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.

  • 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

Copy of Birth Certificate of member

Dependent 

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

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

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

  • 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