All about Philhealth II

[babythug28]

kapag deceased na yung philhealth account holder, wala na bang hospital reimbursements na mangyayari sa naging expenses nya?

[GMGravity]

Deeyosa pwede naman iyon sis, basta pa update mo lang kay hubby mo Philhealth niya make sure na naka-add ka sa dependent. If may Philhealth ka, dapat ipa-deactivate mo muna iyon. Ganoon kasi ginawa namin last visit namin sa Philhealth. Ako kasi ang employed and hubby self-employed. Kaysa nagvovoluntary member pa siya and separate ang payment, add ko na lang siya sa dependent ko hindi naman papalag iyong mga taga Philhealth. Arte pa nga ni hubby ang sagwa daw kasi siya pa dependent ko. Sabi ko sayang din ang 1800/year na ihuhulog niya noh eh wala din naman siya dependent na ilalagay kasi wala pa kami baby.

[trishevil]

I'm due to give birth this March 2014. Yung updated Claim Form 1 na ba ang gagamitin ko to file for the Maternity Benefit Package? At dapat ba dalawa ang i-fill up ko? One for my baby ant one for me?

[katrinac]

Hello mga sis, how much ang deduction kapag Normal delivery? Nasa website kasi nila ako ngayon, parang di ko masyado magets. may iba't ibang rates. 

[GMGravity]

normal delivery lang nalista ko dito sis, for level 1 / lying-in clinics eh 6,500 for midwife and facility services then 1,500 prenatal care.. kapag level 2-4 hospitals naman 3,500 hospital costs, 1,500 doctor then 1,500 prenatal care

[janachen]

Mga sis,

Manganganak kasi ako sa June, kaso hindi updated ang philhealth ko. 2011 pa kasi ang last payment ko. If ever ba na magbabayad ako this month macocover ba sya by the time na manganak ako?

Thanks

[GMGravity]

Ito nabasa ko sa site nila sis not sure if case to case basis pa ito

Payment of at least three monthly premium contributions within the last six months immediately prior to the month of confinement shall be required of you to be able to avail yourself of your benefits.

Baka si hubby mo regular ang payment pwede ka naman niya ipalagay sa dependent niya, need mo lang ipa-deactivate muna membership mo which is madali lang naman gawin may form lang na sagutan ka then submit mabilis lang

[trishevil]

I went to Philhealth last Tuesday and naayos na yung mga kailangan i-amend sa MDr ko. Ang bilis. 5 min lang ako dun. Then, sinabi nila sa akin na starting January 2014, wala na daw direct filing/reimbursement (pero di naman nila ini-specify kung for maternity lang ba). Automatic/outright deduction na lang daw. Sa mga sis natin na plan mag-reimburse, I suggest you clarify this with Philhealth para di kayo mahirapan. I saw a Circular regarding this pero di ko pa masyado nababasa. Here's the link:

http://www.philhealth.gov.ph/circulars/2013/circ35_2013.pdf

[GMGravity]

Paano iyong sa mga government hospitals nagpupunta? Based kasi sa experience namin sa mga ganoong hospitals, ikaw bibili ng mga gamot and other needs, then itatabi mo resibo for reimbursement di ba? Or baka totoo na iyong narinig ko sa radio the other day, na kapag sa government/public hospital ka nagpagamot, wala ka gagastusin kahit singko. Sila magpo-provide lahat, kung wala sila gamot, sila maghahanap and bibili for you, or bibigyan ka ng pera para bumili. Pero sa mga talagang mahihirap lang yata iyon. Parang ang hirap lang kasi paniwalaan, ospital pang magbibigay ng pera pambili ng gamot mo?

[janachen]

I asked the Philhealth staff kanina kung kelan ko magagamit yung Philhealth ko, she told me na pwede na by April so ibig sabihin pasok yung June.. Ang problema wala pa akong ID. Valid po ba yung MDR na ipapakita sa hospital? Thanks

[mommykthea]

Hi, Janachen. Yes, valid ang MDR..usually ang MDR, [textspeak!] Philihealth Claim Form 1 ( dapat fully signed ng authorized signatory galing sa office nyo ha, usually [textspeak!] HR Head) at yung Philhealth Certificate of Contribution ang hinihingi ng hospital a day before madischarge.

[mommykthea]

sis katrinac , iba-iba po talaga ang rates, depende po kasi sa level of accreditation level yan ng philihealth sa isang hospital..
eto po yung link kung san makikita magkano yung benefit coverage po per level ng accreditation:
 
http://www.philhealth.gov.ph/members/employed/coverage.html

[con0120]

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

[janachen]

Thanks mommthea.

Pano pala kung individual po sakin? Anung kelangan ipresent sa hospital? eto lang po ba Philhealth Certificate of Contribution at MDR?

[mommykthea]

sis janachen, eto po [textspeak!] para sa individually paying, based po yan sa PhilHealth link:

Eligibility Requirements
•Payment of at least three monthly premiums within the immediate six months prior to the month of confinement. For pregnancy-related cases, dialysis (except those undergoing emergency dialysis service during confinement), chemotherapy, radiotherapy and selected surgical procedures, payment of nine (9) monthly premium contributions within the last 12 months shall be required except for those enrolled under the KASAPI program.
•Confinement in an accredited hospital for at least 24 hours (except when availing of outpatient care and special packages) due to an illness or injury requiring hospitalization.
•Attending physicians must also be PhilHealth-accredited.
•Availment is within the 45-day allowance for room and board

Outright/automatic deduction of benefits
1. Submit to the billing section the following prior to discharge:

•Duly accomplished PhilHealth Claim Form 1
•Proof of applicable premium payments
•Clear copy of Member Data Record (MDR)

If patient is a qualified dependent but is not listed in the MDR, the member must submit applicable proof of dependency.
2. Agree with your attending physicians on how much is left to be paid for their services over the professional fee (PF) benefit.

Upon submission of all applicable documents, the billing section will compute and deduct your benefits from your total hospital bill.

[frappysabz]

hi mga sis. just gave birth last valentine's day. i am an individual payer din ng philhealth almost a year na kasi ako hindi nag wowork. i paid the whole year of 2013. mdr at receipt lang ang pinakita sa hospital, sobrang laki ng naitulong ng philhealth sa akin. doctors and hospital bills laki nabawas almost 15k din ata yung nabawas if i am not mistaken.

[kariseyow]

Hi mga sis! 

I want to ask sana kung pwedeng magamit philhealth ng bf ko. Hindi kami kasal and i will give birth on May. Mas matagal na siya nagbabayad ng philhealth. Pwede ko ba magamit account nya sa hospital?

TIA 

[babythug28]

^ no sis. unless married na kayo and nakalagay na dependent ka na nya, then you can use his Philhealth.

[kariseyow]

^ Thanks sis. Sayang naman 

[sexy_07]

frappysabz hindi ka hingian ng PHIC Cert of Contribution?