Tag Archive: Maternity Benefits


09 - 25

The arrival of a newborn is always an exciting moment for parents.  There is nothing more precious than welcoming a new member of the family into your home.

Philhealth makes having babies easier and more manageable through its care packages and benefits.  Knowing you are covered by these privileges as a Philhealth member allows you to free your mind from additional expenses in childbirth and post-natal medical care, so you can focus on the new bundle of joy in your arms!

Below are the most updated list of care packages available to Philhealth members who are pregnant or have just given birth to their babies:

Antenatal Care Package

Care package for women during pregnancy: P1,500

  • Pre-natal consultation on essential health services.
  • Hospital, birthing homes, lying-in clinics, maternity clinics, infirmary/dispensaries and check-up providers.

Expectant mother must undergo pre-natal check-ups of not less than four times where:

  • 3 check-ups are done within the first six months of pregnancy.
  • 1 check-up done during the last three months of pregnancy.

Maternity Care Package (MCP)

Care package for the entire duration of pregnancy until giving birth including:

  • Pre-natal consultation and essential health services
  • Normal delivery
  • Post-partum care including follow-up visits from the 3rd to the 7th day after giving birth.
    • Hospital – P6,500
    • Birthing Homes, Lying-in Clinics, Infirmary/Dispensaries, Maternity Clinics – P8,000

Normal Spontaneous Delivery (NSD) Package

Benefits for mothers on during and after childbirth including:

  • P5,000
    • Normal delivery
    • Post-partum care including follow-up visits from the 3rd to the 7th day after giving birth.
  • P6,500
    • Birthing homes
    • Lying-in clinics
    • Infirmary/Dispensaries and maternity Clinics

Newborn Care Package (NCP)

Care packages for newborn babies, including:

  • Essential newborn care
  • Newborn screening test (P1,750)
  • Newborn hearing screening test

Quick reminders to expectant moms:

  • Make sure that your Philhealth records are updated and that your membership status is active.
  • Prepare your documents such as Claim Form 1 and Philhealth ID long before your expected due date.
  • Before checking out of the hospital, double-check your bill to make sure that all Philhealth benefit claims have been deducted from the total amount of hospital bill.
  • Have yourself checked at Philhealth-accredited medical centers right on the first month of your pregnancy; return for regular check-ups as advised by your attending physician.
  • Bring your newborn child to Philhealth-accredited medical centers and hospitals for Essential Newborn Care, Newborn Screening Tests, and Newborn Hearing Screening Test.

If you have more questions regarding the maternity care packages of Philhealth, you may call their hotline at 02-441-7442.  They are available to take your call, 24/7.

Reference: www.philhealth.gov.ph

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05 - 12

This article is for our mom-to-be followers who are wondering if they are qualified to claim for maternity benefits from the SSS.  Often, expectant mothers who only recently began making SSS contributions, or those who missed a month or two prior to their delivery dates, are worried that they would not be able to claim assistance from SSS.

We lifted the official computation and other guidelines from the SSS website to help all female SSS members understand how maternity benefits are determined.

Read on!

The SSS Maternity Benefit

  • For normal delivery and miscarriages: 100% of member’s average daily salary credit multiplied by 60 days.
  • For caesarean section delivery: 100% of member’s average daily salary credit multiplied by 78 days.

Benefit Computation

  1. Exclude the semester of contingency (delivery or miscarriage).
    • A semester refers to two consecutive quarters ending in the quarter of delivery.
    • A quarter refers to three consecutive months ending March, June, September, or December.
  2. Count 12 months backwards starting from the month immediately before the semester of contingency.
  3. Identify the six highest monthly salary credits within the 12-month period.  The monthly salary credit means the compensation base for contributions and benefits related to the total earnings for the month.  The maximum covered earnings or compensation is Php 16,000.00 effective January 1, 2014.
  4. Add the six highest monthly salary credits to get the total monthly salary credit.
  5. Divide the total monthly salary credit by 180 days to get the average daily salary credit.  This is equivalent to the daily maternity allowance.
  6. Multiply the daily maternity allowance by 60 (for normal delivery or miscarriage) or 78 days (for caesarean section delivery) to get the total amount of maternity benefit.

Below is an example:

Let’s say the SSS member will give birth on December 2017, how do we determine the amount of maternity benefit she can expect from SSS?

  1. The semester of contingency is from July 2017 to December 2017.
  2. The 12-month period before the semester of contingency would be from July 2016 to June 2017.
  3. Assuming the six highest monthly salary credits are Php 15,000 each, then the total monthly salary credit would be Php 90,000.00 (Php15,000 x 6).
  4. The daily maternity allowance would be Php 500.00 (Php 90,000 / 180).
  5. To get the total amount of maternity benefit: multiply the daily maternity allowance by the number of days based on the type of delivery:
    • For normal delivery and miscarriages: Php 500 x 60 = Php 30,000.00
    • For caesarian section delivery: Php 500 x 78 = Php 39,000.00

Important Reminders:

  1. The SSS maternity benefit is paid to a female member for the first four deliveries and miscarriages only, by virtue of the Social Security Act of 1997 (RA 8282).
  2. Employed members shall receive the full amount of the maternity benefit within 30 days from the date of filing of the maternity leave application.  This will be given in advance by the employer (who shall then be reimbursed in full by the SSS).
  3. If the employee member gives birth or suffers a miscarriage and the required number of contributions have not been properly remitted by the employer, or if the employer fails to notify the SSS, the employer will be required to pay damages to the SSS.  Such damages shall be equivalent to the benefits that the employee should have been entitled to.
  4. Separated / voluntary / self-employed members shall be paid directly by the SSS.
  5. A female member cannot claim for sickness benefit for a period of 60 days for normal delivery or miscarriage and 78 days for caesarean delivery.  No member can be entitled to two benefits for the same period.

The moment you have confirmed that you are pregnant, notify your employer right away.  If you are a voluntary member, file the necessary papers at the SSS immediately.  This will secure the validity of your claim, whether you carry the child to full term or suffer a miscarriage (anything can happen).  It also pays to create an online SSS account so you can monitor your and your employer’s monthly contribution.

We hope this article helps all new and future mothers!

Source: www.sss.gov.ph

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SSS Maternity Benefits Denied

Our article on the SSS Maternity Benefits Reimbursement gathered a lot of feedback and questions from women wanting to avail of the SSS maternity benefits.  A handful were asking why their claims were denied in spite of following the step-by-step process we posted.

We conducted further research on the reasons why some are not granted the expected maternity benefits and were able to gather the following.  Note that these were collected from various women’s personal experiences when applying for the said benefits from SSS.

a. Child’s birth certificate is not authenticated by the Local Civil Registrar or by the Philippine Statistics Authority PSA (formerly NSO).

You may order for a copy of your child’s birth certificate by calling (02) 737-1111 or order online at psahelpline.com.  You will receive an PSA-authenticated copy of your child’s birth certificate in 2 to 3 days.  You may also get a Certified True Copy of your child’s birth certificate from the LCR where your child’s birth was registered.  The birth certificate issued by the hospital alone will not be honored by the SSS.

b. The Signature on MAT1 is not the same as the signature appearing on MAT2.

This happens when the mother’s personal data in her SSS account is not duly updated; a common reason is that her civil status has not been updated from Single to Married.  Her maiden name is reflected in her MAT1 form while her MAT2 already shows her married name.

When changing your last name while you are processing your claim, wait until the change has taken effect before your submit your MAT2 claim.  You may check your SSS online account regularly to see if your last name has been updated already.

c. Member has paid contributions but employer has failed to remit or has not posted the payments yet.

For employed members, make sure to check that the six monthly contributions to be considered by SSS in computing the benefit are properly posted and reflected in your SSS account.

d. Coverage Status on record is not the same as Coverage Status on member’s claim.

It could be that in the MAT2 form, the member checked his status as VOLUNTARY while her status on her SSS account is employed.  Double-check all entries in your MAT2 form before submitting to the SSS.

e. Clarifications on the child’s Middle and Last Names

In cases when the mother’s last name (if she is married) is not the same as the middle name reflected on the child’s birth certificate or that the child’s last name is not the same as the father’s last name, you will need to submit an Affidavit to Explain Discrepancy in Names.

f. The MAT1 form was not submitted to the SSS prior to child’s birth.

It is important to report your pregnancy to the SSS at the earliest possible time.  If you fail to do so and you give birth before you are able to submit your MAT1 or notify SSS of your pregnancy, your claim may be denied.

If you failed to notify SSS of your pregnancy, attach a letter of explanation to your MAT1 form, along with the ultrasound reports or pregnancy test reports as supporting documents.  Take note that the decision to approve the claim entirely depends on the SSS officer evaluating your claim.

g. Member is not qualified / eligible for maternity benefits.

This happens when the member fails to pay her contributions for at least three of the 12 months before semester of delivery or semester of contingency.  Visit this site to see how the semester of delivery is determined.

h. The member gave birth by Caesarean Section but failed to submit an Operating Room record.

Secure a list of documentary requirements for SSS Maternity Benefits reimbursement before giving birth.  Make a checklist of the documents you already have on hand and those that will be collected from the hospital.  You can actually begin collecting the documents while you are waiting for your due date.

i. Member had a miscarriage and failed to submit the required Histopathology Report and Medical Certificate.

Similar with number 8, you need to make sure that your documentary requirements are complete when claiming for maternity benefits when you had a miscarriage.

j. If the member resigned from work within six months of date of delivery, she needs to submit the following documents when claiming for maternity benefits.  Failure to do so may result to disapproval of claim.

  • Certificate of Separation
    • Date of separation must be included.
  • Certificate of Non-Advancement of Maternity Benefit
    • This will prove that your employer did not give you any amount of maternity benefit.
  • L-501 Form
    • 2 copies of specimen signature card.

On the other hand, if the date of resignation and date of delivery has more than a 6-month gap but less than 1 year, you still need to prepare the said documents as there are officers who may still require these documents.

If you have recently confirmed that you are having a baby, make sure you are well-informed of everything you need to know about claiming your maternity benefits.  The secret is to have a checklist of the documentary requirements and constant communication with SSS to make sure that you are following the correct processes.

Remember Moms, Daig ng maagap ang masipag!

Source: http://sssphilippinesnotes.blogspot.com/2013/07/reasons-sss-maternity-benefit-denied.html

SSS Maternity.jpg

As a female SSS member, whether employed, self-employed, unemployed, or voluntary, you are entitled to Maternity Benefits. To help you in filing for your Maternity Benefit claim, here is a summary of procedures and requirements. These were lifted from the SSS website (www.sss.gov.ph) and other helpful websites; the links are provided at the bottom of the page:

  1. Notification Procedures:
    • For Employees:
      • As soon as a member has confirmed that she is pregnant, she needs to notify her employer.
      • Include in the notification the probable date of her childbirth which must be at least 60 days from the date of conception.
      • These information must be reflected on the SSS Maternity Notification Form; attach other supporting documents that will corroborate the pregnancy.
    • For Employers:
      • Upon receipt of employee’s Maternity Notification Form and other supporting documents, the employer must notify the SSS.
      • Submit the SSS Maternity Notification Form and other supporting documents submitted by the employee to SSS. This may be done over-the-counter at an SSS branch, or online through the SSS website.
      • To submit online, both employee and employer must be registered users of the SSS website.
    • For Unemployed, Self-employed, and Voluntary Members:
      • If your member category is any of the above, you must notify SSS directly.
    • If the employee fails to notify the employer, or the SSS, in the case of an unemployed, self-employed, or voluntarily paying member, the maternity benefit application may be denied.
  2. Application Requirements
    • For Notification
      • For Employees, Unemployed/Self-employed/Voluntary Members
        • Maternity Notification Form
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
        • Proof of pregnancy (ultrasound report)
    • For Reimbursement
      • For Employed Members
        • Maternity Notification Form duly stamped and received by SSS
        • Maternity Reimbursement Form
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
        • As an additional means to ensure that the member will receive the said benefits, the company’s representative who will be filing the claim must present the member’s SSS digitized ID or the E-6 acknowledgement stub with two valid IDs (at least one with photo). This is in addition to the presentation by the company representative’s own SSS digitized ID and blue card.
      • For Separated Members
        • Maternity Reimbursement Form
        • Certification from last employer showing the effective date of separation from employment or notice of company’s closure/strike or certification from the Department of Labor and Employment that the employee or employer has a pending labor case.
        • Certification that no advance payment was granted (if confinement days applied for are within or prior to separation).
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
    • Additional Requirements
      • Normal delivery – certified true or authenticated copy of duly registered birth certificate. In case the child dies or is a stillborn, duly registered death or fetal death certificate.
      • Caesarean delivery – certified or authenticated copy of duly registered birth certificate and certified true copy of operating room record/surgical memorandum.
      • Miscarriage or abortion – obstetrical history stating the number of pregnancy certified by the attending physician an dilatation and curettage (D&C) report for incomplete abortion, pregnancy test before and after abortion with age of gestation and histopath report for complete abortion.
  3. Filing Procedure

Claims may be filed at the nearest SSS office; however, processing will be done at the branch where the employer and employee records are based.

For your reference, here are copies of the SSS Forms: Maternity Notification and SSSForms_Maternity_Reimbursement.

Sources:

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=maternityapplication

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=maternitycomputation

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