All about Philhealth II

[evilwoman]

Dapat ba pag nagpacompute ng philhealth kasama sa bill ang professional fees?nagtataka lang kasi ako bat nagkakaiba-iba pa ng deduction e same hospital,same income bracket din naman.

[frappysabz]

frappysabz hindi ka hingian ng PHIC Cert of Contribution?

sis hindi na since binayaran ko kasi whole year ng 2013 isang receipt lang yun. yun na yung pineresent sa hospital.

[lanee_beu]

hello mga sis, please help. I resigned from my work last month, april 2014, and i will give birth in november or december 2014. do  i need to ask pa my previous employer to provide me a certification na na hulugan nila yung march and april ko to complete the 9months required contribution until november?magbo voluntary contri nalang ako ngaun may to nov. how much ang monthly contri pag voluntary payment?  TIA!

[gharz412]

ask ko lang mga sis, 19K ang bawas sa philhealth di ba? yung sa akin ang binawas lang ng hospital 11K. bakit kaya ganun?

sis regarding this, kung CS ka girl 19k nga tlaga.. Cs kba? If yes, then ndi lang dpat 11k yun...

[kariseyow]

How much ba bawas ng philhealth? for normal delivery and cs. TIA!

[mommykthea]

Dapat ba pag nagpacompute ng philhealth kasama sa bill ang professional fees?nagtataka lang kasi ako bat nagkakaiba-iba pa ng deduction e same hospital,same income bracket din naman.

sis, ang alam ko nakafix na yung PF ng OB sa Philhealth benefit mo..magkakaiba lang talaga kung normal or CS delivery.

"Normal Spontaneous Delivery (NSD) in accredited Levels 2 to 4 hospitals, members are entitled to a cost benefit of P6,500. (Note that this applies only the first four (4) low-risk normal spontaneous deliveries.

P2,500.00 - Hospital (room and board, drugs and medicines, laboratories, supplies, ancillary procedures, other medically necessary charges);
P2,500.00 - Physician (actual deliver, immediate postpartum care, counseling);
P1,500.00 - Prenatal care.


[ii] while coverage for Caesarian Section(CS) delivery in said facilities and performed by accredited health professionals is P19,000.


Babies of members are also assured of the Newborn Care Package (NCP) provided for in accredited hospitals and lying-in clinics for a cost benefit of P1,750, which would include physical examination, eye prophylaxis, Vitamin K administration, BCG vaccination, first dose of Hepatitis B immunization, newborn screening tests, and breastfeeding advice. - excerpt from Philhealth site

Check mo tong PDF File sis, makikita mo yung maternity coverage ng Philheath:
http://www.philhealth.gov.ph/circulars/2006/circ23_2006.pdf


Hope this helps!

[outandaboutph]

hello mga sis, please help. I resigned from my work last month, april 2014, and i will give birth in november or december 2014. do  i need to ask pa my previous employer to provide me a certification na na hulugan nila yung march and april ko to complete the 9months required contribution until november?magbo voluntary contri nalang ako ngaun may to nov. how much ang monthly contri pag voluntary payment?  TIA!

hingi ka ng copy ng certificate  of contribution sa previous employer mo sis para sure, and pagkakaalam ko kapag voluntary eh 450 yata kada quarter ang hulog.

[outandaboutph]

How much ba bawas ng philhealth? for normal delivery and cs. TIA!

pagkakaalam ko sis 19k and icover ng philhealth kapag CS

[lanee_beu]

hingi ka ng copy ng certificate  of contribution sa previous employer mo sis para sure, and pagkakaalam ko kapag voluntary eh 450 yata kada quarter ang hulog.

Thank u sis outandaboutph, same amount lang ba ang marereceive ko from philhealth khit voluntary na payment ko.. kasi kapag employed mas malaki ang contribution db. so pag 450 per quarter ba pareho lang.TIA

[Jaguar.Paw]

mga sis, nabalitaan nyo ba ito

https://ph.news.yahoo.com/private-hospitals-threaten-bill-philhealth-members-full-155927118.html

"..members of Philippine Health Insurance Corporation (Philhealth) may have to pay for the full cost of their medical bills before they could reimburse it. By next week, private hospitals will accept Philhealth patients but will not remove the Philhealth part (of their bill)”

di ata magandang balita. pero nag email ako agad sa Philhealth pagkabasa ko, ito ang reply nila:

Below is the Official Statement of PhilHelath on the PHAPI Issue:

The Philippine Health Insurance Corporation (PhilHealth) has been in constant communication with Dr. Rustico Jimenez and the Private Hospitals Association of the Philippines, Inc. (PHAPI) especially where the issue of claims payments is concerned. In relation to this, all PhilHealth regional offices have even made a commitment to pay claims of all our providers, including PHAPI member-hospitals, faster than the 60 days processing time as mandated by law.

Please be clarified that the perceived delays in the payment of claims of PHAPI member-hospitals are not because of 'possible mismanagement at PhilHealth' as alleged by PHAPI, but as part of the technical challenges and birth pains PhilHealth is currently experiencing as a result of the full implementation of the case-based payment system in January of this year.     

Rest assured that PhilHealth is working double-time to address these glitches and save partner-providers from further inconvenience.

However, should the PHAPI decide to pursue its move of not deducting the benefit of PhilHealth members from their total hospital bill, they will definitely be doing a greater disservice to members who are relying on their PhilHealth coverage for help, especially in times of medical emergencies.

Such move also constitutes a violation of their Performance Commitment which the member-hospitals of the PHAPI have executed with PhilHealth, particularly item 14 which states that hospitals “shall provide and charge to the PhilHealth benefit of the client the necessary services including but not limited to drugs, medicines, supplies, devices and diagnostic and treatment procedures for (their) PhilHealth clients.”

While there are sanctions that can be imposed on these hospitals, PhilHealth would want that services to its members remain uninterrupted, and that the matter be settled soon without depriving members of the benefits due them.

PhilHealth's lines are open for Dr. Jimenez and the PHAPi to further discuss this matter in the confines of our working environment. Thank you.

Reference: ISRAEL FRANCIS A. PARGAS, MD
OIC-Vice President, Corporate Affairs Group
Mobile No. 0915-6450808

-- hay.. ang tagal pa naman nila mag reimburse. need mo pa i follow up palagi tapos limited time to submit the requirements. pfffft 

[mommykthea]

hi, sis jaguar.paw..


I watched the news this evening at ang say ng philhealth ot the issue is they will sue those private hospitals na hindi ideduct ang philhealth benefits sa bill ng patients nila..

[Jaguar.Paw]

naku sis, philhealth beneficiaries nanaman ang maiipit neto.. isipin mo na lang, you will not even get your whole salary kasi automatic deduction na ang mga yan tapos ganito pa.. hay. sana gawan nila ng paraan.

[iamABreal]

aww. sana madededuct agad, hindi maganda yung reimbursement, matagal :/

[twisted_halo]

I recently called the Philhealth hotline to verify requirements. Sabi ng kausap ko they only need proof of 3 consecutive months of contribution instead of 9 months.

[iamABreal]

kailangan ba may PhilHealth ID ka pag mga ganito? o basta alam mo yung PhilHealth number mo?

[ikaela]

^To avail of the Philhealth benefits, okay lang na kahit number mo lang. That's all they need to pull up your Member Data Record anyway, which is what hospitals ask for. But getting a Philhealth ID is easy anyway, kaya kung kukuha ka lang din ng MDR, isabay mo na yung pagkuha ng ID.

[iamABreal]

ikaela
ok sis, thanks for clarifying. may nabasa kasi ako sa web na kailangan ng ID kaya naloka ako. haha

matagal pa naman ang EDD ko, gusto ko lang habang maaga alam ko na tong mga to. hehe

[ikaela]

Regarding Philhealth lifetime membership for individually paying members:

"Individually Paying Members, including SSS self-employed and voluntary members, who continued paying premiums to PhilHealth, have reached 60 years old and have met the required 120 monthly premiums as provided for by law."

Tama ba pagkaintindi ko dito, na after making 120 contributions AND reaching the age of 60, pwede na mag-apply for the lifetime membership? Na kapag naka-120 contributions ka na, pero hindi ka pa age 60, kailangan mo pa rin magbayad para covered ka pa rin ng Philhealth? Or para ba itong SSS, na basta naka-120 contributions na, pwede na mag-stop at covered ka na/pwede mo i-avail yung benefits for life?

[ilovemybaby01]

hello po, im turning 6months pregnant po this coming july 7.. Due date ko is oct. 28 .. employed member po ako last year oct. 2013 pero nagresign na po ako and sa pagkaka alam ko po hindi po nahulugan ng employer ko philhealth ko.. pag naghulog po ako kailangan ko pa po ba ipaupdate sa philhealth yung membership ko to individually paying member ? or pwede na po ako maghulog sa bayad centers kahit di ko na ipa update yung membership ko..

sa pagkaka intindi ko po, kailangan ko po bang hulugan yung pang 3rd quarter (july-sept) para magamit ko yung benefits ng philhealth ko pag nanganak ako sa october 28 ? nabanggit po saken sa lying in na 600 yung kailangan kong bayaran tama po ba ? thanks po..

[hun_nie08]

Tama ba mga sis..

May  1500 na pre natal benefits
tapos may 9k sa delivery
at may 1750(newborn benefits) ?


yan mga makukuha ko?