-84417442.


Philippine Health Insurance Corporation


Published by MasterCitizen

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2 thoughts on “How To Use Your PhilHealth Benefits During Hospitalization

  1. It is clear that we can only use The Senior Philhealh card if Hospitalized only, many Senior Citizens can’t afford hospital bills just rely on how medications like me : I have cardiovascular disease having regular check up. Blood chem. To D echo and medicines for six months HoW can we reimburse such thing pls help

    1. Please find out if your barangay offers free assistance for check ups and medicines of senior citizens. Some barangays do that for their residents. YOu may also ask for help at the Sweepstakes office or your Mayor’s office.

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