This article will give you the complete and comprehensive list of PhilHealth cash benefits for specific illness. Along with this list will be the coverage, eligibility and guidelines for that specific illness or disease.
Requirements to Claim the PhilHealth Cash Benefits
- The member must have at least three (3) months’ premium contributions within the immediate six (6) months before the month of availment.
- One (1) copy of Member Data Record or PhilHealth Benefit Eligibility Form (PBEF)
- A duly accomplished PhilHealth Claim Form 1
Illness Covered by PhilHealth and the Corresponding Benefits Coverage
| ILLNESS | COVERAGE |
| Case Rate for Hemodialysis | Php2, 600.00 per session |
| Case Rate for Outpatient Blood Transfusion | Php3, 640.00 (one or more units) |
| Thyroidectomy (Total or Complete Cash Benefits) | Php31, 000.00 |
| Ovarian Cystectomy (Unilateral or Bilateral) | Php23, 300.00 |
| Pneumonia | • Moderate Risk Pneumonia: Php15, 000.00 • High-Risk Pneumonia: Php32, 00.00 • Primary Care Moderate Risk Pneumonia: Php10, 500.00 |
| Tonsillectomy (Primary or Secondary) | Php18, 000.00 |
| Normal Spontaneous Delivery (NSD) | • Lying in: Php6, 500 • Hospitals: Php5, 000.00 • Pre-Natal: Php 1, 500.00 |
| Tubal Ligation | Php4, 000.00 |
For IN PATIENTS 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
| ILLNESS | COVERAGE |
| Intrauterine Device Insertion or IUD | Php2,000 |
| Vasectomy (Unilateral or Bilateral) | Php4,000 |
| Viral Hepatitis | Php11,800 |
| Rheumatic Fever | Php10,100 |
| Breech Extraction | Php12, 120 |
| Appendectomy | Php24, 000 |
| Cerebral Infarction | Php28, 000 |
| Cerebral Palsy | Php9, 500 |
| Cellulitis | Php9, 600 |
| Cataract Surgery | Php16, 000 |
| Cholecysectomy | Php31, 000 |
| Cholecystitis | Php11, 300 |
| Caesarian Section | Php19, 000 |
| Congenital Anemia | Php15, 200 |
| Newborn Care Package | Php1, 750 |
| Emphysema | Php11, 400 |
| Upper Respiratory Tract Infection (URTI) | • Hospitals: Php4, 000 • Primary Care Facilities: Php2, 800 |
| Dengue | • Dengue Fever: Php10, 000 • Severe Case of Dengue: Php16, 000 |
| Chronic Obstructive Pulmonary Disease (COPD) | Php12, 200 |
| Congenital Syphilis | Php12, 800 |
| Diabetes Mellitus | **With complications other than Coma and Ketosis: Php12, 600 |
| Asthma | • Asthma in acute exacerbation for hospitals: Php9, 000 • In primary care facilities: Php6, 300 |
| Congenital Hypothyroidism | Php9, 900 |
For OUT PATIENTS Benefits
- Day Surgeries (Ambulatory Or Outpatient Surgeries) Are Services That Include Elective (Non-Emergency) Surgical Procedures Ranging From Minor To Major Operations, Where Patients Are Safely Sent Home Within The Same Day For Post-Operative Care
- Radiotheraphy
- Hemodialysis
- Outpatient Blood Transfusion
- Primary Care Benefits
- Preventive Services
- Diagnostic Examinations
- Drugs and Medicines
MDG Related
- Outpatient Malaria Package (P600.00)
- Outpatient HIV-AIDS Package (P30,000.00 per year or P7,500/quarter)
- Outpatient Anti-Tuberculosis Treatment through Directly-Observed Treatment Short-course (DOTS) Package (P4,000)
- P2,500 – Intensive phase
- P1,500 – Maintenance Phase
- Voluntary Surgical Contraception Procedures (P4,000.00)
- Animal Bite Treatment Package
P3,000.00
PhilHealth Z Benefits
There are expensive treatments that can also be covered through the PhilHealth Z Benefits. The following are the type of illnesses or diseases that are covered:
- Z001 Acute lymphocytic leukemia, standard risk (for children)
- Z002 Early breast cancer, stage 0 to IIIA
- Z003 Prostate cancer, low to intermediate risk
- Z004 Kidney transplantation for end stage kidney disease, standard risk
- Z005 Coronary artery bypass graft surgery, standard risk
- Z006 Total correction of Tetralogy of Fallot (for children)
- Z007 Closure of ventricular septal defect (for children)
- Z008 Cervical Cancer, stage I to IV
- Z009 The Z MORPH (Mobility, Orthosis, Rehabilitation and Prosthesis Help)
Who can avail the PhilHealth Z Package?
All members and their dependents are eligible for this package regardless if the member is employed, individually paying (voluntary), lifetime member program, sponsored program or overseas worker program.
PhilHealth Z Package can also cover (a) operating room expenses, (b) drugs and laboratory exams, (c) hospital room and board fees, and (d) professional fees for the entire course of the treatment.
Please refer to this article published by the PhilHealth official website for the list of selection criteria and the partner hospitals for the PhilHealth Z Package.
You can contact the nearest PhilHealth Regional Office if you have questions regarding the details of the requirements. Read: PhilHealth Regional Offices Directory
Read Also: Updated PhilHealth Contribution Table 2018
Source: philhealth.gov.ph
Hello! May concern lang po ako, Last July 30,2018 na ipasok po ako sa Emergency Room ng Makati,upon my assessment po na diagnosed ako ng COMPLICATED URINARY TRACT INFECTION. Hindi po nagamit ang aking philhealth dahil sa case na emergency sya, at hindi narin ako na pa admit. Hoping po sana na baka may makuha ako na benefit. Active po ang paghulog ko since September 2016. Na sa akin po ang mga resibo or necessary requirement para patunay po. Maraming Salamat.
Try to inquire directly at any PhilHealth regional office. You can also PM the FB Page: m.me/PhilHealth
Paano po magkakaroon ng philhealth ang 16 years old na teenager wala na po xang magulang..orphan po at lola lang ang kasama..pregnant po xa
May PhilHealth po ba si Lola? Pwede po iyon ang maging guardian niya para magkaroon ng PhilHealth. Punta rin po kayo sa inyong munisipyo para makahingi ng tulong. Under pa po iyan sa DSDW.
ofw po ako,gusto po sana ipa verify s aswa ko ung Philhealth number ko para mahulugan,at kung active pa po sya..anu po ang mga kelangan para sa pagpapa verify..salamat po.
Hi Mam, please message the PhilHealth po: https://www.facebook.com/PhilHealth/
Marrefund p po ba un bnayad nmin para s ct scan. Mgkano po b charge ng philhealth s ct scan?
Please coordinate with the nearest PhilHealth office po.
Gudpm poh ask q poh…how about nman poh katulad q my goiter nagpaparadiation aq out patient…my makukuha b aq s philhealth?
Please inquire po mismo sa PhilHealth. You can also PM the Office Facebook Page of PhilHealth: https://www.facebook.com/PhilHealth/
WHEN MY WIFE DELIVER OUR FIRST BABY IN SEPTEMBER 2014 IN A NORMAL DELIVERY,MY WIFE FILED HER USE HER PHILHEALTH AND FORWARDED TO THE CLINIC WHERE SHE ADMITTED, WE PAID P15,000.00 FOR THE SERVICES THEY HAVE RENDERED IN HER DELIVERY. THE CLINIC STAFF INFORMED US THAT THE AMOUNT WE PAID, PHILHEALTH BENEFITS WAS ALREADY DEDUCTED IN OUR BILL THAT IS WHY THEY COME UP WILL BILL OF 15,000.00. HOW CAN WE CHECK IF THE AMOUNT WE PAID ACCURATE AND NO DOUBLE CHARGES IS BEING DONE DURING THE PAYMENT. I HEARD THAT THE HOSPITAL OR CLINIC COLLECT PAYMENT AT PHILHEALTH AND AT THE SAME CHARGE THE PATIENT. HOPING FOR YOUR KIND REPLY TO THIS QUERY.
Hi Mr. Javier, please contact the nearest PhilHealth Regional Office. They will answer all your inquiry po. You can also send an email. Check the directory here.
I am regular member since 2007 , I am ofw ,when my member of family admitted to the hospital ,these were not exactly given.
You should call the nearest PhilHealth Regional Office so that you can report those cases. And also, for you to be informed more on the benefits. PhilHealth Regional Offices Directory
naaksidente p oak osa ebike last november. pero hindi po nahonor ang philhealth k osa aman rodriguez memorial hospital. nagpa ctscan, xray, attinahi din po ako sa ulo one stitch lang naman.. at umuwi na din ako ng kinagabihan… may benefits po ba makukuha sa philhealth pag ganun…ang sabi kasi sa ospital wala daw po dahil ang philhealth ay in patient lang. tama po ba iyon? naiatabi ko pa rin po lahat ng bills ko pati yung mga resibo ng gamot. salamat po sa pagreply
Hi! Try to send a PM to the Official FB Page of PhilHealth: https://www.facebook.com/PhilHealth/
If wala pong reply, you may call PhilHealth at Call (02) 441 7442
How can i be a Philhealth member, not working but with money remittance from abroad by monthly basis
You can register online: https://eregister.philhealth.gov.ph/