Philhealth

PHILHEALTH

Provides financial support to individuals to achieve universal healthcare coverage and ensure access to affordable and quality health services regardless of their socioeconomic status.

Non-Emergency Admission

Hospitalization of 24 hours or more due to an illness or an injury
Hospitalization of less than 24 hours is accepted by Philhealth for emergency cases, or death during confinement [If the patient expired and resuscitative measures were done
A member is entitled to a maximum of 45 days confinement per calendar year and another 45 days to be shared by dependents.
Patients diagnosed with CKD5 on hemodialysis treatment shall be allowed to avail of 156 HD treatment sessions per year based on the prescription of their nephrologists

Secure Philhealth Claim Form 1, Form 2, Claim Signature Form (CSF) and PMRF from admitting staff if the patient is a Philhealth member

Forms

Attachment for form 1

Copy of Birth Certificate of member

Dependent

Member Data Record (MDR) appearing the name of dependent patient

Member not Available

A representative can sign the Form 1 when the member is out of town, abroad, incapacitated, or for a valid reason. He/She, however, must provide the corresponding document/s that will serve as a proof to establish their relationship.

Spouse
Children 18 years old and above Parents
Guardian of member’s children below 18 years old
Next of kin
Letter stating the reason for signing in behalf of the member
Valid ID of authorized signatory
Power of Attorney for guardians and next of kin

Securing Member Data Record MDR

Member Data Record (MDR) can be secured and updated at any PhilHealth Office

Special Requirements

Submit a photocopy of old billing to Philhealth section if last confinement with Mediatrix or another hospital falls on the same year
Submit a copy of Letter of Authorization (LOA) if patient seeks to reimburse from HMO, Insurance, or company

Philhealth

PHILHEALTH

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