Philhealth Maternity Benefits

January 13, 2011 · Filed Under philhealth 

Philhealth started implementing its Case Rates Payment system for maternity cases and certain other medical/surgical cases for patients admitted starting September 1, 2011.

For Normal Spontaneous Delivery (NSD) in Level 1 hospitals and in lying-in facilities, maternity clinics, RHUs and birthing facilities, the total Philhealth payment consists of 8,000 pesos (6,500 for the facility and health professional and 1,500 for prenatal care).

For NSD in Levels 2 to 4 hospitals, the total Philhealth payment consists of 6,500 pesos (5,000 for the facility and health professional and 1,500 for prenatal care).

For delivery by Caesarian Section (CS) in accredited Levels 2 to 4 hospitals and performed by accredited health professionals, Philhealth’s coverage is 19,000 pesos. 11,400 pesos is for hospital costs and 7,600 pesos is for the doctors. CS is not covered in level 1 hospitals or maternity clinics.

The Newborn Care Package (NCP) has been increased from 1,000 to 1,750 pesos. NCP includes physical examination, eye prophylaxis, Vitamin K administration, BCG vaccination, first dose of Hepatitis B immunization, newborn screening tests, and breastfeeding advice.

Based on recent Philhealth circulars and advisories, here are some bits of info about Philhealth maternity benefits:

Q: How much is the total maternity benefit for normal deliveries?
The benefit has been increased to 6,500 pesos in Level 1 hospitals and in lying-in and m
aternity clinics. It remains at 5,000 pesos for normal deliveries at Levels 2 to 4 hospitals.

There’s an additional benefit of 1,500 pesos if you submit ORs of prenatal care services. Philhealth will refund this prenatal benefit. It will not be reflected or deducted from the hospital bill.

Q: Can I receive this maternity benefit for all my normal deliveries?
No. Only the first 4 births are covered under the normal delivery package.

Q: Can I automatically receive the total benefit of 6,500 pesos or 8,000 pesos for my normal delivery?

Not always. The benefit of 8,000 pesos pays for the following:
- hospital costs
- for the attending doctor
- 1,500 pesos for prenatal care

For lying-in clinics or midwife-managed facilities:
6,500 pesos for midwife and facility services
1,500 pesos for prenatal care

For level 2 to 4 hospitals:
3,500 pesos for hospital costs
1,500 pesos for the doctor
1,500 pesos for prenatal care

So if you didn’t submit prenatal care receipts, you get only 5,000 pesos or 6,500 pesos. Your prenatal care refund amount also depends on the amount of ORs you submit.

Q: If I’m one month pregnant now, can I apply for Philhealth membership so I can avail of the maternity benefits when I give birth?

No and yes.
For Voluntary Members or Individually Paying Members, nine prior monthly contributions are required for receiving the maternity benefit package. Count 9 months
within the 12-month period prior to child delivery. Let’s say your expected delivery month is September 2013. For the period from September 2012 to August 2013, you should have paid 9 months. Late payments are not accepted. There’s however a once-in-12-months grace period for long-term paying active members. Ask also about the newly-launched Individually Paying Contract (IPC) program.

If you’re an OFW or an OFW dependent, yes, you can avail of the benefit as long as your delivery date is within the validity dates written on the receipt of payment made by the OFW member.

The same condition for Sponsored Members. They also have validity dates, as reflected in their Sponsored ID cards.

For Employed Members, 3 months of payments within the 6-month period prior to delivery are required.

Q. If the hospital is Philhealth-accredited, can I be sure that I get the maximum hospital benefit?

No. You have to make sure that your doctor is also Philhealth-accredited.

Q: How do I get my pre-natal care benefit?
Keep your official receipts for paid prenatal consultation and care, and then submit them
to your accredited hospital/clinic/lying-in/maternity facility, so the receipts will be included in the Philhealth claim. You will get your refund from Philhealth.

Q: When should I file my claims?
Submit your documents to your accredited health facility before discharge so that your
maternity and newborn test cost benefits will be deducted from your hospital/clinic bill.

If you’re unable to submit your papers before discharge, file your claim with Philhealth within 60 days from date of discharge. Waiting for reimbursement can take months.

Q. What are the documents needed to enjoy maternity benefits?

1. Philhealth Member Data Record (MDR). Get this from any Philhealth branch.
2. Philhealth Claim Forms. You can ask for these forms from your employer, the hospital or
from any Philhealth branch. Ask for two copies, the other is for your baby’s newborn care package. If you’re employed, ask for a certificate of Philhealth premium payments.

3. Philhealth ID. Bring also an additional photo ID, in case the hospital asks for further identification.

4. Philhealth payment receipts, if you’re voluntary or individually paying, OFW or dependent. Bring original and xerox copies

5. If you’re a dependent of your husband, bring your marriage certificate, in case the hospital asks.

6. If you have pre-natal care receipts, bring them to the hospital/clinic and attach them to the claim forms. Pre-natal care benefit is 1,500 pesos.

Q. Are there other reasons why I can’t avail of Philhealth’s Normal Maternity Care Package (NCP) of benefits?

You CAN NOT avail of certain maternity-related care in non-hospital facilities such as lying-in and maternity clinics. Avail of these maternity services in hospitals.

Here are exclusions (both hospital and non-hospital facilities):

- fifth normal delivery and subsequent deliveries
- normal delivery after 1 breech delivery and 3 normal deliveries
- normal delivery after 1 cesarean delivery and 3 normal deliveries
- normal delivery after 1 preterm delivery and 3 normal deliveries
- normal delivery after 1 stillbirth and 3 normal deliveries
- normal delivery after 1 normal delivery, 1 abortion and 3 normal deliveries
- normal delivery after 3 abortions and 4 normal deliveries

Exclusions in non-hospital facilities:
- you’re younger than 19
- you’re already 35 years old or older and this is your first time to give birth
- multiple pregnancy
- uterine or ovarian abnormalities, such as ovarian cysts and myoma uteri
- placental abnormality, such as placenta previa
- abnormal fetal presentation, such as breech
- history of 3 or more miscarriages or abortion
- history of 1 stillbirth
- history of cesarean section (CS), or uterine myomectomy, or other major gynecologic or
obstetric operation

– history of hypertension, eclampsia, pre-eclampsia, diabetes, heart disease, asthma, epilepsy, bleeding disorders, renal diseases, thyroid disorder and morbid obesity

– risky conditions that may arise during pregnancy such as vaginal bleeding and premature contractions

CS is NOT covered if it’s performed in a level 1 hospital or maternity clinic.

Above exclusions are sourced from: Philhealth Circular signed by Philhealth President Rey Aquino on November 10, 2008.

Q: If my child is delivered via Cesarean Section (CS), will Philhealth cover my expenses?

Yes, as long as it is Indicated CS. Under the Philhealth Case Rate program, the coverage for CS is 19,000 pesos. This 19k is allocated as 11,400 pesos for hospital costs and 7,600 pesos for professional fees.

CS is covered only at Level 2 to 4 hospitals.

Q: What is the Newborn Care Benefit?

This is a Philhealth benefit worth 1,750 pesos for your newborn baby:
- 500 pesos for umbilical cord care, eye prophylaxis, thermal care, Vitamin K, BCG vaccine
administration, and newborn resuscitation, 1st dose of hepatitis immunization

– 550 pesos for the newborn screening test
- 200 pesos for the newborn hearing screening test
- 500 pesos for the pediatrician

- Available for all normal deliveries, even for fifth and succeeding deliveries, and for CSdeliveries.

Ask your doctor about it beforehand because the newborn tests must be performed within a certain number of hours after the baby’s birth in order for the tests to be paid by Philhealth.

Q: What’s the best way to get the maximum Philhealth maternity benefits?

Find an obstetrics-gynecologist who is Philhealth-accredited, who works in a Philhealth-accredited hospital, and who is willing to help you get the maximum benefit starting from prenatal care up to newborn care.

Or find a midwife’s clinic or a lying-in clinic which is Philhealth accredited and willing to help you get the maximum benefit starting from prenatal care up to newborn care. Make sure that your midwife is also Philhealth-accredited.

Related article:
Philhealth Requires Nine Months of Prior Payments

Philhealth Branches — Membership Reactivation

 

Comments

442 Responses to “Philhealth Maternity Benefits”

  1. jasmin joy bathan on February 8th, 2013 10:42 pm

    how much will be the benefits for INDIVIDUAL POLICY CONTRACT…..THANKS

  2. Nors on February 9th, 2013 4:21 pm

    Hi Sam, is September your due date? If you pay Jan to Aug, this will count only 8 payment, so it lacks 1 payment. But I suggest you go to a Philhealth branch and ask about the new program called Individually Paying Contract (IPC). Ask if you can claim your maternity benefit if you avail of this program.

  3. Nors on February 9th, 2013 10:53 pm

    Hi jasmin, the same benefits. Only the eligibility and payment requirements/rules are more flexible under the IPC program.

  4. son on February 11th, 2013 7:24 pm

    hello mam, just want to ask about the limits of ob-gyne PF for CS here in Baguio at Baguio General Hospital. I’ll be delivering my baby on March 21 via CS because the baby is in a breech position. My Ob-gyne quoted 35 to 40k as total costs including hospital costs, her PF, and that of the pedia and anesthesiologist. This estimate already considered the Philhealth benefit. Just wondering why I’d be paying a lot more now that I have Philhealth. In 2009, in the same hospital (my former ob-gyne has gone abroad), I spent only about 35k. Please I need your advice.thank you very much

  5. Sel on February 12th, 2013 12:18 pm

    Hi Ms. Nors! your site was a great help during the time when I was pregnant :)…I gave birth last nov. 26, 2012 to a healthy baby girl via NSD. just want to ask because based on my bill, I found out that they deducted only 5k for Philhealth; there’s no newborn care package of 1,750. Newborn screening was free, but they didn’t administer any vaccine to my baby. FYI, I gave birth at Sta. Monica Gen Hospital in Marikina. Thanks po.

  6. Nors on February 13th, 2013 5:15 pm

    Hi Sel, congrats! Welcome, healthy baby girl! Thanks for appreciating my blog. Philhealth will send you your benefit payment notice and your check via postal mail within the next several months. If they did not bill you for newborn care, then it would be the same as they have deducted the newborn care benefit. Sometimes, as I have observed, hospitals do not deduct the full 1,750 because they don’t have all the procedures available, or a certain procedure is way more costly than the 1750 provided by Philhealth, such as BCG.

  7. Nors on February 13th, 2013 5:30 pm

    Hi son, sad to say, as far as I know, there’s no law that limits the PF that doctors can charge, even if the hospital is a public hospital, since you’re availing of the hospital’s pay department services.
    Doctors also differ from each other; some are more considerate and some are more conscious about their income. CS ranges from about 30k to 180k or more. Certainly prices have increased, so your 35k in 2009 is no longer the price today. The 19k provided by Philhealth for CS is further allocated to 11,400 for hospital costs and 7,600 for PF. If your ob-gyne quoted 35 to 40k, then the cost must be about 60k. Minus 19k, and that would be around 41k. take care and best regards

  8. angelo victoria on February 15th, 2013 3:07 am

    good day, want to ask if we can avail of Philhealth discount. My partner’s due is may and we’ve paid 4th quarter last year and we’ll pay 1st and 2nd quarter this year, so June would be the 9th month. thank you po.

  9. Nors on February 15th, 2013 5:44 am

    Hi Angelo, count only the months before delivery. So Oct to April is only 7 months. There’s a new program called Individual Policy Contract. Visit Philhealth and ask about IPC. Under IPC, you can avail if you have paid 3 months of the 6 months before hospitalization. IPC is a contract where you commit to pay 1 year, 2 years, or 3 years.

  10. ria mae abarquez on February 16th, 2013 6:47 pm

    hi I am Ria.I just want to know what to do if have receive a notice that i will not be reimbursed by philhealht because my doctor is not accredited.

  11. Nors on February 17th, 2013 12:20 am

    Hi ria, I think you can not do anything anymore, except to go to Philhealth and inquire again if you like. But it has been a long-time policy of Philhealth that you need to be treated by a Philhealth-accredited doctor at an accredited hospital to be eligible for Philhealth coverage.

  12. Ayen on February 23rd, 2013 2:38 pm

    Good day!

    Is it true that when you file at Philhealth Office, the benefit you can get is larger than submitting at the hospital?

  13. Nors on February 23rd, 2013 3:50 pm

    Hi Ayen, Philheath benefits are the same, whether deducted or refunded. But you could be correct in the sense that Philhealth will refund to you all, while the hospital may not deduct the PF (because maybe some doctors insist on cash; or maybe it’s hospital strategy). For example, some hospitals (level 2 to 4) will deduct only 3k (for normal delivery), while Philhealth will refund to you 5k plus 1500 (if you submit prenatal ORs worth at least 1500). You just have to wait for some months for the refund, and you need to obtain the accomplished papers and receipts including PF receipts from the hospital so you can submit a complete claim to Philhealth.

  14. Arlyn on February 23rd, 2013 10:33 pm

    Hi!

    Kung 8 mos LNG po nabayaran prior to my delivery. Can I really avail the IPC ma’am? Or if not.. I am going to use my husbands philhealth. What are the requirements? He is an ofw. Can I ask his MDR at philhealth? Tnx

  15. Weng on February 24th, 2013 7:16 am

    Hi, my husband is an inactive philhealth member since he became an ofw. If he updates his membership and continues to pay, can he or his dependents avail of the philhealth benefits even just after two months of continuing membership? Thank you in advance and God bless.

  16. Nors on February 24th, 2013 7:48 am

    Hi Arlyn, if OFW, you need: orig and copy of OEC receipt with Philhealth payment and with your delivery date within the validity dates on the receipt, his updated MDR, copies of his valid ID and passport , authorization letter authorizing you to sign the Philhealth claim papers, another letter asking Philhealth to name you as payee on any reimbursement check such as the prenatal care check (if he does not have a bank account where you can deposit a check), marriage certificate (orig and xerox), another letter authorizing you to request for his Philhealth ID. Bring your 2 valid IDs too.

  17. Nors on February 25th, 2013 7:55 am

    Hi Weng, yes, because for OFWs, their eligibility is immediate — hospitalization should be within the validity dates on the receipt, which usually starts from date of payment to the 365th day. By the way, if he just paid his OEC, Philhealth is included in the OEC.

  18. Ayen on February 25th, 2013 11:35 am

    Hi Nors! A pleasant day to you!

    My husband and I are not yet legally married, but I’ll use his last name to our newborn baby. Can either one of us or both of us apply our Philhealth for the newborn care package? Thank you

  19. Nors on February 26th, 2013 12:23 am

    Hi Ayen, yes, either one of you, as long as both of you are updated in payments, but it would be easier if you use your Philhealth membership for both your maternity and newborn care. Anyway, the surname of your baby will not matter with regards to newborn care because the hospital knows and will note that you’re the mother.

  20. Michaela on March 1st, 2013 3:48 pm

    Hi ms.n0rs, i am due to give birth this march..my employer paid my contributi0ns for the january to july and september to december..am i entitled to p.health’s maternity benefits? I haven’t paid yet my 1st quarter.

  21. Nors on March 2nd, 2013 7:14 am

    Hi Michaela, are you still employed? If your employer signs your claim form 1 and gives you a certification of payment of premiums for Oct, Nov, Dec 2012, then you can avail.
    If you file as voluntary, count if you have 9 months paid in the period Mar 2012 to Feb 2013. Pay Jan Feb 2013 if needed, or to be sure. Ask others too.

  22. Cathy on March 4th, 2013 5:52 pm

    Hi Nor,

    It’s really great to find this kind of blog! really helpful!

    I am an OFW and currently pregnant. I’m on my 4th month. My husband and I decided that I will just deliver in the Philippines. Since I am an OFW, my last payment to PHILHEALTH was Aug 2011, I think it’s for annual contributions, just would like to know, if I can still continue my payment and can still avail of the maternity benefits?

    Thanks a lot!

  23. Nors on March 5th, 2013 7:42 am

    Hi Cathy, yes, pay as an OFW, so your validity dates would be March 2013 to March 2014, and so your delivery date would be covered. You can pay there abroad (that’s proof you’re an OFW), or you can pay when you arrive — bring proof of your being OFW, such as OEC, job contract or foreign ID (xerox and orig). I hope you’re also an SSS member.

  24. racel on March 5th, 2013 12:36 pm

    g0od pm mam,ask ko lang po can i get my refund even withou the n0tice?im waiting 4 the n0tice alm0st 8 m0s but til n0w wla p po,n0rmal dlivery po aq last june 2012.tnx nd gby

  25. Nors on March 5th, 2013 2:17 pm

    Hi racel, you can try asking the hospital. Bring your IDs, and hospital receipt (xerox and orig).

  26. janice on March 8th, 2013 5:56 pm

    gud pm mam.can i use the phil.health of my husband he is an ofw he paid oct.2012-oct.2013 and my expected due date was on juy 2013.what are the requirements i shoud submit?thank you so much!

  27. Nors on March 8th, 2013 10:54 pm

    Hi janice, yes, you can use your husband’s Philhealth. requirements: your husband’s MDR (get this from Philhealth), xerox of Philhealth payment receipt or OEC with Philhealth payment, authorization letter from your husband authorizing you to sign Philhealth claim forms and to update and get your MDR from Philhealth (xerox authorization letter), orig and xerox of marriage certificate, your IDs, xerox of your husband’s IDs.
    http://www.healthphilippines.net/2012/04/philhealth-maternity-benefit-for-ofw-members-and-dependents/
    http://www.healthphilippines.net/2012/05/philhealth-maternity-benefits-requirements-for-voluntary-members/#comment-12434

  28. joan barrieta on March 10th, 2013 5:18 pm

    hi maam,

    I’m expected to give birth on may 15 2013.
    My philhealth contributions are from 2009 till Aug.2012.
    Then my new employer will submit my payments from jan 2013 to may 2013.
    Am I still eligible to get the philhealth discount/
    This is my fourh pregnancy..

    thanks!

    hope you could reply in my email as well

  29. Nors on March 10th, 2013 8:53 pm

    Hi joan, yes, you will qualify for maternity benefits. For employees, the requirement is only 3 months paid of the 6 months immediately BEFORE delivery month. The 4th delivery is covered. Take care

  30. ling on March 11th, 2013 3:44 pm

    hi!!itatanong ko lang po,im giving birth last feb.11,2013,my baby was confined in ICU due to some complications..hindi po kami kasal ng partner ko,isa po syang seaman..apelyedo po nia ang dala ng baby ko.. pwede po ba mka claim kami ng refund??at kong sakali pwde what are the requirements??salamat po!!im looking forward for your reply…take care

  31. Nors on March 12th, 2013 9:26 am

    Hi ling, was the hospital where your baby was confined Philhealth accredited? Is your partner’s marine agency updated in his Philhealth payments? Documents needed: updated MDR from Philhealth, signed Philhealth claim form 1 from his agency plus certification of payments with OR nos., claim forms from hospital, receipt of payment made to hospital (keep your xerox), birth certificate (orig and xerox, so you can update MDR), your IDs, xerox of your partner’s IDs, authorization letter from your partner authorizing you as the mother of his child to sign claim papers in his behalf (keep xerox). File within 60 days from discharge from hospital.

  32. tata on March 13th, 2013 12:01 pm

    Can i still process my benefits? i was discharge from cs delivery last January 5, 2013.

  33. CELIA L.BAGUI on March 13th, 2013 2:25 pm

    good day po,im celia i want 2 ask,what if already receive my phlhealth notice,in a cs delivery.written there is 19k from philhealth,what if the hospital give me the receipt wherein written there is 11k somthing under the word phic,do i stiil have a refund

  34. joan barrieta on March 13th, 2013 3:17 pm

    hi maam,

    thank you for the fast reply….
    this webpage helps us a lot…
    More Power and God Bless!!

  35. Nors on March 13th, 2013 4:13 pm

    Hi tata, do you mean you haven’t submitted your Phihealth papers to the hospital? If you did not submit anything, sorry, you’re past the 60-day deadline for filing of claims. Ask others too.

  36. Louise on March 13th, 2013 8:50 pm

    Good pm!
    Just wanna ask if i can i use my maternity benefits.
    My due date is on july 8, 2013, my husband was already member since 2008-2010, but we forgot to pay it since then
    At 2012 we started to pay again at july-september , again, oct-dec wasnt pay, but we already paid jan-june 2013.. Pls help!
    July-sept 2012 -paid
    Oct-dec2012 – unpaid
    Jan-june2013- paid
    Due date is on july 8, 2013..
    Thanks!

  37. Nors on March 13th, 2013 9:56 pm

    Hi Celia, I suggest you xerox your notice and your hospital receipt (so you have copies) and then go to the hospital and ask for refund. Your benefit is 19k (11400 for hospital cost and 7600 for PF). You can refund the PF which is 7600.

  38. Nors on March 13th, 2013 11:57 pm

    Hi Louise, yes, you’re eligible, you’ve paid 9 of the 12 months before July. I hope your husband’s MDR is already updated with you written as dependent.

  39. Louise on March 14th, 2013 7:17 am

    Ok thanks, but what if I will deliver on june 24-30, let’s say im nsd? Could this be possible to get maternal benefits?

  40. Nors on March 14th, 2013 12:50 pm

    Hi, if your due is June, June won’t be counted, so there’d be just 8 months. If this is the case, I suggest you go to Philhealth and ask about Individually Paying Contract. Under IPC, you’re qualified by having paid 3 of the 6 months before month of delivery.

  41. Marites on March 14th, 2013 2:34 pm

    Gud pm! I just wanna know what benefits aside from New born care package, I can get reimburse from Philhealth. Last March 8, 2013 I delivered my 7th child via normal delivery at Capitol Medical Center in Quezon City, this is the first time I decided to give birth at the hospital, my 1st to 3rd child I delivered at Lying In clinic not a philhealth accredited,I did’nt use my philhealth. 4th to Sixth child Home delivery with registered mid wife I did’nt use my philhealth again, now I am 43 yrs. old still working and contributing to philhealth. Why I decided to give birth at the hospital? because I want to undergo tubal ligation, at my age I can’t say If I won’t be pregnant again. Now can I reimburse something from Philhealth (my hospital bill was too expensive and we are really drain for incoming expenses for my new born) can I reimburse it directly to your office because our hospital bill was paid before the hour of my delivery?

    Hoping for your immediate and positive response.

    Thank you and more power.

    Respectfully yours,

    Marites

  42. Nors on March 15th, 2013 8:54 am

    Hi Marites, if you underwent tubal ligation, that can be reimbursed. BTL’s coverage is 4k. Ask others too. By the way, I’m not working for Philhealth, I just blog about Philhealth. best regards

  43. CELIA on March 15th, 2013 10:58 am

    good am po,i already have my xerox copy of receipt.the hospital refuse to gave me the 7600.they only ask me the receipt of all things that i bought b4 the opration,but when they receive those receipt,they choose some and return me the other and they told that those receipt will have the refund but it is not sure.thy told me told that they r going to submit that 2 the audit comitte,and if those receipt did not pass in the auditing i will no longer receive my refund,pls help me po,

  44. Marites on March 15th, 2013 11:05 am

    Gud am, thank you so much that info helps a lot. GOD BLESS and more power.

  45. Nors on March 15th, 2013 1:44 pm

    Hi Celia, you said you bought things before the operation? So this is a government hospital?
    When I gave my first answer, I thought you paid the balance from the 11k that was deducted from your bill. I thought you paid the doctors or professional fee (PF). Did you pay the PF? Because 7600 is for PF; 11400 is for hospital costs. That PF is the one that you can refund. You can refund the PF amount that you paid, up to 7600, not medicines, because your 11k (for hospital and medicines) was already deducted. I don’t know why they did not explain it this way. I’m sorry I did not ask first if you paid PF. Been answering a lot of questions. best regards

  46. CELIA on March 18th, 2013 10:26 am

    gud am mam,yap it is a government hospital,mam pls help me.try 2 look at this my sttment of acount came from the hspital.this is by column * particulars room @ bed 4 days 1k,medicine 165,miscllneous billing 300,professional fee 7600,operating room fee 2200.has a total of 11,265 under the word PHIC.and then,at the bottom TTL:(actual-disc-Bene) 11,265,and after that i paid 25,400 + all the things that i bought b4 the operation.so if i am going to sum it all ,11,265+25 400+19k since they told me that this is my phlhealth benfts and i cnnot refund that,so it means i paid 65,665,in a government hospital,daig p po ang private,tulungan nyo nmn po aq,reply po asap pls,pls po,tnx

  47. Nors on March 18th, 2013 1:49 pm

    Hi Celia, I wonder why the 25,400 that you paid was not described. What was that 25,400 for? Did you have a deal with the OB before having your CS? What is right in your case is that the hospital refund you 7,735 (19k – 11,265) because you paid 25,400 and that you bought items for the operation and Philhealth paid them 19k.
    Following your computation, your total expenses would have been 25,400 plus 19k = 44,400 plus cost of items you bought. If the hospital does not refund you 7,735, you can go to Philhealth and file a complaint. Bring copies of statement and receipts and keep your copies. best regards

  48. megan on March 18th, 2013 2:15 pm

    hi,,malapit n po akong manganak,waiting nalang po ako,.i am employed,kaso lng ang problema wala pa akong philhealth id,kasi wala pa dw nirerelease ang philheath ng ohilhealth id kc my enhancement daw n gngwa s id nila,eh nirerequire ako ng lyin in n aanakan k ng philhealth id,ano po dapat k kunin,meron n po ako,cert of contribution,MDR,at CF1.sayang nmn po kung hindi k mgamit philhealth k,eh d k nmn kasalanan kng wala p silang maibgay n id.please i need an answer

  49. Nors on March 18th, 2013 2:39 pm

    Hi megan, Philhealth has already released another circular in January 2013 (Philhealth Circular No. 0001, s. 2013 issued Jan 21, 2013) instructing health facilities to accept MDRs as substitute for Philhealth IDs, because of the problem with Philhealth IDs. But if your lying-in does not want to listen to you, just make sure that they help you with the claim forms for refund. What will happen is you will pay them, and then you file for refund from Philhealth; get a promise from the lying-in that they will give you the needed documents before you are discharged, claim forms for you and for your baby (newborn care). Then you will be the one to file your claim directly with Philhealth. Include your prenatal ORs worth at least 1500.

  50. megan on March 18th, 2013 3:23 pm

    Thank you so much,this advise would really help me,nanghihinayang lang ako kasi ilang taon n akong employed and this will be the first time that i will be using my maternity benefit,sabi nmn s philhealth buong pilipinas dw wala png ID kc bago ang president nila,kya pg ng insist p rin dw ang lying in patawagin k sa knila.

  51. Jen on March 19th, 2013 2:54 am

    Hi mam..your blog was really helpful and thanks for all the info. Im already on my 7th month and im also an ofw. Me and husband decided that I’ll give birth in the Phil. I just want to ask if i still need also to submit a copy of my MDR to the hosp together with my OEC? Thanks in advance and Godbless..

  52. Nors on March 19th, 2013 7:29 am

    Hi Jen, yes, you need to submit copies of your MDR and OEC with Philhealth payment (Bring originals). Bring also any valid ID.

  53. Angelo on March 19th, 2013 11:48 am

    Hi Ms. Nors, I just want to verify if this Philhealth Maternity benefit program is exclusively for married couples?

  54. Nors on March 19th, 2013 12:39 pm

    Hi Angelo, no, not exclusive. An unmarried woman can avail of this benefit, as long as she’s a Philhealth member, or if she’s a dependent of her parents. A marriage certificate is needed only when a married woman is not a Philhealth member, so she needs to use her husband’s Philhealth membership as legal dependent of her husband.

  55. Elizabeth Cabaluna on March 19th, 2013 12:58 pm

    hello!

    My lying-in clinic is not philhealth accredited. I heard some fedback that we can still claim our benefits through direct filing? How true is it?

    thanks a lot

  56. honey on March 19th, 2013 1:58 pm

    hi ma avail ko p b ung maternity benefits s philhealth,ngstart aq ngbayad nung jan2013,due date ko po oct 2013,salamat po

  57. Nors on March 19th, 2013 4:10 pm

    Hi Elizabeth, it’s required that the health facility must be Philhealth-accredited, whether outright deduction or direct filing for refund. But please ask others or Philhealth.

  58. jovy on March 19th, 2013 5:43 pm

    Hi,can i still avail my maternity benefits pf philhealth i started to pay 5 months year 2005 & this year 2013 i paid the whole year. then my expected labor will be this coming july 2013. thanks & god bless…

  59. Nors on March 19th, 2013 9:08 pm

    Hi honey, yes, pay Jan to Sep so you will accumulate 9 months, so you will qualify. Don’t miss any payment.

  60. Nors on March 20th, 2013 6:58 am

    Hi jovy, if we follow the voluntary-maternity requirement of 9 months BEFORE month of delivery, you cannot avail since Jan to June counts only 6 months. I suggest you go to Philhealth and ask about Individual Policy Contract. Under IPC, you can avail.

  61. jovy on March 20th, 2013 9:04 am

    Hi, THANKS for the information, is their any requirements in availing IPC? i dont understand what is IPC means.

  62. Angelo on March 20th, 2013 10:56 am

    Thank you so much for your quick response here Ms. Nors. Just a follow up question though, what if an unmarried woman had an accumulated 12 months Philhealth contributions from her previews employments which had ended in Nov. 2012, and got pregnant this year with an Expected date of Delivery of Oct. 2013, does she just needs to INDIVIDUALLY fulfill her Jan-Sept 2013 Philhealth contributions to qualify?

  63. Nors on March 20th, 2013 2:27 pm

    Hi jovy, IPC is a new program launched by Philhealth this 2013. You’ll pay 1 year to 3 years in advance. Under IPC, you can avail as long as your delivery month is still at least 4 months away. Bring your IDs and your receipts of payments for 2013.

  64. Nors on March 20th, 2013 2:43 pm

    Hi Angelo, you’re correct, the woman will be eligible. Jan to Sep is 9 months — enough to comply with the required 9 monthly payments within the 12-month period BEFORE month of delivery, which is Oct 2013. Months of Oct and Nov 2012, if paid, can even be counted, but to be sure, just pay the whole Jan to Sep 2013. If she delivers in Sep, she can include her payment for Oct or Nov 2012 in her claim.

  65. jovy on March 20th, 2013 3:18 pm

    okey thank you very much for the information it helps a lot. thanks & god bless…

  66. Charmaine on March 20th, 2013 8:41 pm

    Gud PM po! Just want to ask! My husband is a Seaman. He is onboard last March 6. And to my last experience to my first Baby their contribution was submitted delayed by 1 month lets say onboard sya ng march kahit nakaltasan na sya ng march na philhealth April pa nila isusubmit to Philhealth that’s why I haven’t used his philhealth beacause their’s a lapsed paymnet. Right now i’m pregnant with my 2nd Baby. May EDD will be on Oct.2013. Can I use his Philhealth for my delivery if just in case April’2013 pa magstart ung Philhealth nya? Thank you!

  67. Nors on March 21st, 2013 1:51 am

    Hi Charmaine, yes, you can avail. Seamen are considered employed members of Philhealth, and employed members need only to pay at least 3 of the 6 months BEFORE month of delivery. In your case, since your due is Oct, your husband and his employer have lots of time to pay and remit 3 months or more BEFORE Oct.

  68. Angelo on March 21st, 2013 6:28 am

    Thanks Ms. Nors..I do have another question here, is there any cases that a women can request for an OB who would handle a first baby delivery instead of a Midwife even if the Philhealth maternity benefits is to be rendered at a Level 1 Philhealth accredited facilty?

  69. Charmaine on March 21st, 2013 7:03 pm

    Thank you Ms. Nors for replying. I can sleep na without worrying!

  70. Nors on March 21st, 2013 10:02 pm

    Hi Angelo, do you mean the woman’s OB is working in a level 2 to 4 hospital? Yes, she can ask the OB if she’s affiliated with a level 1 hospital and ask her if she can have her delivery there. If not and if the delivery is still far away and if this is what she decides and she’s comfortable with, she can find a good OB in a level 1 hospital.

  71. Grace on March 22nd, 2013 3:29 pm

    Hi, my sister gave birth to her twins last March 20, though she was advised by her OB to bed rest since December 2012 which resulted to her contributions to philhealth to stop from dec 2012 up to present. The hospital told her to pay the Dec 2012 up to Jan 2013 for her to avail her philhealth benefit. Will she be allowed to pay her contributions from Dec 2012 up to present? If yes, where can she pay such? Payment facilities in SM said they can only accept payments for the current year 2013. Thanks!

  72. Nors on March 23rd, 2013 4:22 pm

    Hi Grace, she can pay her Jan and Feb premiums (and pay also March 2013 — pay the whole 1st quarter so they’ll accept the payment; asap, within this March) — then add at least 7 months paid within March 2012 to Nov 2012, to accumulate 9 months — the required no. for voluntary (9 months paid within the 12 months BEFORE month of delivery). On 2nd thought, is she employed? Because as employed member, she only needs to submit her employer’s certificate of premium payments with OR nos. for Sep Oct Nov 2012 (complying with the rule of paying 3 of the 6 months BEFORE month of delivery).

  73. aivy on March 25th, 2013 5:38 pm

    Helo ms. Nors, question lng, in applying the IPC is thier any requirements? i will change my status into voluntary since im not employed now. Then i plan to apply sa IPC in order for me to avail the benefits coz im 5 months pregnant now & expected labor will be July. I plan to pay the whole year this march, can i avail the benefits?

  74. Nors on March 25th, 2013 10:52 pm

    Hi aivy, I think there are no special requirements for IPC. Bring your IDs. Under this new program, you can avail as long as you have paid 3 of the 6 months before July. But ask them when you’re there to be sure.

  75. jovy on March 26th, 2013 3:25 pm

    mam is it okey to pay my contributions for 1 year at Bayad Center as voluntary before i change my status as voluntary member coz before im employed 2 years ago. I think its a long holiday, march 31 falls on sunday also.

  76. Nors on March 27th, 2013 1:20 pm

    Hi jovy, I suggest you go to Philhealth Center and apply for the Individual Policy Contract (IPC) — this has more flexible eligibility rules. If you cannot go yet to Philhealth, I suggest you pay only the 1st quarter at Bayad Center, then apply for IPC after the holidays. After March, you can no longer pay for Jan to Mar.

  77. Cheskalita on March 27th, 2013 9:46 pm

    Hello mam. I think your blog here is very helpful so now id like to share my own dillema. Ive been reading a lot in preparation for my delivery this upcoming April. I understand now that as a Philhealth member i am entitled to maternity package of 8000 if nds an 19k if Cs. However sa dami ng nabasa ko I got confused kasi sabi ng iba mas malaki daw sa 8k ang nakuha nila from philhealth for normal del. ive read a few on forums and blogs. How can this be? Is it possible na ang ma refund for nds is greater? Btw my OB is philhealth accredited and i will be delivering at st lukes med qc. Kaya im hoping sana mas malaki laki don ang matulong ng philhealth, mu ob advised me to prepare atleast 80 for normal and 120 for cs.. Ang mahal :( thanks in advance po mam!

  78. jonathan on March 28th, 2013 1:07 am

    could my wife avail the maternity benefits?she’s six months pregnant here in dubai and planning here also for her delivery and she’s my dependent.please advice what the benefits she can claim here in dubai.

  79. Nors on March 28th, 2013 11:44 am

    Hi Cheskalita, thanks for appreciating my blog. You’re delivering in an expensive hospital — so the Philhealth maternity benefit is just a very small percentage of your hospital bill. Parang patak lang yong benefit. For level 2 to 4 hospitals (St Luke’s is L4), the benefit for NSD is only 5k (3k for hospital and 2k for PF), some hospitals don’t even deduct the 2k. If CS, it’s 19k (11400 for hospital and 7600 for PF). For NSD, there’s 1500 for prenatal if you submit prenatal care ORs worth at least 1500. No prenatal care benefit for CS. For both NSD or CS, there’s 1750 for newborn care package. I hope that 80k estimate already includes newborn care. Take care and have a safe and happy delivery.

  80. Nors on March 28th, 2013 12:48 pm

    Hi jonathan, Philhealth’s maternity benefit is fixed. If normal delivery in big or foreign hospital, it’s 5k (3k for hospital and 2k for doctor). If CS, 19k (11400 for hospital and 7600 for doctors). If normal delivery, there’s 1500 for prenatal care if you have prenatal care ORs worth at least 1500. There’s newborn care package of up to 1750 if you submit another claim form for the baby with receipts. http://www.healthphilippines.net/2012/03/how-to-claim-philhealth-benefit-for-overseas-hospitalization/ The delivery date should be within the validity dates on your Philhealth premium receipt.

  81. vangie on March 29th, 2013 6:15 pm

    mam im member for almost 5yrs sa philhealth pero na stop ako,,pero nun july 2012 nagbayad po ako ulit hangang dec.2013 binayaran ko na. ngayon im 34 weeks pregnant pero sabi nag ob ko 37 weeks mag schdule cya nag cs sakin kasi placenta previa po ako, can i avail ba sa philhealth. pls. reply kailngan ko kasi sa hirap nag buhay,,,voluntary payment ako sa philheath mam.
    tnx so much!

  82. Nors on March 29th, 2013 9:31 pm

    Hi vangie, do you mean you paid for July 2012 to Dec 2013? You will have your CS in April? If yes, you are eligible for the CS coverage of 19k (11,400 for hospital and 7,600 for doctors). July 2012 to Mar 2013 = 9 months (before month of delivery) — the required no. of months for maternity benefit. take care

  83. vangie on March 31st, 2013 10:15 pm

    thank you so much maam for your response, its a big help to me.

  84. Blenda on April 4th, 2013 8:23 pm

    Hi ms.Nors , question lang po
    Im employed . Since sept.2007 kinakaltasan na po ako ng philhealth contri. ko . Maternity duedate ko is this april 10 2013 . Nakaleave na po ako last year Dec.19, 2012 . Ask ko lang po kung maavail ko po ba yung philhealth benefits ko yung sa 9months contribution. Thanks for your reply :)

  85. Nors on April 4th, 2013 10:28 pm

    Hi Blenda, was your December premium paid? If paid, yes, you can qualify for Philhealth coverage, either as employee (3 months paid of the 6 months before April) or voluntary (9 months paid of the 12 months before April). If your Dec was unpaid, request your employer to pay — because they can pay even if late; they just pay the late penalty. Tell them you can pay the premium plus the penalty. This April, voluntary members can no longer pay for Jan to March.

  86. Blenda on April 6th, 2013 4:04 pm

    thankyou Ms.Nors
    Quetion po ulit , . What if kung hindi ko po nabayaran ung sa month ng December ? Kung 8months lang ang contribution ko . Maaavail ko pa din po ba ung philhealth benefits ko . Thanks and GodBless

  87. Nors on April 6th, 2013 10:35 pm

    Hi Blenda, sorry I think you cannot, you should have paid 9 months of the 12 months before April, or 3 of the 6 months before April. But ask others too about this.
    You can go to Philhealth and ask to pay for first quarter. Tell them it’s your first time to pay late and that you took a leave. In their FAQ release (page 24), a member can pay for the past quarter late once in a 12-month period.

  88. jane borja on April 8th, 2013 8:09 pm

    hi pwdi rin po ba refund ng philhealth ang prenatal care kahit dito sinagawa ang sa ibang bansa ang prenatal care. thank you & god bless

  89. Nors on April 9th, 2013 11:34 am

    Hi jane, yes, submit the official receipts of prenatal care expenses abroad together with the maternity claim.

  90. Emme C. Cabahug on April 10th, 2013 7:57 am

    Good morning,ma’am! Just want to ask, I was not able to avail a Philhealth maternity benefit when I delivered my fourth child, can I avail it for my fifth delivery? All deliveries were under normal conditions.
    Thank you so much. God bless.

  91. Nors on April 10th, 2013 10:01 am

    Hi Emme, sorry, but Philhealth is counting all normal deliveries, even those not covered by Philhealth, so your 5th won’t be covered. You can claim your newborn care package though. Please ask others too.

  92. chris on April 12th, 2013 3:02 pm

    Good afternoon!
    I just had our HR state my wife as my philhealth dependent. She was about 4 months pregnant by that time. She’s a stay at home wife but was employed before, maybe 2 or 3 years ago, so I assume that she’s an inactive philhealth member. As a dependent, will she get the same benefits as me when she gives birth? How will you claim the benefit? Do you claim your philhealth benefit after giving birth or before? Obviously, I still have no idea how to go about this. This is my first child. Hope you could help. Thanks!

  93. Nors on April 12th, 2013 9:21 pm

    Hi chris, yes, members and dependents get the same benefits. Submit the documents before discharge, so you get deductions outright. Get your MDR from Philhealth and see if your wife is already written there as your dependent. If she has prenatal ORs worth at least 1500, then she can submit them too, so you can refund 1500 — this is only for normal delivery cases. Your wife should talk with her OB about expenses and Philhealth because doctors/hospitals/maternity clinics have different ways in applying Philhealth, specially their professional fees.

  94. Beth on April 13th, 2013 7:47 pm

    Hi, thanks for this post. If my hospital bill was covered by private HMO, can I still file for a philhealth reimbursement?

  95. Nors on April 13th, 2013 10:51 pm

    Hi Beth, if your HMO pays your total hospital bill including that portion covered by Philhealth, then you can refund the Philhealth coverage. But what I know is that many HMOs require you to submit your Philhealth documents before discharge because they will not pay the portion of the bill that should be paid by Philhealth.

  96. Edna on April 14th, 2013 1:43 pm

    Hi, just to clarify, Can I avail the New born screening package even if I am to delivered via c-section? When was the New Born Screening package effective? I gave birth to my first child in 2009 not knowing of this package. Thank you!

  97. Emme C. Cabahug on April 14th, 2013 6:11 pm

    Thanks for your reply ma’am; just a follow up question; what about if my fifth delivery would be via CS,can I avail the Philhealth maternity benefit?
    Thanks a lot!

  98. Nors on April 14th, 2013 7:18 pm

    Hi Edna, yes, CS patients can also avail of the newborn care package. Submit one claim form 1 for maternity and another for the baby. But not all newborn care procedures are covered because the Philhealth newborn coverage is only 1750.

  99. Nors on April 14th, 2013 7:34 pm

    Hi Emme, I think it would be covered, as long as it is an Indicated CS. But ask your OB, so you can be sure; there could have been changes that I’ve missed.

  100. zarj on April 16th, 2013 7:19 am

    hi nors…i dont know if you can still remember me…until now wala p din ung maternity ko sa sss…nun december pa un…ilang beses ako pinabalik balik…then ngaun madedenied lng bec of bertcerti…ung bertcerti ko kc is frm the hospital may pirma n ng registrar d man lng cnb sakin na dapat may tatak..akala ko ok n lahat..pag tingin ko online..boom…denied…pls submit true copy of bertcerti. nagpunta ako dun sabi sakin imamail daw un mga papele and submit ko ulit grabhe na ito!!!anu bang klase ung sss dito sa pinas…8 tyms ako bumalik sa knila then denied lang!!!pwede ko ba ireklamu ang sss grabe na kasi…to tthe point na pagpasa ko sabi wait nlng daw after 3 weeks…nakakainis na…anu ang gagawin ko???feb 27 na denied til now d pa nabalik ang papers ko…hnd ko na kc alam kung sang articel ako nagcomment before kaya dito ko nlng nagcomment pacenxa na/…thanks…

  101. rizza on April 16th, 2013 7:25 am

    hi,,ill b delivering on july 8 and i just started contributing last august 2012..im i eligible for the maternity benefits..thanks,, also my partner is a philhealth member too..but were not yet married..pwede po ba namen gamitin yun for our baby during my delivery..thanks alot

  102. rizza on April 16th, 2013 8:05 am

    im currently employed po..pero yong partner q wla po sia work ngayon.. can i still avail maternity benefits? thanks\

  103. Nors on April 16th, 2013 8:55 pm

    Hi zarj, it’s so sad to know about your case. Yes, I remember your case — the one who had to get a signature specimen card from the employer. I now realize that you had the misfortune of dealing with an SSS officer/branch who is not very helpful. I can say that here in our place, the Alabang SSS office is a very efficient one; I have had at least 5 transactions with them, and the results were all good. I see that some people filing maternity claims have incomplete papers and they’re being instructed on what to do. Which SSS branch did you file your claim? They should be able to check the documents being submitted. I’m puzzled that the SSS officer was not able to see that the birth certificate was not certified by the local registrar. I’m also puzzled that it was the hospital that gave you the birth certificate. Usually people get this document from the city or town local registrar or the NSO.
    About the original documents you submitted, I think it’s their SOP to mail these back. Because of the volume of documents being handled, they don’t know exactly where your documents are — they just know it’s somewhere in the workflow — that’s why they told you to wait for the mail.
    For filing a complaint, yes, you can file your complaint at the main office in Diliman. You will fill up a complaint form and submit together with an incident report or a letter describing your experiences. But I suggest you do this when you already have received your maternity check. Take care and best regards

  104. Nors on April 16th, 2013 9:00 pm

    Hi rizza, yes, you can avail of the Philhealth maternity benefit. For employees, only 3 monthly payments are required (3 of the 6 months BEFORE month of July). If you paid 3 months of the 6 months Jan to June 2013, you are eligible. Keep your prenatal ORs; you can claim up to 1500 — submit ORs to the hospital so they will include it in the maternity benefit.

  105. rizza on April 17th, 2013 2:59 am

    thaks a lot for your quick response..i appreciate it much.,NORS, yong midwife clinic po na pinupunthan ko for chrck up dun ko din po kasi gusto mgdeliver,,and they have their package of painless delivery 12k(5k for phil.health member)sa ob na po yun.. pag napasa ko po ung lhat ng paper needs ,, mkakapagrefund padin po ba aq sa mga magaastos ko..thanks.. 1st baby ko po kasi so im not reli aware about this benefits that i am entitled to :) .. thats why i need your advise po..thank u so much

    and regarding po dun sa tanong ko sa father ng baby ko,magagamit din po ba nia yong philhealth,, or mas mgandang yong akin nlng po muna dahil employed naman po aq.. ;) thanks ulit

  106. Nors on April 17th, 2013 9:36 am

    Hi rizza, you cannot yet use your partner’s Philhealth because you don’t have yet a marriage certificate. Aside from that, an active member cannot be at the same time a dependent. About refund — you said the package is 12k, and 5k if Philhealth is used. Tama ba yong intindi ko? So that means if you pay only 5k for everything, your 7k deduction is already your Philhealth benefit (6500 maternity benefit plus, I assume, 500 newborn care). You can refund only the prenatal care up to 1500 (if you submit ORs) — it would be Philhealth that will send you the prenatal refund.

  107. rizza on April 17th, 2013 11:12 pm

    thanks i do understand now ;)

  108. zarj on April 18th, 2013 2:31 pm

    im glad that you still remember me. thanks for your concern. if ever i already have my requirements back, can i just process it in alabang? coz sss binan is not doing their job properly. lahat cla nagmamadali at minsan naiinis pa kapag nagtatanung ka at kung hindi ka pa magagalit hindi p cla mag eexplain grabe cla…pwede bang iprocess ko nlng sa alabgn un tutal dun namn ako work nganun…imagine 8 tyimes na ko bumalik sa knila grabe..kulang kulang sa impormasyon…ewan ko sa knila…bhala na si lord sa knila…

  109. MARCHIE on April 18th, 2013 5:13 pm

    Good pm po.
    ask ko lang po sana kung pwede po naming gamitin yong philhealth naming dalawa ng asawa ko, manganganak po ako on june, ano po mga requirements po na dapat dalhin sa hospital incase po na manganganak na po ako. Government hospital po ako manganganak. Thank you po and good day.

  110. Mycah on April 18th, 2013 10:43 pm

    Hi. My due date is on may pero ngayon lang ako kukuha ng philhealth. Can i still use it for my maternity? Can i just pay the 9mos required during my registration so i can use it? Thanks.

  111. Nors on April 19th, 2013 5:59 am

    Hi zarj, yes, I think you can file in Alabang, because the SSS instruction is file at the branch nearest your work or your residence. I hope Alabang branch will be helpful. best regards

  112. Nors on April 19th, 2013 6:04 am

    Hi Marchie, are you employed? If yes, you need to use your own Philhealth because you cannot be an active member and at the same time a dependent of your husband. If you meant using 2 Philhealth memberships, sorry, no. Only one. Documents: Updated MDR, claim form 1 for you and for your baby – signed by employer, prenatal ORs at least worth 1500 if you have, certificate of premium payments from employer, your Philhealth ID or valid IDs. In some government hospitals, you have to buy certain supplies outside if these are not available at the hospital. Good day too.

  113. MARCHIE on April 19th, 2013 8:04 am

    thank you for immediate response. sobrang nakakatulong po ang inyong blog. thank you so much.

  114. MARCHIE on April 19th, 2013 8:26 am

    Good am po.
    Tanong lang po ako ulit, yong ultrasound po ba kasama po sa prenatal care? bakit po yong hipag ko philhealth member po sya pero CS po sya nung nanganak sabi po sa hospital non na yong baby lang yong pwedeng gumamit ng philhealth nya. Thank you po ulit.

  115. Nors on April 19th, 2013 11:21 am

    Hi Mycah, sorry you cannot use Philhealth immediately. You’re not allowed to pay past quarters. You can start being a member for future needs.

  116. Nors on April 19th, 2013 11:38 am

    Hi Marchie, include the ultrasound; although the rules say it should be medically necessary, they might consider it.
    Is your hipag voluntary? Can you ask if she had paid contributions for 9 of the 12 months BEFORE her month of delivery? Because if she had paid and she has premium payment receipts, she should have qualified for the 19k coverage. She can claim her refund from the hospital using her benefit payment notice and hospital receipts. By the way, where did she have CS? If it was in a level 1 hospital, CS is not covered.

  117. Nich on April 24th, 2013 3:05 pm

    Hi Mam Nors., tanong ko lang po, manganganak na po ako next month and gusto ko po sanang malaman kung pwede ako mg-avail ng maternity. eto po ang hulog ko.

    Jan2012 – pd.
    Feb2012 – unpaid
    March2012 – pd
    April-June2012 -pd
    July2012 – pd
    Aug. & Sept.2012 – unpaid
    Oct-Dec2012 – pd (ngvoluntary na po ako dto)
    Jan-March2013 – pd

    nakakuha na po ako ng cf1 sa employer ko before and sbi sa lying in titignan pa daw nla kung ok lang dw ba sa philhealth. Mgbbyad na rin kami dis April to June2013. thanks po.

  118. Nors on April 24th, 2013 9:08 pm

    Hi Nich, yes, you’re eligible because you’ve paid at least 9 of the 12 months BEFORE May, which is your month of delivery (hindi kelangang consecutive; basta yong 9 months within the 12-month period). You should accomplish your claim form as voluntary. What you should get from your previous employer is a certification of premium payments (year 2012) with OR nos. But if your premium payments are written in the claim form that you have, maybe the lying-in can accept that already as certification.
    Get your updated MDR from Philhealth

  119. zarj on April 27th, 2013 9:32 am

    kapag deniedba tlgang ibabalik ang docs..2 mos ng denied wala pdin

  120. Nors on April 27th, 2013 12:52 pm

    Hi zarj, ganyan din naman ang advice ng SSS sa kasabay mo ring nag-comment dati last year — wait for the documents to be returned and then re-file. Her mistake naman is membership type yata or name of company, I forgot na. Frustrating really. Pero look at the bright side na lang — at least hindi mo pa nagasto :)

  121. zenia on April 28th, 2013 9:44 am

    Hi just wanna ask lang po im a dependence of my husband in his philhealth and his working in private company for 3 years my delivery will be on july 23 2013 can i avail any benefits from philhealth ?

    Tnx and best wishes”

  122. Nors on April 28th, 2013 5:10 pm

    Hi zenia, yes, you can avail of Philhealth maternity benefit as dependent of your husband. Just ask your husband to ask for a certificate of Philhealth premium payments with OR nos. and accomplished Philhealth claim form 1 and to get his MDR from Philhealth and Philhealth ID if he can (if not, it’s okay if there’s no Philhealth ID). If you’re not yet written as dependent, your husband needs to update his Philhealth data before het gets his MDR by filling up registration form and presenting your marriage certificate (xerox and orig)

  123. MARCHIE on April 29th, 2013 10:50 am

    Good morning po. 6 months lang naman daw nabayaran hipag ko kaya baby nya lang daw po naka avail. Okay na po bang kuni yong premium payment sa employer ko ngayon maam? thank you po ulit.

  124. Nors on April 29th, 2013 7:29 pm

    Hi Marchie, it’s sad that your hipag was able to pay only 6 months. About premium payment, what do you mean? Certification of premium payment? It’s better to request your employer about 1 or 2 months before your due, because your employer will certify that you have paid your premiums for at least 3 of the 6 months BEFORE your due.

  125. Nich on April 30th, 2013 12:31 pm

    Hi po ulit Mam Nors. Pano po pala kung nagamit ko yung Philhealth ko nung Feb2013 kase naconfine po ako tapos manganganak na po ako this May2013. Magagamit ko parin po ba sa Lying in yung Philhealth ko po? Thank you po.

  126. Nors on April 30th, 2013 2:49 pm

    Hi Nich, yes, you can use your maternity benefit. Siguro ang naisip mo ay yong 90-day rule: Hindi covered ang 2nd confinement kapag ang sakit ay parehong sakit sa previous confinement sa loob ng 90 days. Hindi applicable sa case mo.

  127. Nich on April 30th, 2013 8:28 pm

    Thank you po talaga Mam Nors.

  128. Loida on May 2nd, 2013 3:42 pm

    hi! tanong lang po, I received BPN from philhealth stating the refundable amount ng maternity benefits and new born care. yund maternity benefit is 8k tapos yung new born care is 1,500. my refund po ba ako na matatanggap? na discharged po ako sa lying-in clinic without paying anything po. yung patient na kasabayan kung na nganak na walang philhealth ay may nabayarang 5k up. if ever may matatanggap po ako na refund, magkano po kaya? I called philhealth about refund, sabi nila wala na akong refund kasi package yung pangaganak ko pero sabi nman nang midwife myroon daw akong matatanggap na refund. which is which po? salamat po. your response will be greatly appreciated.

  129. Lila Veronica V. Natividad on May 2nd, 2013 4:53 pm

    hello po…bakit po kaya ang sabi nung lying in na pinanganakan ko po philhealth accredited sila pero nung nag check po ako sa philhealth di daw po sila accredited kaya denied po ung application ko po. thank you po. sana maliwanagan po ako.

  130. Nors on May 2nd, 2013 9:15 pm

    Hi Loida, you said you did not pay anything, so you will not get a refund. Kasi yong 8k, fixed na yon na payment ng Philhealth to maternity clinics, ke mas mahal na clinic or mas murang clinic. So kahit 5k up lang yong regular rate nila, sa kanila na yong excess from Philhealth. Pero kung sabi ng midwife, eh baka generous/helpful yong clinic. Tanungin mo na lang uli.

  131. Nors on May 2nd, 2013 9:22 pm

    Hi Lila, it’s the fault of the clinic. Nagsinungaling sila sa iyo. Sino sa clinic ang nagsabi? Yong taong yon ang tanungin mo. Bakit nagsinungaling siya. Humingi ka na lang ng discount, kasi hindi sila nagsabi ng totoo. Puede mo ring isumbong sa Philhealth, or sa barangay, but they will ask for proofs.

  132. ash on May 3rd, 2013 11:27 am

    hi mam,i just wanna ask i paid my contribution last year oct-dec 2012 im voluntary paying.then Jan-June 2013 was paid as well.my delivery due this coming June via caesarian section.can i avail my phil health benefits?thanks

  133. Nors on May 3rd, 2013 4:37 pm

    Hi ash, sayang you lack one month. Oct 2012 to May 2013 is only 8 months. Tama ba ang bilang ko? The requirement is payment of 9 of the 12 months BEFORE month of delivery. Ask others too. Take care.

  134. Loida on May 4th, 2013 9:11 am

    thank you po sa feedback,

  135. Raven on May 4th, 2013 10:02 am

    hi, ask ko lang po kasi i was discontinued from my employer just few days ago, due date ko is on Sept. eligible pa kaya ako if di ako makapaghulog ng May and June? or should i transfer to voluntary status immediately? ito po contributions ko: nov 2010-may 2012 (pd),jun 2012 (unpd),july-aug 2012 (pd),sep-oct 2012 (unpd),nov 2012-april 2013 (pd) total of 26 contributions.

    thanks!

  136. Nors on May 5th, 2013 6:56 am

    Hi Raven, what are counted are only the months within the 12 months BEFORE your due which is Sept 2013. So you should pay May to July or May to August so you can avail. Dapat 9 months ang paid within Sep 2012 to Aug 2013.

  137. nina on May 6th, 2013 10:24 pm

    hi po. im 19 yrs old pregnant, unmarried and unemployed, still dependent of my father. can i use his philhealth? how much would philhealth benefit can i get? my ob is philhealth accredited also the hospital im gonna go to.

  138. yza on May 7th, 2013 12:43 pm

    Hi ms nors.. I am due this may and my employer gave me my certificate of philhealth contribution which was july-sept and oct-dec 2012; they’ve already signed my cf1. I am still employed right now but currently on my maternity leave. Can i avail for philhealth? I’m just confused on the months that they put on my contribution. Thanks and god bless.

  139. Nors on May 8th, 2013 12:39 pm

    Hi nina, yes, you can use your father’s Philhealth as long as he’s updated with his premium payment. Normal delivery: 5k for level 2 to 4 hospital, 6500 for level 1 hospital. CS: 19k at level 2 to 4 hospital only. Newborn care = 1750 (normal or CS). Prenatal care = 1500 if you present at least 1500 worth of prenatal care ORs (for normal only)

  140. zarj on May 9th, 2013 1:53 am

    hi nors ganu kaya katagal maibalik ang docs??/antagal wala padin kc..feb 27 pa nadenied ayon sa web pag check ko dati online

  141. nina on May 9th, 2013 10:16 am

    follow up question po. even though im going to avail a package presented by my ob, i can still get those benefits?

  142. nina on May 9th, 2013 12:17 pm

    and also po my mom used up 3 normal delivery benefits and 1 cs benefit of my fathers philhealth. could i still use the normal delivery benefit?

  143. MARCHIE on May 9th, 2013 1:31 pm

    Good pm po. is it okay po ba na ngayon palang po ako magrerequest ng certification of premium payments ko maam? thank you po ulit.

  144. Nors on May 9th, 2013 1:39 pm

    Hi nina, ask your ob if she’s Philhealth accredited and if you can use your father’s Philhealth, so your ob can tell you if her package price includes Philhealth coverage. Are you single, unemployed and under 21? If yes, you can use your father’s Philhealth even if your mom already had 3 normal deliveries; you are a another dependent and you are eligible for another set of maternity benefits.

  145. Nors on May 9th, 2013 1:49 pm

    Hi Marchie, yes, get your certificate within the month before your due. It will show that you have paid 3 of the 6 months BEFORE your month of delivery.

  146. Nors on May 10th, 2013 2:03 am

    Hi zarj, it’s really sad. Meron akong nakita dito sa forum na ito at sabi niya, 4 months na hindi pa naibabalik yong papers niya, at 2010 pa ito. E ngayon 2013 na, mas dumami pa ang SSS claimants: Maternity Claim Denied

  147. Angello on May 10th, 2013 8:58 am

    Hi Nors, this is Angelo, my partner is due on first week of Nov. 2013 and I just need to know if she can still apply for an Individual Policy Contract? or was there a estblished deadline for this type of application? assuming that her last philhealth contribution was back in Nov. 2012.

    Thanks in advance.

  148. Nors on May 10th, 2013 4:08 pm

    Hi Angelo, magkukulang yata ng 1 month. The requirement for maternity benefit for individual payor is payment of 9 of the 12 months BEFORE month of delivery. This May, what you can pay are only April to Oct 2013 — 7 months plus Nov 2012 = 8 months in all, kulang ng 1 month. Check my counting. Please ask others too.

  149. tenten on May 12th, 2013 2:54 pm

    1st pregnancy ko po,due is on Sept and an OFW. since its my first time to be a member, i asked my mom to pay my philhealth contribution for the whole year last week. just want to double check, pasok po ba un sa delivery ko? and how much is the refund? thanks a lot!

  150. Anne Ramirez on May 12th, 2013 5:00 pm

    Hi, ms. nors! this is Anne of marikina… ask q po bout availing maternity package and newborn package? i am a philhealth member since may-dec2011 may hulog po ang employer q then mar-june2012 ulet sa another employer q and lastly sept-jan2013 po last na hulog ng employer q sa other comp again… by july06 ang due date q but in my ultrasound it seems aug. 03… paxok po b q sa benefits? o may other way pa to avail my benefits? thank you… waiting for quick response. :)

  151. Nors on May 12th, 2013 11:01 pm

    Hi tenten, did your mother pay for you as OFW? Did she show proof of your being OFW? If your receipt and MDR show you’re OFW, yes, you’re covered. For OFWs, the date of delivery should be within the validity dates written on the receipt. How much is your benefit?

  152. tenten on May 12th, 2013 11:54 pm

    yes, she showed proofs..Thank you so much Ms. Nors!
    i will be waiting for the link! such a great a help!

  153. Nors on May 13th, 2013 12:38 am

    Hi Anne, if you deliver in August, and if you pay for April to July, you will qualify. Sep to Jan is 5 months and April to July is 4 months, which will equal to 9 months. I doubt if you can still pay for Feb or March. Requirement: Dapat paid ang at least 9 of the 12 months BEFORE July or BEFORE Aug. Please check my counting.

  154. eloy on May 13th, 2013 9:20 pm

    hi maM , my Due date is on july 2013. my employer paid my philhealth from july 2012 to feb 2013. can i avail my maternity benefits? or is there other way that i can avail the said benefits.. tnx godbless

  155. Jobeth Rose Dela CRUZ on May 13th, 2013 10:10 pm

    I gave birth last May 7, 2013 at south supehighway medical center accredited philhealth, i am via normal delivery my total bill is 34979.55 then they less 5000 for the philhealth so we pay 29500 can i ask if theres any refund for the other cost the breakdown is 8000 included new born screening for the hospital bill then 21500 for doctor’s fee

  156. Nors on May 13th, 2013 11:23 pm

    Hi eloy, are you no longer employed? If no longer employed, pay April to June or May and June as Individual Payor so you can avail of maternity benefit. Get a certificate of premium payments from your employer. Dapat paid ang 9 of the 12 months BEFORE month of July. Please check my counting.

  157. Nors on May 13th, 2013 11:44 pm

    Hi Jobeth, the deduction of 5k was correct, and that’s the only deduction for maternity benefit at bigger hospitals. You can ask for deduction for newborn care costs — up to 1750.

  158. Venus on May 15th, 2013 5:36 pm

    I just want to inquire po if I can be able to use the maximum benefit for normal spontaneous delivery if manganganak po ako sa lying in lang pero philhealth accredited naman daw. Hindi po ako dun nagpaprenatal check up but since yun po ang malapit sa place namin we decided na dun nalang po ako manganak.ano po ba ang mge kailangang infos para masure po namin na magagamit namin ang philhealth?
    Thank you and more power!!!

  159. ZoeRiver on May 16th, 2013 4:57 am

    Good day!
    been reading this blog & it helps me a lot on what to do next. Am currently on my 22 week or 5th month of pregnancy. I started working again end of Feb 2013 & i am thinking of taking a maternity leave by my 7th month or July 2013. So, can I still avail of my Philhealth benefits? When can I file it? On my delivery date ba mismo which is September or I can file it na beforehand?
    Much Thanks!

  160. Nors on May 16th, 2013 8:27 am

    Hi Venus, there’s a rule for lying-ins that you need to have had your early prenatal checkups there to be able to enjoy Philhealth maternity benefit. Ask the lying-in if you can use your Philhealth benefit even if you have not had your early prenatal checkups there.

  161. Nors on May 16th, 2013 2:12 pm

    Hi ZoeRiver, to avail of your Philhealth benefit, you submit your Philhealth documents to the hospital before you’re discharged so that your benefit will be deducted from your bill. Yes, you can avail because you and your employer will be able to pay 3 of the 6 months before month of delivery. You get your signed claim form 1 and certificate of premium payments with ORs from your employer and your MDR from Philhealth before you take your leave. Thanks for appreciating my blog. best regards and take care

  162. julie pearl piga on May 22nd, 2013 3:28 pm

    good day,

    i read about your blog and it really help, just want to ask im on my 30 weeks and my ob want to prepare me the documents i needed. anu yung mga documents na yun?? im a first time mom and im still employed.. but i read alot of blog and naguguluhan na ako. anu yung mga documents na need ko before ako madischarge sa hospital malayo kasi yung head office namen so hindi sya agad madadal im from pasig city and our head office is from pampanga.. thank you so much

  163. Nors on May 23rd, 2013 3:34 am

    Hi julie, the documents you need from your office are certificate of premium payments with OR nos. and signed claim form 1 (1 for you and 1 for your baby — for newborn care). Others are your updated MDR from Philhealth and your ID. If you have prenatal ORs worth at least 1500, you can submit them too to the hospital so it can be filed together with your maternity claim (only for normal delivery though). take care

  164. kris on May 24th, 2013 5:15 pm

    hello po,

    I gave birth last feb.28, 2013 and we decided to refund nalang ung benefit kasi nabayaran na po namen ng buo yung hospital bill.. I’ve receive my BPN yesterday… 6500 po ang total na pwede ma-refund. pro pag punta ko po sa hospital kanina, 4500 lang po daw ang pwede kong ma-refund less tax pa daw po, ung 2000 daw po kasi eh sa PF ng OB ko.. bakit po kaya ganun ms. nors?
    salamat po

  165. Nors on May 25th, 2013 7:01 am

    Hi kris, the 6500 benefit is further allotted as 3900 for hospital and 2600 for PF. Walang tax ang hospital bill sa side ng pasyente; ang nagta-tax yong doctor at hospital sa mga income nila at sa government money na napunta sa kanila, pero sila dapat ang magbabayad. Sa case mo, puedeng baka nabayaran na ang doctor at hindi na nila mabawi yong sa doctor. Or puede ring ayaw ibigay lahat ng hospital. You can file a complaint at Philhealth (affidavit, receipts, notice from Philhealth. Keep copies for yourself.)

  166. kris on May 26th, 2013 11:32 pm

    salamat ms. nors,
    unfortunately wala po akong nasave na copy..kinuha po kasi ng hospital yung receipt at BPN ko. i forgot to photocopy it… :(

  167. aida l. ty on May 28th, 2013 12:21 pm

    HI!!! i Had miscarriage. niraspa po ako and my bill was less than 16 k. I learned also na di accredited clinic sa raspa. normal and cs lang daw po. Can i personally file s philhealth pra mpkinbangan ko nman philhealth ko. Im a school teacher and paying for about 19 years. May sss din po ako unfortunate ly na stop ako s pagbbyad for some months pro 1 month bago po ako nagmiscarriage nkpagbayad n po ako from april 2013 to dec 2013. May maclaim po ba ako sa sss? thanks and God bless!!

  168. zarj on May 29th, 2013 1:16 am

    hi nors, dmating na ung mga docs ko..panu gagawin ko dito pwede bang sa alabang sss ko nlng iprocess toh auko na tlga sa binan grabe inabot ako ng siyam siyam haist…

  169. Nors on May 29th, 2013 11:38 am

    Hi zarj, I’m glad na dumating na rin. Hayaan mo, meron sigurong purpose bakit nagtagal, yon na lang isipin mo para hindi ka masyadong ma-stress at maghinanakit. Parang nasabi mo na you’re working in the Alabang area, so you can file at the Alabang branch. Ang sabi ng SSS ay file at the branch near your residence or your workplace. I really hope you will have a better experience at the Alabang branch.

  170. Nors on May 29th, 2013 1:44 pm

    Hi aida, D&C or raspa can be covered in an ambulatory surgical clinic (ASC). If it’s ASC, yes, you can file directly at Philhealth, but you need claim forms from the clinic. About SSS, check if you have at least 3 contributions within the 12-month period before your semester of D&C. Check this out: What is semester of contingency?

  171. Cyra on May 31st, 2013 10:31 am

    Hi Ms. Nors, good day to you.
    I just want to ask if I am still qualified to avail my philhealth maternity benefits coz this is my fifth delivery. I haven’t availed my ph benefits from my 1st to 4th delivery.
    I am due to give birth this 3rd week of June.
    Thanks.

  172. Nors on May 31st, 2013 4:29 pm

    Hi Cyra, sorry but Philhealth does not cover the 5th normal delivery at yong mga susunod na normal births, kahit hindi nagamit noon ang Philhealth for the first 4 normal deliveries. Please ask others too.

  173. catherine cabusao on June 3rd, 2013 5:20 pm

    Hi Ms.Nors,

    I am going to use my husbands philhealth. What are the requirements? He is OFW(seaman). Can I ask his MDR at philhealth? thanks po.

  174. Nors on June 3rd, 2013 11:14 pm

    Hi catherine, some Philhealth branches will give your husband’s MDR kahit marriage certificate and ID mo lang ang ipakita mo. Yong iba naman, they ask for your husband’s authorization letter and copy of your husband’s ID. Sa Philhealth, considered employed members ang seamen, hindi OFW. Requirements: MDR, certificate of premium payments from agency, signed claim form 1 from agency, your ID, marriage certificate (orig and xerox)

  175. maureen on June 4th, 2013 12:58 pm

    hi Ms.Nors,
    do i already have a philhealth number? i was working almost 7 months this June.When i started working,i didn’t get a philhealth #, but my employer is deducting from my salary for philhealth.it is said in every pay slip i received.
    Also, can i get maternity benefit?i am now 8 months pregnant as of this month.What are the requirements/process i need to do? thanks and i will wait for your response. god bless!

  176. Nors on June 4th, 2013 9:26 pm

    Hi maureen, you can ask your employer about your Philhealth no. You can also verify your Philhealth no. and contributions at Philhealth or at Philheath desks at Robinsons malls. I assume your employer has paid your Philhealth for at least 3 months, so you’re qualified. Requirements: MDR from Philhealth, certificate of premium payments with OR nos. from employer, signed claim form 1 from employer (1 for maternity and 1 for baby), your IDs. God bless din

  177. Ivy on June 6th, 2013 9:34 pm

    Hello good day to all. I need your advices and expertise about Philhealth. First time mom to be po ako and im expecting a baby girl anytime this month (June 2013). I went to Philhealth branch and ask if im eligible to use my Philhealth for Hospital Bill, Ang sabi po nila is atleast 9 months before due date atleast my hulog ang Philhealth. I started my membership last October 2012. Though paid ako until June 2013, ang count lang nila is from October 2012 to May 2013. Ano po ang pwede kong gawin.Sayang naman po kasi malaking tulong din po sana yun sa magiging Bills namin ni Baby. Anyone there na meron pong ganitong case?

  178. Em on June 7th, 2013 10:10 am

    Hi! I expect to give birth in November. I am quite new to the company so they just deducted SSS contributions to my salary in April ( I think that’s for the month of May)…. Am I eligible to get the maternity benefits?

  179. Nors on June 7th, 2013 8:30 pm

    Hi Em, are you asking about SSS maternity benefit? I’m asking because the post is about Philhealth.
    Kapag SSS, you are eligible kapag meron kang contributions for April May and June, or kung walang April, basta nag-work ka before with another employer and you had at least 1 SSS contributions within July 2012 to Mar 2013. Info on maternity benefit: What is semester of contingency?

  180. Joy impol on June 8th, 2013 2:17 pm

    Hello po. Tanong ko lg po anu dapt gawin kng dependent ako nang husband ko at isa siyang police. Anung mga requirements dapt e accomplish before maconfine or madischarge ng hospital. Naka 3 miscarriages ako and this is my 4th and expecting on the first week of october. Pwde pa ako maka avail ng maternity benefit? Counted na ba ang last 3miscarriages ko kahit hindi ako member pa noon? Thank you.

  181. Nors on June 9th, 2013 11:57 pm

    Hi Joy, miscarriages are not counted under the 4-normal-birth limit. Your 4th will be covered. So that you’ll be covered by Philhealth, you need to deliver in a hospital (not lying-in) because you’ve had 3 miscarriages already. Documents: updated MDR with you written as dependent, marriage certificate (orig and xerox just in case hanapin ng hospital), certificate of applicable premium payments with OR nos., signed claim form 1 signed by employer (1 for you and 1 for your baby), and your ID.

  182. Joy impol on June 11th, 2013 2:54 pm

    Thanks for the reply Ms. Nors.. Pero confirmed ko lg meaning pwd pa ako maka avail nang benefits kng manganganak pa ako nang 3 pa? At tanong ko lg po anung ibig sabihin nang level 1, 2-4 hospital?..tnx po God bless

  183. Nors on June 12th, 2013 2:03 am

    Hi Joy, yes, kung meron ka pang 3 deliveries, these are covered. Level 1 hospital refers to a smaller hospital. Level 2 to 4 refers to the bigger hospitals. Makati Med, PGH and East Avenue are Level 4 hospitals. Hospital Levels By the way, about miscarriage, magtanong ka rin sa iba ha para sure na sure. God bless din

  184. julie pearl piga on June 17th, 2013 1:49 pm

    tnx for your reply… what if wala akong receipt ng prenatal check up??? hindi ko kasi alam before na pwede pla syang marefund. as of now im 33 weeks and twice a month na ako nagpapcheck-up pwede pa kaya ako humabol para sa mga receipt ko.. i mean yung last 4 check-up ko magpapagawa na ako ng receipt ako ng receipt and yung receipt ng mga vitamins ko coverd ba sya ng 1500 na yun?? tnx so much..

  185. Raquel medenilla on June 17th, 2013 2:04 pm

    Ask ko lng po, is it possible to get a refund because i was admitted in lying-in because of threated abortion for one night and one day. i didn’t use my philhealth since we are saving it just in case the pregnancy continue, but unfortunately i had normal miscarriage in the house.

  186. Nors on June 18th, 2013 2:15 am

    Hi julie, kelangan ang ORs at least 1500, at dapat maisama ang mga ito sa maternity benefit claim — bring them to the hospital or clinic so it can be filed together with the maternity claim. Prenatal Care

  187. Nors on June 18th, 2013 2:23 am

    Hi Raquel, sorry about the miscarriage, and sorry I’m not very sure, kasi parang nabasa ko na hindi covered ang abortion kapag clinic. Yong lying-in alam nila kung puedeng i-claim, kasi sila ang nagbibigay ng medical documents. Pakitanong na lang

  188. jean on June 21st, 2013 9:04 pm

    hi mam, good day! ask ko lang po individual paying po ako tapos ang husband ko is yung philhealth pa niya is indigent pa. ma avail ko po bah maternity discount ko if i will pay this second quarter until jan 2014? but 2012 and first quarter ds year hindi ako naka byad.

  189. jean on June 21st, 2013 9:41 pm

    due ko po is january 2014 pala..

  190. euwie on June 22nd, 2013 1:58 am

    Hi miss nors! I’ve read all the comments above so i don’t have to be redundant with my questions. I’m sorry if some of my questions has been asked already, it simply means i didn’t understand the answer/s fully.

    I am an ofw and i came back to philippines last May 2013. I will go back to UAE 1st quarter next year and resume my work. I am just on a very long unpaid leave but i get to keep my job in UAE. The last time i paid an oec together with philhealth was july 2012, so it means from july 2012 to june 2013 right? Now i wanted to pay my philhealth but i don’t know what’s the best thing to do. I haven’t updated my civil status yet to married and wanted to change it. If i go to philhealth office to change it, can i pay as well as an ofw? I’m sorry i really have no clue because i used to pay it through poea and agency. Im worried because they might tell me to pay it when i get my oec, but i’m not leaving til next year. I was also thinking if i can pay through bayad centers first as an ofw before i update my civil status? Which plan do you think is better? I have my foreign id card with me and residence/working visa that’s not been cancelled.

    Thank you so much miss nors for your time. I really appreciate it. More power. Your blog is very helpful.

  191. Nors on June 24th, 2013 6:34 am

    Hi euwie, para isang lakad na lang, I think you better go to a Philhealth branch asap with your marriage certificate (orig and xerox) and update your status and name, and then pay June 2012 to March 2013 (or up to the month you expect to get your OEC). I suggest you still pay June if your last validity date was not up to June 30. Bring your passport and foreign ID. Next year, when you pay your OEC, POEA will have you pay 1 year in advance, starting from the date you pay your OEC.
    But if you have no time yet to go to Philhealth, yes, you can pay as OFW at Bayad Center, and then update your status later (sa branch or puede sa Robinsons Philhealth desk offices).

  192. Majie Huang on July 1st, 2013 1:04 am

    Hi and good day.., i just want to ask if i can avail my philhealth in my maternity.. Im giving birth this July 2013.? Im self-employed.
    This are my contributions:
    Oct-Dec 2011
    Jan-Mar 2012
    Oct-Dec 2012
    Jan-Mar 2013
    Apr-June 2013

    If yes, what are the requirements to avail it? Thank you..

  193. Nors on July 1st, 2013 9:23 am

    Hi Majie, yes, you’re eligible. Bring your receipts from Oct 2012 to June 2013 (9 months). Documents:
    http://www.workingpinoy.com/2013/07/documents-claim-philhealth-maternity-benefit/

  194. leann on July 2nd, 2013 12:38 am

    Hi, due date September 2013. 27years old.inactive member since 2008.ask ko lang po kung pwede ko ba magamit philhealth ng mother ko? or kailangan ko ba magbayad ng 9 months contribution para maka avail sa maternity benefits.maraming salamat po.

  195. Nors on July 2nd, 2013 7:06 pm

    Hi leann, sorry hindi ka na puedeng dependent ng mother mo kasi older than 21 ka na. Kung magstart ka pa lang ngayon to pay, hindi ka na aabot for maternity coverage kasi dapat paid ang 9 of the 12 months BEFORE month of delivery. Magmember ka na lang for future use.

  196. ela on July 2nd, 2013 10:24 pm

    hi id just gave birth last june 15 via cs d ko po na avail philhealth ko.i resigned from work since oct 2011 d n din nabayaran philhealth pero last year i change may status to voluntary payer i paid october 2012 to september 2013 incomplete reqs daw ako sabi sa hospital.. maayos ko p b ito sa philhealth? at meron b ako marerefund?thanks in advance..

  197. Nors on July 3rd, 2013 7:42 am

    Hi ela, parang kulang ka ng 1 contribution. Ang requirement for Voluntary na maternity ay payment of 9 of the 12 months BEFORE month of delivery. What you’ve paid are Oct 2012 to May 2013 = 8 months only. Please check my counting and please ask others too.

  198. marlen on July 3rd, 2013 12:17 pm

    i’m marlen and i will be having my 5th pregnancy,i’ve never used my maternity benefits on philhealth before on my four past deliveries,i just want to know if i can still
    avail any benefits on philhealth for my 5th pregnancy? and what are the requirements? thanks.

  199. Nors on July 3rd, 2013 10:26 pm

    Hi marlen, sorry hindi na covered ng Philhealth ang 5th and subsequent normal deliveries, kahit hindi nagamit ang Philhealth sa first 4 normal deliveries. Please ask others too.

  200. Sel on July 5th, 2013 10:43 am

    Hi Ms. Nors here i go again. I just called sa PHIC call center about my prenatal claims. I thought na less ang hassle if I will include the prenatal OR’s for my prenatal claim?. Eh they just advise me to go to PHIC Quezon Avenue for adjustment…eh ano po un?

  201. Sel on July 5th, 2013 11:06 am

    Additional po Ms. Nors, di po ba ipapadala ang BPN through mail?

  202. Nors on July 5th, 2013 10:51 pm

    Hi Sel, yes, BPN is delivered via registered mail. Do you mean your prenatal ORs were submitted together with your maternity claim? Tama naman. Dapat kasama na yong prenatal check together with the BPN.

  203. Sel on July 8th, 2013 7:19 am

    Thank for the response Ms. Nors. That’s the problem po they told me that they already paid the 5K to the hospital but I will be the one to coordinate with PHIC Quezon Avenue regarding the prenatal claim. I am so annoyed with it. Kaya ko nga po isinama na sa claims to avoid the hassle. What could be the reason on why this happen po kaya?

  204. Nors on July 8th, 2013 9:11 pm

    Hi Sel, sorry I can’t say the exact reason. Usually the prenatal check is sent with the BPN. This is my first time to know a case wherein the member was instructed to go to the branch for adjustment.

  205. Geronima Advincula on July 11th, 2013 10:29 am

    Gud day,
    I am scheduled for CS operation these July 15, 2013 and at the same time ligation and removal of my Mayoma Uteri, with these 3 procedure done in one operation , can i claim three benefits in Phil health or only the 19,000 for the cs which is 11,400 for hosp expenses and 7,600 for the professional fee or i can also claim with the other two procedure?
    pls reply ASAP thanks a lot…

  206. Nors on July 11th, 2013 12:34 pm

    Hi Geronima, CS and ligation are covered as one with a single coverage of 19k. Sorry I don’t know if myomectomy can be claimed separately because it will be done in the same operative session. Please ask Philhealth/billing officer of the hospital.

  207. shiela on July 13th, 2013 4:41 pm

    hello po maam nors, nanganak po ako last june 26 via normal delivery at binayaran po namin ung lying in worth 13k to follow nlng po ung philhealth ko kasi po may hinihingi sila na O.R receipt 9 mnths backward,bale po employed ako mula jan last yer,may binigay na cert of actual premium ung employer ko hanggang april 2013,kelangan ko pa dw ng O.R ng phealth frm august to april frm my employer,ang problema po is nawawala po ung resibo nila ng jan at feb 2013,sbi ng lyng in di dw pwd n wlang O.R..totoo po b un?db po sa cert n galing sa employer nkalagay dun ung o.r number ayaw p dn nila tanggapin, den sbi ng lYing in if mairerefund po is that 4500 lng dw marerefund namin,tama po b un?tnx po

  208. shiela on July 13th, 2013 4:53 pm

    magkano po b dapat ang makukuha namin na refund?pag ang lying in po b ang nag asikaso ng reimbursement namin eh mas malaki makukuha nila kesa sa ibibigay samin?pag kmi b ang magdirect na magsubmit s philhealth mas malaki ba ang reimbursement na makukuha namin?tnx

  209. Anna on July 13th, 2013 5:01 pm

    Hi Ms. Nors…

    I just want to ask kung pwede kong magamit yung philhealth ng asawa ko? Kinasal kami last June 18, 2013, nagpa-update siya ng MDR this July 3 to list me as his dependents. Mangananak ako this coming (maybe) last week of August or 1st week of September. My OB says I can’t use it, 1 year pa daw bago ko magamit philhealth ng asawa ko after ng pag-update niya ng MDR.

  210. Nors on July 13th, 2013 7:38 pm

    Hi shiela, nanigurado ang lying-in kaya cash ang ipinilit. Dapat marefund nio is 6500. Wait for your benefit payment notice from Philhealth (the 6500 payment will appear there) and then claim your refund from lying-in. Keep your copies of receipts and BPN.

  211. Nors on July 13th, 2013 7:43 pm

    Hi Anna, Voluntary ba ang membership ng husband mo? If yes, ang requirement ay dapat nabayaran niya ang 9 months sa 12 months BEFORE August or September na panganganak mo. If employed, payment of 3 of the 6 months BEFORE Aug or Sep lang ang requirement.

  212. Anna on July 13th, 2013 9:50 pm

    Employed po ang husband ko, so ibig po bang sabihin pwede namin magamit yung philhealth niya sa panganganak ko? I mean, hindi na namin kailangan maghintay ng “1 year” para mapakinabangan ko yun?

  213. Nors on July 14th, 2013 12:34 am

    Hi Anna, yes, basta paid ang Philhealth premium for at least 3 months within Feb to July (if delivery month is August) and within Mar to Aug (if delivery is Sep). You already have a marriage certificate, so meron ka nang document to present. You’re already your husband’s dependent.

  214. Anna on July 14th, 2013 10:09 am

    Thank you Ms. Nors… :) You’ve helped a lot! God Bless you…

  215. Anna on July 14th, 2013 4:59 pm

    Ms. Nors, last question na po, paano namin ma-avail yung newborn care package ng philhealth?

  216. shiela on July 14th, 2013 5:08 pm

    maan nors, another question po,pag ako ba ang mag asikaso sa philhealth sa akin din b naka pangalan ang cheque iniisip namin na kami nlang mag asikaso kasi po ayw p rn tanggapin ng lying in ung philhealth ko hanggat walang O.R ng philhealth na bayad ng employer ko for the month of jan and feb 2013..tnx po ulit

  217. Nors on July 14th, 2013 8:18 pm

    Hi Anna, submit 2 claim forms: 1 for maternity and the other for newborn care. You can use the live birth certificate issued by the hospital for this claim. The pediatrician should be Philhealth-accredited.

  218. ara on July 15th, 2013 8:55 am

    gud am po, tanong ko lng kung kasama ba ang professional fee ng O.B at antibiotics na injection ng baby sa philhealth?binayaran kasi namin ay 10000 package for normal delivery via O.B Plus 1400 na antibiotics ng baby for 1 wek kc na overdue sya plus room 800, nasa 12000 pesos bill namin,lying lng po ako under lng ng O.b..magkano b refund ko,tnx

  219. Nors on July 15th, 2013 11:23 pm

    Hi shiela, yes, puedeng mag-file ka directly sa Philhealth within 60 days after discharge. Have your claim papers accomplished and signed by the lying-in before discharge para ma-file mo agad. Get ORs and waiver from the lying-in so Philhealth will issue the check in your name.

  220. Nors on July 15th, 2013 11:29 pm

    Hi ara, 6500 ang maternity benefit kapag lying-in (5k pag hospital). Hindi yata covered yang antibiotics, kasi hindi kasama sa newborn care package. Ito ang newborn care package

  221. shiela on July 16th, 2013 7:11 am

    cge po,maraming salamat maam nors..puntahan ko nlng lying in para makuha ko na mga requirement..thank u po ulit

  222. Marlie Tabar on July 17th, 2013 12:20 pm

    good pm po ulit ma’am nors..ask ko lang po kung magagamit ko po ba ulit yung philhealth ko kc last May 2012 nanganak po ako sa panganay ko then after 6 months nabuntis ulit ako..due ko po nxt month..ang problem ko po hanggang jan – march 2013 yung nbyaran lo last year nklaimutan ko po byaran yung april – jun 2013..kung magbabayad po ba ko kahit this week..mahahabol ko po ba yun quarter na di ko na bayaran? or kung hindi man..magagamit ko parin ba yung philheath ko pag nanganak po ako next month.? thank you po in advance..sana po masagot po ninyo mga tanung ko.. :)

  223. Marlie Tabar on July 17th, 2013 3:07 pm

    Eto po yung mga last contributions ko
    Apr 2011 – March 2012 – paid
    Apr 2012 – Dec 2012 – paid
    (May 2012 po yung first delivery birth ko & na ka avail ako ng 5000 deduction sa bill ko po..)
    Jan 2013 – March 2013 – paid
    (nakalimutan ko po bayaran yung Apr 2013 – Jun 2013)
    Duedate ko po is Aug 19,2013
    Makaka avail pa po ba ako ulit ng maternity benefit kahit di ko po nabayaran yung apr- jun 2013??

  224. Nors on July 17th, 2013 11:58 pm

    Hi Marlie, paid ba ang Aug to Dec 2012? Kasi if yes, then you can pay July 2013 so you can accumulate 9 months (payment of 9 of the 12 months BEFORE August). Another option: If you have paid all months in 2012, you can ask Philhealth to allow you to have your grace period (for good payors) and pay Apr to June.
    ooops..I saw your other comment. Since 2011 ka pa pala good payor. Bring these receipts to Philhealth, they will allow you to pay Apr to Sep or Apr to Dec para paid na the whole 2013. In case they don’t allow, you pay July or July to Sep — eligible ka pa rin because you have paid 9 of the 12 months before August.

  225. Marlie Tabar on July 18th, 2013 9:25 am

    Opo ma’am paid po yung aug – dec 2012 ko po..thank you so much po ma’am..helpful po tlga para sa min tong blog na ito..God Bless you always ma’am..^_^

  226. Jhema on July 18th, 2013 9:37 am

    Hi good day, may i ask for how many months for me to wait to get my child reimbursement? nanganak ako last march 8, 2013. Binayaran ko muna ung para sa baby ko. The hospital staff told me 2-3 months lang to wait then the philhealth will give me the payment. But until now wala pa din. Im trying to call the healthline but no one is answering. can you please help me. I’am looking forward to your fast reply. Thank you in advance…God bless

  227. Nors on July 18th, 2013 10:17 pm

    Hi Jhema, yong newborn care benefit ba? Did you sign or submit two claim form 1? Did the hospital file the newborn claim together with your maternity claim? It might take longer because of lots of claims.

  228. Lessie on July 22nd, 2013 11:15 am

    Good day mam nors! Very helpful ang blog mo. Ask ko lang po sana, ang painless delivery sa lying in ng ob ko is 8,500. Ngayon po nag quote sya sakin na ang pwede ko bayaran ay 5,500-6,500 less philhealth na daw po yun. Nagtataka lang ako bakit ang liit lang po ng less eh ang nabasa ko sa website ng philhealth at sa mga forum nasa 8k ang dapat ma less. Mas ok po ba na bayaran nalang namin yun 8,500 sa lying in wag na gamitin ang philhealth ng husband ko at magrefund nalang kami sa philhealth. Mas malaki po ba makukuha namin kesa sa sinabi ni ob na ile-less nya? Btw dependent po ako ng asawa ko. At yun prenatal care service po ba na OR’s eh yung binayad sa check up? Included po ba dun un mga laboratory? Saka po pwede ko din ba isama yun OR nun sa ibang hospital pa ako nagpapacheck up? Salamat po ng marami. Confused po kasi ako.

  229. Nors on July 23rd, 2013 5:27 pm

    Hi Lessie, ang coverage pag sa lying-in ay 6500 plus 1500 for prenatal pag may prenatal ORs worth at least 1500. Ito ang about Prenatal Care. Puedeng ORs from other hospitals. Puedeng gawin mo yang option na sinasabi mo na kayo na lang ang mag-file, basta kumuha ka ng waiver sa lying-in at doctor na you paid the lying-in and doctor in full and that Philhealth coverage was not deducted. Get clinic bill and ORs from lying-in and from doctor. Be prepared to wait for several months to get your Philhealth refund.

  230. margot on July 23rd, 2013 6:48 pm

    Hi good day Nors, i just want to ask if i can avail my philhealth maternity benefit. Im giving birth this September 2013? I was employed from May 2012 to December 2012. I currently self-employed.
    This are my contributions:
    May 2012-Dec 2012
    July 2013-Sept 2013

    Thank You very much. God Bless you. :D

  231. Lessie on July 24th, 2013 8:16 am

    Mam nors, its ok for me to wait for several months pero may assurance po ba ako na mas malaki ang pwede ma-reimburse kung kami ang mag file ng claim? Kesa po sa ileless ng ob ko na about 2-3k lang. Ni hindi po umabot sa 6,500 na nakalagay sa website ng philhealth. Maternity clinic po pala yun owned by my ob-gyne. Thank you po ulit.

  232. Lessie on July 24th, 2013 8:30 am

    One more thing po, what are the different documents that we need to claim a refund? At same lang po ba ang painless delivery sa NSD? Baka po kasi dahil sa painless ang pinili namin kaya 2-3k lang ang less ni ob sa bill namin instead of 6,500..

  233. jess on July 24th, 2013 10:27 am

    just wanna ask if i can use my maternity benefits

    my due date is sept.2013.my contribution in philhealth was got whenever i’m employed then i’d never contributed voluntarily every end of my contract.fyi this is my 3rd pregnancy and i’ve never used my philhealth since then for my pregnancy.
    may – june 2009 employed
    feb. – may 2011 employed
    july – nov. 2012 employed

    pls. help

  234. jess on July 24th, 2013 10:37 am

    and one more thing po maam nors can i and my future child avail of any benefits in my case of long interval contributions or if im not is there any way i can do to have this benefits?

  235. Nors on July 24th, 2013 12:14 pm

    Hi margot, sorry, baka hindi ka eligible, kasi ang bibilangin ay 9 months paid sa loob ng Sep 2012 to Aug 2013 (12 months BEFORE month of delivery). Ang paid mo ay Sep 2012 to Dec 2012 and July to Aug 2013 = 6 months. Please check my counting and ask others too. God bless din.

  236. Nors on July 24th, 2013 1:59 pm

    Hi Lessie, puede rin na reason ng OB mo yang additional cost of painless delivery, kasi normal delivery pa rin ang classification niyan, at 6500 pa rin ang coverage niyan pag sa clinic (5k lang pag hospital level 2 to 4). Documents for Refund

  237. Nors on July 24th, 2013 2:13 pm

    Hi jess, pareho kayo ng situation ni margot. Ang requirement for Voluntary sa maternity ay payment of 9 of the 12 months BEFORE month of delivery. Ang mabibilang sa iyo ay Sep to Nov 2012 = 3 months. Pag bayaran mo today ang July and August = 2 months, so 5 months lang, kulang sa 9 months na required. Please ask others too.

  238. jess on July 24th, 2013 7:49 pm

    so maam nors hindi ko po pala magagamit ung philhealth ko this time? khit ung sa new born care hindi rin po pede?

  239. Lessie on July 24th, 2013 7:49 pm

    Thank you so much po. Hindi po kaya 2-3k lang ang less ni ob sa total bill eh pag nagclaim sila sa philhealth kanila nalang yung sobra? Kasi like what you have said naka classified pa din sya sa normal delivery. Ano po ba ma advice mo? Should we use the philhealth benefits or bayaran nalang namin in cash then mag file nalang po ng refund? Pasenya na po sa madaming tanong. Confused lang po talaga.

  240. Nors on July 25th, 2013 8:07 am

    Hi jess, sori hindi ka pa covered kung tama yong bilang ko na 5 months lang. Kahit newborn care, requirement na rin nila ang 9 contributions sa loob ng prior 12-month period. Ask others too

  241. Nors on July 25th, 2013 8:22 am

    Hi Lessie, if they file for the refund, the full Philhealth payment mapupunta sa kanila. If you file directly, include prenatal ORs. You can also file for newborn care (separate claim forms). Ask your OB kung magbabayad kayo ng cash at kayo na lang ang mag-file ng claim, ibibigay ba nila yong lahat ng claim forms plus OR and waiver before you’re discharged. About deciding, meron na ring nag-comment at nag-advise ng ganyan dito, na sila na lang ang mag-file para sa kanila lahat ang refund. Meron din akong nabasa na hindi lang OR ang hinanap ng Philhealth sa kanila, pati waiver.

  242. Lessie on July 25th, 2013 10:31 am

    Mam nors thank you po. Ang laking tulong mo sa pagdecide namin tutal we’re not in a hurry naman for the refund. Ang importante kasi magamit lahat ng benefit na dapat para samin sayang din kasi. :)

  243. Lessie on July 25th, 2013 10:47 am

    Isa pa po pala, regarding sa OR from maternity clinic, kaylangan po ba sa asawa ko nakapangalan kasi sa kanya yung philhealth or ok lang din kahit sakin nakapangalan tutal ako po yung patient.

  244. Nors on July 25th, 2013 1:56 pm

    Hi Lessie, yes, under your name because you’re the patient. Sa Philhealth claim forms ang name ng husband mo at ikaw na dependent patient.

  245. Shela on July 26th, 2013 10:03 pm

    Hello maam im shela. Im gonna give birth here in europe this aug.23,2013. I just wanna ask if pwede po ba ako mag avail nag maternity benefits ng philhealth ko in the philippines when i come back?how?anyway maam iam a member since 2011 and i just stop paying last june 2013 to present coz nag flight na po ako. What will i do regarding all these matters maam. Pls.help.
    ThAnk you

  246. Nors on July 27th, 2013 9:43 am

    Hi Shela, where are you in Europe? Are there partners of IRemit or Ventaja there? It’s best if you pay your Philhealth there for one year in advance — that’s proof enough you’re an OFW. If you pay as OFW, you’ll be covered in August as the validity dates for OFW start from date of payment to one year after or 2 years after, depending on no. of years paid in advance. If you pay here when you arrive (must be before delivery), you need to present your foreign ID, OEC, job contract, or work visa so you’ll be covered as OFW.

  247. Marie on July 27th, 2013 10:40 am

    Hi Ms. Nors, my due date is on Nov. 2013, im a voluntary member, paid my contributions, starting last april to september 2013? Am i entitled for a claim? If I will apply for the IPC this month (July) will they accomodate my request? Thank you.

  248. Marie on July 27th, 2013 10:43 am

    add on…by the way Ms. Nors, wasn’t able to pay the whole year of 2012 up to March of 2013…

  249. Nors on July 27th, 2013 7:23 pm

    Hi Marie, sorry Apr to Oct is only 7 months; so not eligible. Ang required is payment of 9 months BEFORE month of delivery (9 of the 12 months BEFORE delivery). Ask others too, and you can ask Philhealth if IPC program has been reopened — it was previously suspended. Take care

  250. Glady Grace Ocampo on July 28th, 2013 8:09 pm

    Is it possible if you can check if I can use my philhealth for maternity (CS)? I was already an old member but I wasn’t able to pay for one year. Last January or february, I continue my payments. Kindly check if I can use it. Thank you. PhilHealth#19-050939798-1

  251. Nors on July 29th, 2013 12:14 am

    Hi Glady, sorry I’m not affiliated with Philhealth. If you will use it to cover ordinary illness, payment of contributions for 3 of 6 months BEFORE confinement is required. For surgery or maternity, payment for 9 of 12 months BEFORE confinement is required.

  252. Marie Reyes on July 29th, 2013 1:13 pm

    Hi Ms. Nors, thanks for the reply, went to Philhealth this morning and they told me it was deffered last March pa…

  253. Nors on July 29th, 2013 1:16 pm

    Hi Marie, I appreciate very much that you came back to tell that IPC program has not been reopened.thanks

  254. Kim on August 2nd, 2013 8:59 am

    Hi I’m Kim. I’m now 5 months pregnant and my due is on December. Is the maternity benefit will be deducted in hospital bill before my discharge on December? Or will it be refunded after my discharge?

  255. Nors on August 2nd, 2013 12:02 pm

    Hi Kim, if you submit to the hospital your Philhealth documents before discharge, your benefit will be deducted before discharge. If not, you have to file for your refund.

  256. kim on August 2nd, 2013 12:25 pm

    what if my hospital bill is less than 6,500..yung excess po ba makukuha ko pa?

  257. Nors on August 2nd, 2013 12:58 pm

    Hi kim, sori hindi. Mapupunta sa hospital. Pero parang wala nang ganon ngayon. Siguro sa province. Pag government hospital, usually pabibilihin ka pa ng gamot sa labas, so mag-prepare pa rin.

  258. anna on August 4th, 2013 1:32 pm

    i have 2 inquiries
    1.
    hi i would like to ask.. im pregnant now.. my ob is not philhealth accredited..i ask her how much if it is hospital… he said 40k if it is 40k and it is package andun n lhat ng mga needs ko.. how much i can refund using my philhealth? or remaining balance i still need to pay?

    2.
    what if i choose lying in 17k to 18k? the clinic is not accredited and also my ob can i reimbursed my expenses to philhealth? what are the requirements?

  259. Nors on August 4th, 2013 6:26 pm

    Hi anna, sorry you cannot get Philhealth coverage if the hospital or clinic and if your ob is not accredited. Should be both. Both hospital/clinic and ob should be accredited.

  260. anne on August 6th, 2013 5:01 pm

    Philhealth personnel said that I can use my Husband (OFW) membership then upon presenting required documents of my Husband , she also told me to pay July 24 2013 to July 23 2014 OFW contribution. As the doctor said I may give birth end of this month Aug 2013 or 1st week of Sept 2013 . Am I qualified for Philhealth maternity benifit / package offered by the hospital. My ultrasound and check-ups resulted to be normal , but the hospital admitting personnel told me that upon delivery , there suppose to be the idea if I’ll be qualified or not for Philhealth benifit. thanks

  261. Jenie Grace Pamintuan on August 6th, 2013 6:12 pm

    Hi good evening! I just want to ask about my case. My EDD will be on Nov.9, 2013 when i just found out from my previous company for almost 3 years that they didn’t pay from Nov.2012 until May 2013. I started here in my current job from June 2013 and i will file a leave on Oct.15, 2013. I can’t see any problem with my current company cause they are paying on time. But the problem is can i still avail philhealth benifit? If not what shall i do?… Please let me know what to do po and i will truly appreciate it. Thank you so much!

  262. Cha S. on August 6th, 2013 9:08 pm

    I must emphasize: BEST BLOG about Philhealth maternity benefits I’ve read so far! (Even better than Philhealth’s website info, :D) very comprehensive and detailed yet simple to understand. Bookmarked! I’m excited to read your other articles. Keep it up!

  263. Nors on August 7th, 2013 11:01 am

    Hi anne, if Philhealth told you to pay, it means that your husband’s Philhealth payment through OEC no longer covers Aug or Sep 2013, which is your delivery month. Did you then pay July 24 2013 to July 23 2014 under your husband’s name and OFW status? If yes, check that your receipt contains those validity dates and that your husband’s status is OFW. As an OFW dependent, your delivery, which is August or Sep 2013, should be within the validity dates in your receipt. Ask for an authorization letter from your husband authorizing you to sign Philhealth papers on his behalf plus xerox of his passport/ID.

  264. Nors on August 7th, 2013 11:05 am

    Hi Jenie, yes, you can avail because as a currently employed member, you need only 3 months of contributions to avail (3 of the 6 months before Nov 2013). Get 2 signed claim forms (for you and newborn care) and cert of premium payments with OR nos. from your employer. take care

  265. Nors on August 7th, 2013 11:15 am

    Hi Cha, I’m so thrilled and humbled by your comments! Thank you so much…perked me up at my low moment today. I now will have to look again at that post, to deserve your wonderful feedback; it may need some updates. We have better Philhealth posts at healthphilippines.net…thanks again Cha!

  266. ?Jenie Grace Pamintuan on August 7th, 2013 4:39 pm

    Hi Miss Nors! Thank you so much for this information. I thought 9months within 12months yung dapat mahulugan this is such a great help. Thank you again such a very big help! ^_^ I was also thinking that 3 months can only avail if your sick but not for maternity.

  267. anne on August 7th, 2013 8:06 pm

    Hello Ms. Nors , yes I paid P 1200. covering July 24, 2013 to July 23, 2014. Before I pay , I submit a copy of my Husband Working Visa ID , Marriage contract . I signed on his behalf his PMRF . After I present the receipt of P 1200. , she gave me a copy of my Husbands MDR also stating I am his dependent. She deactivated my membership in able to use my husbands philhealth. Am I covered if I give birth this August or Sept 2013.

  268. Marnie on August 8th, 2013 9:33 am

    Hi good day to you!! I’m Philhealth member but not active right now, I want to continue voluntarily, what I’m going to do? I’m one month pregnant now can I avail the benefits of it? If possible what benefits? Can you help me out? I’m confused right now of what I’m going to do. Thanks a lot. More Power..!

  269. kim on August 8th, 2013 10:43 am

    Hi! I’m expecting to give birth by December.What if my contributions are from November 20212 to September 2013, pwede parin ba makaclaim this benefit?

  270. Jenie Grace Pamintuan on August 8th, 2013 2:59 pm

    Hi Miss Nors! Am i right that i can still avail the maternity benifit even if i didn’t pay from nov2012 until may 2013 as long as i’m currently employed now? Can you please help me clear this thing Miss Nors. I’m a bit confused.. Thank you!

  271. Nors on August 8th, 2013 8:53 pm

    Hi anne, yes you’re covered because your husband’s membership type is OFW and Aug or Sep is within July 2013 to July 2014.

  272. Nors on August 8th, 2013 9:18 pm

    Hi Marnie, when is your due? You can avail if you’re able to pay 9 of the 12 months BEFORE your month of delivery. This August, you can pay July to Sept and the next quarters. maternity benefit eligibility

  273. anne on August 8th, 2013 9:20 pm

    Thanks a lot , Ms. Nors !

  274. Nors on August 9th, 2013 12:04 am

    Hi Jenie, yes, as long as you’re still employed when you give birth, and that you have paid at least 3 of the 6 months BEFORE your month of delivery. http://www.philhealth.gov.ph/members/employed/condition.html

  275. Nors on August 9th, 2013 12:33 am

    Hi Kim, yes, you can avail. Maternity benefit eligibility

  276. ?Jenie Grace Pamintuan on August 9th, 2013 3:32 pm

    Thank you so much Miss Nors! ^_^

  277. phoebe ruth estabaya on August 14th, 2013 2:43 pm

    HI po Ms. NOrs…ask k lng po..im a philhealth member since 2007 to 2009..but nastop po kc nagabroad ako..nagcontinue ako this year i paid april-dec 2013..im 23 wks pregnant po and im about to give birth on november..magagamit ko po kaya ung philhealth ko?thanks in advance

  278. Nors on August 15th, 2013 5:37 am

    Hi phoebe, did you pay April to Dec 2013 as OFW? Is your OFW status written in your MDR? If OFW, yes your November delivery will be covered because Nov is within April to Dec 2013.

  279. phoebe ruth estabaya on August 16th, 2013 1:56 pm

    hi again ms. nors…individually paying po ang nakalagay sa status k now since im unemployed po..covered po ba ako?thanks alot po

  280. Nors on August 16th, 2013 8:35 pm

    Hi phoebe, if your payments are updated. For maternity or surgery, dapat nabayaran mo ang 9 of the 12 months BEFORE month of delivery. Kapag ordinary confinement, 3 of the past 6 months ang dapat nabayaran.

  281. phoebe ruth estabaya on August 20th, 2013 2:40 pm

    hi po again…i went to philhealth po..pinaupdate ko ung contributions ko,nung ngstart po ako ng philhealth single po status k dun so pinaupdate ko po xa dis year from single to married..then ask nila ko san k gagamitin ung hinihingi k na copy ng contribution k sabi k for my delivery sa november,binigyn po nila ako ng certification ng contribution k from april-dec 2013 ung nilagay nila..un daw po pakita k upon discharged.then may fill up ako na form parang to iadjust ung contribution k since nung nging member ako ng philhealth. worried lng po kc baka dko rin magamit ung philhealth ko since in sched for CS..pd ko po ba bayaran ung jan-march 2013 pra mabuo ko po ung one yr contribution?thanks po tlga

  282. Ariane on August 21st, 2013 4:52 am

    good day po..!! i just wanna ask about IPC program of PHILHEALTH.. i just started paying my Contributions this year and i paid whole year na po..the last time i’d visit the philhealth, i asked them if magagammit ko yung philhealth sa panganganak ko but they told me not..they dont even explain me why..when i go home my sister-in-law told me that as far as she knows i can use my philhealth even i have 6mons contributions pero limot kasi nya ung IPC program kaya di nya nasabi sa akin kung anong program yun..my due date is on september 16, 2013 but my ob gyne told me that pwede na akong manganak by the first week of september 2013..i want to avail the philhealth benefits for me and for my baby boy..the staff of my obgyne told me that their normal delivery package is 12k-15k..i just wanna know how much will i reimburse in philhealth? thank you and GOdbless..

  283. Ariane on August 21st, 2013 5:01 am

    ms. nors, one thing pa po pala gusto ko malaman about po sa pre-natal OR’s..they dont gave me any receipts of my laboratories and pre-natal check up..now ko lang po nalaman un dahil nabasa ko dito..if i can get all of it from them can i use it or not?

  284. Nors on August 21st, 2013 10:58 pm

    Hi phoebe, nagtaka naman ako sa Philhealth na hindi sinabi sa iyo na hindi kasya yong april to Dec2013. If you deliver in Nov, ang Apr to Oct is only 7 months, not enough for the 9 contributions required for Individual Payors. Hindi na puedeng bayaran ang Jan to Mar. Hindi ko ma-gets yong merong form to adjust your contributions. Pakitanong na lang sa Philhealth kung ano yon, baka meron silang new policy na hindi ko pa alam.

  285. Nors on August 22nd, 2013 6:01 am

    Hi Ariane, IPC is a contract program na puede ka sanang maging eligible, pero Philhealth suspended this program. Sorry hindi ka siguro eligible kasi ang Jan to Aug is only 8 months http://www.healthphilippines.net/2013/07/individual-payor-eligible-philhealth-maternity-benefit/ Show your receipts to the ob-gyne’s staff kung okay. Kung okay sa kanila, tanungin mo na rin kung puedeng pasabay ang mga prenatal ORs mo sa claim. God bless din

  286. phoebe ruth estabaya on August 23rd, 2013 11:30 am

    hi again po.if gnun po ung case I wnt be able pla to use my philhealth..kc kulang ng contributions.ung husband k po may philhealth kya lng d nya k pdng gwing dependent kc may philhealth ako pd po kayang icancel k ung akin pra pd nya k malagay na dependent.ofw po xa dun sa mdr nya paid xa ng nov 2011-nov 2012.dis yr dpa po xa nkakabayad.ano po ba pd k gwin ms.nors gsto k po tlaga magamit philhealth kc mlaking tulong tlaga xa to lessen our expenses.thank you po.godbless

  287. Myecia on August 23rd, 2013 1:32 pm

    Hi can i still avail the maternity benefits like CS? i just turned 21 years old this July and an individually-paying(voluntary) Philhealth member. Paid po from April 1- Dec 31, 2013. Expected to give birth 1st week of December or mapaaga.If Philhealth requires me to pay 9 of the 12 months BEFORE December, I guess d umabot. Pero will I still have hope to claim the benefits? How can the IPC help me with this (hope it can)? Thank you :)

  288. Nors on August 23rd, 2013 4:56 pm

    Hi Myecia, sorry Philhealth has suspended the IPC program…last January, I think. Sad to say, kulang ka ng 1 contribution at hindi na puedeng bayaran. Please ask others too.

  289. Zoe on August 25th, 2013 5:51 am

    Hi ms. Nors. Super thanks to your blog because it was so helpful informing us. By the way, i just want to ask po regarding the 1500 that i can reinburse sa maternity package. Ibibigay ko lang po yung receipts sa lying in then after months of months of waiting i can receive it? Thanks po and more power. :)

  290. Nors on August 25th, 2013 11:44 am

    Hi phoebe, first ask your husband to pay his Philhealth so the validity dates on his receipt will cover your delivery date. You can pay for your husband (proof of his being OFW such as work visa or foreign ID, authorization letter to register you as his dependent and to process all Philhealth papers related to your maternity claim, copy of ID, your ID). Write to Philhealth requesting them to cancel your membership and to register you as dependent of your husband. Get an updated MDR where you are written as dependent of your husband.

  291. Nors on August 25th, 2013 11:49 am

    Hi Zoe, do you mean yong 1500 for prenatal care? Yes, makiusap ka sa lying-in na isama nila sa maternity claim mo yong prenatal ORs mo para makatanggap ka ng prenatal check later on from Philhealth. Maganda rin na tanungin mo na agad kung puedeng isama nila ang prenatal ORs mo sa maternity claim mo, kasi yong ibang lying-in, gusto nila yon lang prenatal ORs nila (na hindi naman ganon ang rule, pero makiusap ka na lang).

  292. Chamni on August 28th, 2013 9:44 am

    Hi ms Nors, I am pregnant and my due is Feb 2014. I have been employed since Feb 2013 but my contract will end this September 2013 (only 7 mo.). Can i get my benefit if i pay my 2 mo contribution from Oct- Nov as voluntary member? best regards, thanks

  293. Nors on August 28th, 2013 11:30 pm

    Hi Chamni, yes, pay those 2 months as individual payor so you will qualify. Get certification of premium payments from your employer for Feb 2013 to Sep 2013. http://www.healthphilippines.net/2013/07/individual-payor-eligible-philhealth-maternity-benefit/

  294. Jenie Grace Pamintuan on August 29th, 2013 2:34 pm

    Hi miss nors! I just want to ask kung kelan ko pwd hingin yung “2 signed claim forms (for you and newborn care) and cert of premium payments with OR nos. from my employer” sabi kase ng company ko ngayon sila na daw bhla EDD ko is Nov.9 eh sept. pa daw nila mbi2gay. What should i do? Ndi ndin nila ako pinapunta sa Philhealth office since sila nnga daw bhala…

  295. Nors on August 30th, 2013 7:39 am

    Hi Jenie, perhaps that’s your company’s policy, or maybe they also want to include August’s premium. Anyway, Sep is way ahead of Nov, so that’s okay. I don’t know if your company also gets MDRs for their employees, but if not, you can get your MDR from Philhealth.

  296. Gladdies on August 30th, 2013 2:28 pm

    Hi Ms Nors, I’d like to ask if I can use my Philhealth already since I paid for the whole 2013 na po. And I’m due this last week of September. Thank you :)

  297. nel on August 30th, 2013 2:38 pm

    hi po ask ko lng po qng mkakaavail po b aq ng maternity benefits s phil health qng ang payment q lng po eh july – nov 2012 kc ng end of contract n po aq ., then ngpay po uli aq this month for july – dec2013 as voluntary member n., kc ang due q po eh this dec 2013.,
    july to nov 2012 – paid
    dec 2012 – unpaid
    jan-june 2013 – unpaid
    july to dec 2013 -paid

    sna po msgot nyo thanks

  298. ?Jenie Grace Pamintuan on August 30th, 2013 4:12 pm

    Thank you Miss Nors!

  299. Jane Lariscy on August 30th, 2013 6:20 pm

    Good day Maam,

    I just want to ask if i can refund something from PHilhealth, Im a member of Philhealth for three years then I stopped from working March 2013, I gave birth August 2013. I lapsed from paying my contribution April-July 2013. My hospital didnt accept my philhealth since i lapsed paying. Is there a way I can reimburse from philhealth? I undergo CS tHANKYOU. – JANE

  300. Nors on August 30th, 2013 7:13 pm

    Hi Jane, sayang 1 month lang ang kulang. Sori, kasi 9 contributions ang requirement ng Philhealth.
    http://www.healthphilippines.net/2013/07/individual-payor-eligible-philhealth-maternity-benefit/
    Puede pang bayaran ang July, basta quarter of July to Sep ang bayaran mo, para ma-complete mo yong 9 months, pero hindi ko sure kung acceptable itong ganito sa Philhealth. Magtanong ka na lang sa Philhealth mismo.

  301. Nors on August 30th, 2013 7:25 pm

    Hi nel, sori July to Nov is only 5 months, kulang. Count 12 months pabalik from Dec 2013. Dapat sa 12 months na yan, meron kang nabayaran na 9 months. http://www.healthphilippines.net/2013/07/individual-payor-eligible-philhealth-maternity-benefit/ Please ask others too

  302. Nors on August 30th, 2013 7:26 pm

    Hi Gladdies, sori kulang ng 1 month. Jan to Aug is only 8 months. http://www.healthphilippines.net/2013/07/individual-payor-eligible-philhealth-maternity-benefit/ Please ask others too

  303. Marielle on September 7th, 2013 11:47 am

    hi, i have delivered my 1st bby last sept 2, 2013 in a lying -in owned by a midwife , i have insisted to have a twilight/painless delivery.. i dont have any requirements for philhealth before i was discharged from the lying-in so i have just decided to file it on my own..(the midwife gave me an Ofcial recpt worth 6k+ ( excluding the DR’s PF and items that were not covered with philhealth) do i still have to ask for a waiver?), ( am i still qualified to receive claim from philhealth since i had painless delivery and my pregnancy was considered as post term (and + for meconium stain?)

  304. Nors on September 7th, 2013 1:35 pm

    Hi Marielle, is the midwife and lying-in Philhealth-accredited? You need accomplished Philhealth claim forms 1 and 2 from the midwife, statement of account or billing paired with OR, waiver stating that all accounts were fully paid by the patient and that all Philhealth benefits should be given to the patient. Painless delivery is still normal delivery, so it will be covered. Submit also MDR and applicable premium payment receipts.

  305. Joy impol on September 11th, 2013 3:02 pm

    Hello po. Ask ko lg kng na receive nyo po ba ang mail kanina lg? Tnx

  306. Nors on September 11th, 2013 6:17 pm

    Hi Joy, to which email address did you send your email? If it’s to Philhealth, sorry, this blog is not affiliated with Philhealth.

  307. Jasmin on September 12th, 2013 11:43 pm

    Hi, i ask if my daughter can she use the philhealth of her boyfriend. Ngayon ay may work na yung magiging husband nya. They plan to get married this coming sept. 28, 2013 and she giving birth on nov 11, 2013. Is she covered to the maternity benefit .
    Thanks

  308. Nors on September 13th, 2013 10:02 am

    Hi Jasmin, yes, she can be a dependent of her husband because she’ll be married to her before she delivers. Pero dapat her husband should be able to pay at least 3 contributions as Employed before Nov (payment of Aug Sep Oct) so she’ll be covered (at least 3 of the 6 months BEFORE month of delivery).

  309. Jammie on September 13th, 2013 12:27 pm

    Hi!

    ..i’m currently pregnant and waiting nlng for my due date..ask ko lng poh kung pwede ako mag Personal reimbursement sa Philhealth..kasi ung Lying-in ng pag papaanakan ko hindi Philhealth accredited but my OB is Philhealth accredited may makukuha pa rin poh ba ako n reimbursement??

    Thank you!

  310. Nors on September 13th, 2013 10:36 pm

    Hi Jammie, sori, Philhealth says that both the clinic and the OB should be Philhealth-accredited. Pero ask others too

  311. lulu andes on September 25th, 2013 1:15 pm

    Hi

    My due is Feb 2013 at 35 years old na ako during that time..it’s my first baby..active philhealth member ako at isang public school teacher..gusto ko sana sa lying in clinic ako manganak para makatipid..can i avail the maternity package kahit 35 na ako and first time ko?

    tnx a lot

  312. Nors on September 25th, 2013 3:51 pm

    Hi lulu, because you’re already 35, you need to give birth in a hospital so you can avail of Philhealth. http://www.philhealth.gov.ph/members/special_package/maternity.htm Check mo na lang kung saan mas lower ang gasto mo — lying-in without Philhealth, or hospital with Philhealth. Kasi merong mga hospital na 3k lang ang dinededuct (pag hospital, 5k ang maternity coverage; 3k for hospital and 2k for ob-gyne), so in some cases, mas mura pa sa lying-in kahit walang Philhealth.
    On the other hand, okay ang hospital kung may possibility na mahirapan. Pero we pray na normal delivery. Ask your prospective lying-in; baka lang hindi na ina-apply yong 35-years-old rule. take care

  313. Charmaine on September 30th, 2013 10:52 pm

    Good evening po Ms. Nor! My concern po is my EDD will be on 1st week of Nov. (CS). Dependent po ako ng husband ko which is a seaman. His contract started March 05,2013 then end this Sep.25,2013 (6 mos.)My concern po is usually delayed ung remittance nila sa Philhealth. Can I avail po ba ng maternity benefits of my husband? Or if we need to pay pa po ung oct.-dec. nya na contribution voluntary? wala po bang maging problema? Thank you po!

  314. Nors on October 1st, 2013 10:41 am

    Hi Charmaine, your husband should file as seaman, meaning as employee, because if he files as Individual Payor, he needs 9 months of payments before Nov, and March to Oct is only 8 months. Visit Philhealth and verify if your husband’s company has already paid at least 3 months from May to Oct. For employees, the requirement is payment of 3 of the 6 months BEFORE month of delivery. Get your cert of premium payments with OR nos. plus signed claim form 1 (2 sheets) from the company.

  315. may villarosa on October 5th, 2013 3:53 pm

    Hello, i started paying july 2013 for my philhealth and i will give birth around dec. or january. I am so confused coz my mom says 6 months continuous payment for philhealth is consider okay but as i was reading the comments it is also like sss that maternity benefits are 9 months of payment. I would like to ask which is really is it? Thank you and Godbless.

  316. may villarosa on October 5th, 2013 4:15 pm

    Hello, by the way i am currently employed and to my 1st comment if my mom is right that i can avail it eventhough i only paid 6 months, can i automatically use it on decmber or it should be january before i am able to avail of the benefits? And what else should i process as early as now ? Regarding the prenetal care reciepts if it is below 1500 do you still refund it? And what if it is all check ups? Thank you so much. Looking forward to your reply.

  317. Nors on October 6th, 2013 4:52 pm

    Hi may, you said you’re currently employed, so you will be eligible. As employed, you only need 3 months of payments — 3 of the 6 months immediately BEFORE month of delivery. Around Nov/Dec, ask for a cert of premium payment with OR nos. plus claim form 1 from your employer. Yes, you can submit your prenatal ORs even if they total less than 1500 and even if they’re all checkups.

  318. may villarosa on October 8th, 2013 2:29 pm

    Hello, i went to Philhealth today and when i asked regarding if i can use my philhealth she told me since i am employed i can but then it depends on the hospital if they would consider the 3 of the 6 months payment. My question is that what type of Hospitals do considers the 3 of 6 months payment, since i am planning to give birth in a provincial hospital with a private doctor. and regarding the 1500 of prenatal ORs is ultrasound and laboratory included? Thank you so much.

  319. Nors on October 9th, 2013 1:24 am

    Hi may, I’m sad and frustrated that Philhealth answered you like that. It’s their rule that for employees, the requirement is payment for at least 3 of the 6 months prior to month of confinement. What hospitals may not accept is a plain certification of payment of premiums — some hospitals require a copy of the ORs. Ask your doctor about your Philhealth use and PF estimate if with Philhealth. About prenatal, yes, necessary ultrasound and lab expenses are included.

  320. lang on October 9th, 2013 2:29 pm

    Hi good day mam nors,
    Ask ko lang po maka kuha po bh ako ng maternity benefits ko if covered lang ako ng husband ko? I went to philhealth and I will pay sana may contribution but they say na sponsored yung philhealth ng husband ko and paid na siya jan to dec2013 so they advised na wag na ako mag bayad coz covered nalang ako sa husband ko. We plan by jan 2014 e self employed ko na status husband ko..kasi feb is my delivery and cesarian po ako..slamat po..

  321. Nors on October 12th, 2013 7:57 am

    Hi lang, yes you can use your husband’s Philhealth as his dependent. Kung Feb 2014 ang due mo, maco-cover ka ng sponsored payments.

  322. Michiko on October 14th, 2013 9:11 pm

    Hello! I’m scheduled to give birth (CS) on fri Oct.18. Do we have to update my husband’s mdr since im not yet listed as his dependent or can i just submit our marriage cert to the hospital together with the other requirements? Another is do i have to deactivate my membership so i can be a dependent. I have been an inactive member eversince the company i worked in closed last 2011. Thank you in advance!

  323. Nors on October 15th, 2013 8:46 am

    Hi Michiko, some hospitals accept not-updated MDR plus marriage cert; some do not. To be sure, update MDR. Write Philhealth to deactivate your Philhealth membership and register you as your husband’s dependent. Your husband can authorize someone if he can’t go to Philhealth. Present marriage cert (xerox and orig), your IDs, ID of representative and your letter and authorization letter.

  324. lang on October 15th, 2013 2:03 pm

    Thnk u po mam nors, follow up question lang po what is the diffrence between indigent and self emplyed coz wev plan by jan 2014 e self emplyed na ung philhealth husbnd ko baka kc alanganin yung indegent hindi hh yun maka affect sa papngank ko? Tnx ulit po…

  325. lang on October 15th, 2013 2:42 pm

    And also po mam nors may ma tatangap po bh ka ako ng reimbursement kahit indigent ung philhealth tnx.

  326. Nors on October 15th, 2013 7:16 pm

    Hi lang, buti nagtanong ka uli, kasi napasunod ako sa sinabi ng Philhealth sa iyo na eligible ka na in February using your husband’s indigent card. Naisip ko nga pala na merong validity dates diyan sa card ng husband mo at hanggang Dec 2013 lang, di ba? So ang gawin nio, magbayad ang husband mo for January 2014 as Individual Payor, puede ring Jan to Mar (1 quarter, kasi sa Philhealth, 3 months ang minimum payment na tinatanggap). Mag-update na rin siya ng Philhealth record niya at iregister ka as his dependent (bring your marriage certificate, orig and xerox), at mag-request na siya ng MDR at Philhealth ID niya. Magrequest din ng cert of eligibility from Philhealth para magamit sa hospital, baka hindi enough sa kanila ang indigent card plus your premium payment receipt as individual payor. In February, you will use Philhealth as individual payor and not indigent, kasi up to Dec 2013 lang yong card. Pero keep your indigent card kasi kasama yan para mabuo yong 9-month requirement sa Individual Payor.
    Maghanap din kayo ng nag-offer ng Philhealth package na affordable, kasi maraming mga hospitals na hindi kasya ang Philhealth for CS or normal, at sobrang malaki pa rin ang binabayaran.

  327. lang on October 16th, 2013 2:02 pm

    Thank u pa mam nors,pro mam baka may ma recieve ako na reinbursement anong mga reciept na kylangan ko e pasa..

  328. Catherine on October 17th, 2013 1:54 pm

    Hi po! Im giving birth this November under CS dahil breech po si baby. May I ask if ano po young mga requirements na kailangan ko po I submit? If wala pa po akong philhealth ID na mapresent as one of the requirements am avail ko po ba yung 19k? Thanks po in advance.

  329. Carene on October 18th, 2013 9:53 am

    Hi mam,,ask q lng po,,,im 7 mnths pregnant now,,,last aq ng hulog sa philhealth ko last may 2013,ng employer,simula po nuon hndi q na po nhulugan ung philheath ko,anu po gagawin ko para ma avail.ko ang philhealth benefits,,wat month po ako magsimula ng bayad?june to december po ba ang kailangan kong bayaran?anu po kailangan ko gawin?pls help me nman po,,,

  330. Urdz on October 18th, 2013 10:02 am

    Hi mam,,ask q lng po,,,im 7 mnths pregnant now,,,last aq ng hulog sa philhealth ko last may 2013,ng employer,simula po nuon hndi q na po nhulugan ung philheath ko,anu po gagawin ko para ma avail.ko ang philhealth benefits,,wat month po ako magsimula ng bayad?june to december po ba ang kailangan kong bayaran?anu po kailangan ko gawin?pls help me nman po,,,

  331. Urdz on October 18th, 2013 10:04 am

    Hi mam,,sa first wek po ako ng jan manganganak,,,,

  332. Nors on October 18th, 2013 11:40 am

    Hi Urdz or Carene, magregister ka na Informal Sector ang category mo para ma-qualify ka sa 3-month requirement. Pay Oct to Dec 2013 asap. Bring your ID. Keep your receipt.

  333. Nors on October 18th, 2013 11:43 am

    Hi Catherine, updated MDR, premium payment receipt (OR and xerox), claim form 1, any valid ID if you have no Philhealth ID yet. About 19k: dapat ob ang magdecide kung CS ka or not. Sa 19k, 11400 is for hospital cost. Yong for PF, depende sa OB; sometimes bukod sa PF nila na babayaran mo, kukunin pa nila yong bigay ng Philhealth.

  334. Catherine on October 18th, 2013 1:54 pm

    Thanks ma’am nors. Pero sure po ba na may ma le less na philhealth maternity benefits Sa bill ko po if ever I pass the complete requirements to the hospital before I discharge?

  335. Nors on October 18th, 2013 2:23 pm

    Hi Catherine, dapat ganon, immediate deduction, pero based on some comments in our blogs, depende rin sa ospital and ob. Merong mga hospitals na clear ang deductions at sumusunod sa Philhealth rules. Meron namang mga ewan. Dapat accredited ang ob and hospital. If this is a private hospital, you should ask your ob about your cost whether normal or CS so you can prepare. Pag government hospital, mas complicated minsan dito ang philhealth kasi pabibilhin ka ng meds sa labas, and then yong doc pababayarin ka directly, and not to the cashier, so paano madededuct?

  336. myecia on October 22nd, 2013 7:51 pm

    Hi Ms. Nors!

    I want to confirm if this article is true. Found this from PhilHealth.

    http://www.philhealth.gov.ph/news/2013/liberalize_availment.html

    I am an Individually Paying member, aged 21.
    I paid straight from April to December 2013.
    I will give birth November 28, 2013 via Caesarian.

    I am confused because I was told that I am not eligible for the benefits because it has to be 9 months within the 12 months prior to delivery and that I would be eligible only if I were to give birth January 2014.

    My question is, with regards to the article above, will I now be 100% qualified for the maternity benefits/Philhealth discounts like undergoing CS?

    I really want to be secured. That’s why I’m asking ahead so that I could act immediately if there are missed requirements or payments that I need to take care of in order to avail the benefits. sayang kse ang laki ng discount pag-CS. :(

    Thanks Ms. Nors!:)

  337. Nors on October 23rd, 2013 9:44 pm

    Hi myecia, yes, that article is from Philhealth, so it’s valid. What I’m not sure is if the 3-month eligibility is valid for all types of individual payors, (the article mentioned informal sector), but if you’re currently unemployed, I think you qualify for the informal sector category. Ask others too.

  338. myecia on October 26th, 2013 10:31 am

    hi po..do i need to update my PMRF before giving birth and malagay name ni baby sa MDR pra ma.avail ung new born package? or mkakaavail pdn kme kht d nklagay? voluntary po kxe aq.dont know if theyre that strict..sayang pg.wala aq nagwa at d maavail ung package. thanks po :)

  339. Nors on October 26th, 2013 5:34 pm

    Hi myecia, Philhealth needs your baby’s birth cert to update your MDR; so you cannot yet update. At the hospital, you can avail of the newborn care package because they’ll be the one filling up your birth cert (to be submitted to the city or town’s local registrar later on) — they’ll use that cert for the newborn care claim; just make a request beforehand.

  340. phoebe ruth estabaya on October 26th, 2013 6:02 pm

    hi po..ask ko lang po if magagamit ko po philhealth ng husband ko if this month lang pobsiya nakaalis ofw dependent po ako.next month na po kasi due ko.thank po

  341. Nors on October 27th, 2013 2:20 am

    Hi phoebe, yes, ma-avail mo kasi OFW ang category niya. Ask for a copy of his OEC and his ID.

  342. jocelyn on November 9th, 2013 11:23 pm

    hi i’m jocelyn, i’m expecting to deliver my first baby on april 19, 2014.i am a dependant of my husband, can i ask weather i can claim any benefits because my husband has just started his payment last october, 2013. thank u

  343. Nora on November 10th, 2013 7:47 am

    Hi jocelyn, yes, if your husband is employed. Sa mga employed, 3 months of payments lang ang required. If not employed, ask him to update his registration and change member category to Informal Sector, kasi 3 months din lang ang required sa Informal Sector.

  344. jocelyn on November 10th, 2013 8:08 am

    i’m an OFW and my last payment po was i think year 2006, pwede pa rin po ba ako magbayad kahit 4months pregnant na po ako para maka avail po ako ng benefits? thank u

  345. jocelyn on November 10th, 2013 8:10 am

    thank u for you reply miss nora, have a good day po :)

  346. Nora on November 11th, 2013 12:06 am

    Hi jocelyn, yes, puede dahil iba sa individual payor ang eligibility ng OFW. If you’re OFW, and you have OEC or OFW ID or job contract, pay as OFW — pay 1 year in advance so that the validity dates in your premium receipt covers the date of your delivery date.

  347. melanie on November 13th, 2013 9:43 am

    Good day mam,ask ko lang po kung hindi na po ba ako pwede maging dependent ng husband ko n ofw kung may philhealth po ako na binibigay ng government.ayaw po kasi ako tanggapin s philhealth office kasi active member dw po ako,nagsasubmit po ako requirements pra maging dependent ako ng husband ko,manganganak po kasi ako last week of march 2014.pareho lang po b ung discount n makukuha pg ofw ung pilhealth at s libreng pilhealth n binibigay ng government?o pwede po gmitin yung 2 na un dahil magkaiba nman dw po nagbabayad nun.thanks po

  348. Nora on November 13th, 2013 5:10 pm

    Hi melanie, ano ang validity dates ng Philhealth mo na sponsored? Maco-cover ba ang March 2014 na date of your delivery? If yes, then it’s ok that you use that sponsored card. Mas easier because you don’t need to get docs from your husband. Hindi puedeng gamitin ang 2 memberships. At pareho lang ang benefit, ke OFW membership or sponsored. You can register as a dependent of your husband after your sponsored card is no longer valid. If your sponsored card is valid only up to Feb 2014, then register as dependent about a week before expiry date.

  349. janice on November 22nd, 2013 11:25 am

    hi po good day..tatanong ko lang po kung magagamit ko po ba yong philhealth ko sang panganganak ko ngaung december kasi po march to may company po ang nagbayad sa philhealth ko tapos ng leave ako tinuloy ko po nagbyad po ako ng quarterly binayaran ko po june to sept. at october to december magagamit ko po ba ng full kung manganganak ako dito sa Mapandan Comunity Hospital thank you po

  350. Nora on November 24th, 2013 6:33 am

    Hi janice, yes, you’ll be eligible. Sa bilang ko, you have paid 9 of the 12 months within Dec 2012 to Nov 2013. Ask from your former employer a certificate of premium payments with OR nos. kasi usually hinahanap ng hospital. Kung malayo na ang former company mo, puedeng humingi ka ng certificate of eligibility from Philhealth.

  351. jane on December 1st, 2013 7:16 pm

    how many c section po covered ng philhealth? regardless po ba yan kung pang ilang beses mo nagamit ang philhealth?

  352. Nora on December 2nd, 2013 11:44 am

    Hi jane, Philhealth did not put a maximum no. for CS. But it should be Indicated CS, meaning it’s your OB who decides to perform CS. CS will also covered even if you have used your Philhealth for other illnesses, as long as you have not reached the yearly limit of 45 confinement days. Please ask others too.

  353. Merasol Palarca Oga on December 2nd, 2013 7:22 pm

    Just want to ask if pwede po ako mag avail ng maternity as an OFW member if this December 2013 me magbayad ng philheath tapos yung due date ko ay March end ng 2014.

    Isa pa I will deliver my baby here in UAE may chance po ba na maka avail ako ng philhealth benefits, Will my expenses be reimbursed & how can I claim it?

    Regards,

    Merasol Palarca Oga

  354. almira de guzman on December 3rd, 2013 2:55 pm

    Sir/Madam,

    Good day! Is it possible if I request to pick up my cheque somewhere in Rizal Branch because Im leaving at Taytay, Rizal area. Maybe near in Sta. Lucia Cainta Mall.
    Hoping for your kind consideration. Thank you and God Bless!

    Respectfully yours,

    Almira De Guzman

  355. Nora on December 5th, 2013 2:50 pm

    Hi Merasol, yes, you can file for refund. Keep your hospitalization ORs, medical certificate with translation in English. The coverage is 5k for normal and 19k for CS. Send your representative a copy of your OEC or OFW ID or OFW contract so she can pay for you under the OFW category. File your claim within 180 days after your discharge. http://www.philhealth.gov.ph/members/overseas_workers/procedure.html

  356. Nora on December 5th, 2013 3:06 pm

    Hi almira, your check or payment notice is delivered by registered mail to the address written in your claim form. God bless.

  357. reina on December 8th, 2013 2:49 pm

    hi po. tatanong ko lang po kung mag kahiwalay po ba ang philhealth refund if kung ang case ay tulad ng sa akin.. nka sked po ang ng CS this dec 26 at isasabay na rin po ang operation ko for may ovarian cyst. my doctor advice me to prepare 50k for my CS and addtl of 15k for my cyst operation….. tnx po

  358. Nora on December 8th, 2013 10:47 pm

    Hi reina, usually isa lang ang kino-cover kapag ang 2 surgeries ay ginagawa in a single operative session. Halimbawa isang coverage lang for CS and appendectomy, or CS and ligation, or CS and adhesiolysis. Ask your doctor kung magkano ang babayaran mo kapag madeduct na ang Philhealth.

  359. Perla on December 9th, 2013 8:01 pm

    I gave birth last july (Bangkok) after an hour my baby need to be stayed at NICU for almost 2 weeks due to complications (we’re hubby’s dependent sa kanyang Philhealth) question po–will my baby receive refund as well?( birth cerificate already been processed too) thanks po.

  360. Perla on December 9th, 2013 9:44 pm

    I just gave birth last july this year via CS (here in bangkok)and my baby was admitted at the NICU for almost 2 weeks after giving birth.dependent po kami ni hubby and updated naman po sa pagbabayad –concern ko is makakareceive din po ba si baby ng refund aside sa refund na matatanggap ko?(naprocess na po namin ang birth certificate) Thanks po

  361. Nora on December 10th, 2013 7:47 am

    Hi Perla, yes, your baby is covered by Philhealth as your dependent. You can file 2 sets of claims: your maternity claim and your NICU claim. will be back for the list

  362. junalyn cerbas on December 13th, 2013 2:01 pm

    helow po isa poakong OFW ask ko lng po,nkabayad po ako ng philhealth last year bale ng xpire po cya last aug.27…tapos hanggang ngayon po d pa rin ako nkabayad…ano po gagawin ko?kng mgbayad ba po ako nxt yr for the whole year of 2014 ok lng po ba yon nsa list pa rin po ba ako ng philhealth?tnx po!!!God bless

  363. Nora on December 13th, 2013 4:36 pm

    Hi junalyn, yes, magbayad ka na asap ng Dec 2013 to Dec 2014 para active member ka ng Philhealth. Pay as OFW. For OFWs, nagagamit nio ang Philhealth within the validity dates sa premium receipt. If you pay Dec 2013 to Dec 2014, you can use Philhealth within Dec 2013 to Dec 2014.

  364. shiela on December 20th, 2013 10:25 am

    Good day po sa lahat.. nanganak ako last june 26, 2013, binayaran namin ay 12,950, binayaran namin yun at to follow na lang yung philhealth ko, hindi po binigay ng lying in ang requirements ko para sa reimbursement kasi po sila nalang daw maglalakad sa philhealth kasi daw ganun din daw at magpapagod pa kami..ngaun po meron na ko natanggap na BPN ang sabi 8,000 ang binayaran ng philhealth sa akin, sabi naman po ng lying in 4,500 lang daw ibibigay nla na refund? pwede po ba yun?pwede ba ako magreklamo, diba kung ano ang amount sa bpn na nakuha namin ay yun din ang matatanggap ko na reimbursement..what po ba gagawin ko?salamat…sana masagot nyo po..

  365. Nora on December 21st, 2013 4:44 pm

    Hi shiela, 6500 ang dapat irefund sa iyo ng lying-in. Sabihin mo nasa Case Rate list ng Philhealth na 6500 ang marefund mo. Hindi ko alam kung anong ginawa nilang claim na naging 8k ang nakuha nila. Kasi yong 1500 na prenatal ay ibinibigay diretso sa member kung nagsubmit ng prenatal ORs.

  366. shiela on January 2nd, 2014 10:01 pm

    ganun po ba ms nors..thank you po, kelangan ko pa po pumunta sa kanila at dapat ko makuha ung ibang refund nila sa amin, balitaan ko po kau kung ano ang sasabihin nila sa akin na palusot,,thanks po ulit..

  367. Esther Berdejo on January 3rd, 2014 10:07 pm

    Hi. I’m from San pedro laguna po. I’m 18 weeks pregnant.Balak ko pong sa lying in lang manganak. Ask ko po sana ano yung step by step process na kailangan ko gawin para macovered ung maternity?
    Sa isang BPO company po ako nagtatrabaho. Ano po mga documents na dapat ko ihanda? First time ko po kase. Thanks po.

  368. Nora on January 3rd, 2014 10:46 pm

    Hi Esther, check if your company is remitting your Philhealth payments — you can visit Philhealth to verify. A month before your due, request claim form 1 (2 sheets; one for maternity and one for newborn care) from your HR and a cert of premium payments. get also your MDR from Philhealth. For your SSS benefit, have your MAT1 form stamped by SSS asap. You can also file online through your employer’s SSS online account.

  369. Esther Berdejo on January 4th, 2014 8:39 pm

    how about maternity coverage sa SSS??? How’s the process po sa HR?? Ano po mga need kong requirements? at gaano katagal ang process para makuha ko po yung half? magkano din po?

  370. Nora on January 6th, 2014 3:11 am

    Hi Esther, file your MAT1 through your HR — can be filed online via your employer’s online SSS account. Ask your HR for a MAT1 form; present your ultrasound report or pregnancy cert. from your OB. You notify your HR when you’re taking your leave, so they can prepare your benefit. Usually, they give half of your benefit before you take your leave, and the other half, after you submit your baby’s NSO or civil-registrar-certified birth cert. How much? Depends on your 6 highest salary credits within the 12-month period before your semester of contingency.

  371. queenie on January 7th, 2014 9:05 pm

    Hi po.can i avail my benefit this coming june or july? I updated my philhealth just this jan. And paid 12mos. Payment.sa cooperative kasi ako ng.update ng philhealth ko from employed last feb.-sept2013 to individually paying this jan.2014. And is it necessary to get an o.r from my ob-gyne from 1st prenatal to post,for my refund about the prenatal care? First baby ko pa po kasi and im turning 20 pa and i need informations.
    Thank you ..hoping for reply

  372. Nora on January 9th, 2014 12:24 pm

    Hi queenie, yes, eligible ka basta Individual Payor-Informal Sector. Yes, you need prenatal ORs worth at least 1500 at i-submit mo sa hospital para masama sa maternity claim.

  373. Melanie on January 9th, 2014 10:42 pm

    Hi! Just want to ask. I stopped paying my philhealth when I moved to SG and worked there last Oct 2009. I also got married there last Sept 2011 and now I am 8 months pregnant and I’m giving birth here in the Philippines. I did not update my status from employed to OFW, I totally neglected my philhealth (unlike my SSS) which I now regret.
    Is there any way that I can pay in lump sum those years that I did not pay so that I can claim maternity benefit? I am currently going through the process of updating my status from single to married and its a bit complicated since we got married outside the PH. If I wont be able to claim anything then I’d rather focus my energy on something else. I really don’t know where to find the answer to my question. I hope you can help me sis.

    Thanks!

  374. Nora on January 10th, 2014 10:37 pm

    Hi Melanie, you can avail of Philhealth because you’re OFW — just pay asap (must be before your delivery) so you can avail. You can pay there in Singapore at Lucky Plaza (BTI, Brunphil, IRemit, etc). Pay for Jan to June or Jan to Dec 2014. Keep your receipt and xerox. Your delivery date must be within the months you paid for. You can use your married name as long as you have an ID showing your married name.

  375. Jesselyn on January 16th, 2014 5:02 pm

    Im Philhealth member, OFW, had miscarriage for my second child. We paid 4700 Dirham here in UAE. How much is the possible reimbursement i can have after filing?

  376. Nora on January 17th, 2014 7:42 am

    Hi Jesselyn, kapag naraspa (dilatation and curettage), 11k pesos ang coverage (4400 for PF and 6600 for hospital costs).

  377. kim on January 20th, 2014 8:43 am

    gud day po ask ko lng kung pwede kong magamit ung philhealth ko..nakapaghulog po ako nung march 2010 to dec 2011 pa po..due date ko po sa panganganak ngaung feb 3..meron pa po bang way para magamit ko ung philhealth ko..naguguluhan po kc ako sabi sa akin meron daw pong bagong policy ngaun ung philhealth..3 months na pwedeng magbayad para magamit ko ung philhealth ko..sana po masagot at maipaliwanag sa akin kaagad..ngaun ko lng nkita ung site na toh eh,..sana po makapagreply po kau agad..salamat ng marami..

  378. Nora on January 20th, 2014 9:42 pm

    Hi kim, puede na ngang kahit 3 contributions lang, pero dapat 3 contributions before Feb. Dahil hindi mo na puedeng bayaran ang Nov and Dec 2013 para sana meron kang 3 contribution, you update your member data to Individual Payor-Informal Sector, then pay 1 year in advance, kasi sabi din sa new circular na puede ring 1 year in advance kung walang 3 previous contributions. Pero magtanong ka muna uli doon sa Philhealth para sure.

  379. Neneth on January 23rd, 2014 12:40 pm

    Hi ma’am,

    ang expected delivery date is on june 2014. sa Lying in clinic ako manganganak ang sa lying in na to 7000 ang package nila (room,doctor’s fee and yung delivery)so kung 6500 ang maternity care package ng philhealth is it possible na 500 nalang bbayaran ko?or depende pa din sa policy ng clinic??Ksi sabi ng nurse sakin, kung may philhealth ako 5,500 nlang daw babayaran all in na.. so parang sa 1500 lang nabawas sa bill ko?? instead of 6500??naguguluhan po ako.need you help thanks

  380. Neneth on January 23rd, 2014 1:30 pm

    I have another inquiries po pala ma’am. I am employed and yung company po namin eh nakaregister sa tacloban city dun po kasi yung main branch ng Business ng boss ko i am her sectary which is dito sa manila nakabase kasi nandito po ang aking boss and yung mga papers ng binibenta namin dito po sa manila pinaprocess.We all know about supertyphoon yolanda dahil dun wash out ang tacloban. Still operating ang business ng boss ko po and tuloy tuloy ang pagbayad namin ng hpilhealth.the problem is di pa kami makapagsubmit ng report kasi Nang philhealth sa tacloban eh wala pa ding mga computers dahil nabasa. kaya hindi nila maiupload o maipost online yung mga binayaran namin dahil dun hindi kami makagawa ng report. panu po yun? from nov. to dec di pa magawan ng report kasi di pa available online. Panu po papasok sakin yung binayaran kung di pa maiireport. magagamit ko pap po ba philhealth ko?

  381. neth on January 23rd, 2014 2:23 pm

    Neneth on January 23rd, 2014 12:40 pm

    Hi ma’am,

    ang expected delivery date is on june 2014. sa Lying in clinic ako manganganak ang sa lying in na to 7000 ang package nila (room,doctor’s fee and yung delivery)so kung 6500 ang maternity care package ng philhealth is it possible na 500 nalang bbayaran ko?or depende pa din sa policy ng clinic??Ksi sabi ng nurse sakin, kung may philhealth ako 5,500 nlang daw babayaran all in na.. so parang sa 1500 lang nabawas sa bill ko?? instead of 6500??naguguluhan po ako.need you help thanks

  382. Nora on January 23rd, 2014 3:56 pm

    Hi neth, oo bakit nga 1500 lang ang bawas? Pero compared sa mga nakikita kong lying-in package, at sa mga nagco-comment dito, lower ang 7k na package. Usually 10 to 12k. Ang nakikita kong reasons ay mas preferred nila ang cash at naha-hassle sila sa pag-fill-up ng mga forms at pag-file sa Philhealth. Although merong mali sa reasoning nila, depende pa rin sa kanila, kasi puede nilang sabihin 12k ang package nila, para minus 6500 from Philhealth, 5500 pa rin ang babayaran ng pasyente. Pero ask mo pa rin kung bakit 1500 lang ang bawas, para masabi nila kung anong rason.

  383. Nora on January 23rd, 2014 4:07 pm

    Hi Neneth, yes, you can avail. June pa naman ang month of delivery mo, so you still have time to accumulate 3 months of payments, in fact you can pay 5 months (Jan to May) before June, so you don’t need those pre-Yolanda receipts. Ang required naman sa Employed is payment of premiums for 3 of the 6 months immediately before delivery month.

  384. mitch on January 25th, 2014 10:19 pm

    Hi. Just wanna ask if i am elegible to avail of the maternity benefit. I am employed until feb.24 and my duedate is on the 28th day of march. I started paying last nov.2012. And what do i need to submit to the accredited lying in i am going to give birth by the time that i am not already employed. Thank you.

  385. Nora on January 26th, 2014 10:31 am

    Hi mitch, pay for the month of Feb (200 pesos). Ask your employer a cert of premium payments from May 2013 to Jan 2014 (8 payments) with OR nos. 8 payments as employee plus 1 payment as individual payor = 9 payments — good for complying with the 9-payment requirement. Docs: MDR, ID, premium receipt and cert, claim form 1.
    Note in case of future need: For individual payor (informal sector), 3 premiums paid immediately before confinement is enough.

  386. maricar on January 28th, 2014 2:34 pm

    hello po .. ask lang po about sa contributions kasi po nung naghulog po ako nung october 2013 to december 2013 450 pa lang po ang quarterly kaya nag-advance payment po ako for january-march 2014, since tumaas po pala ang quarterly paano ko po mababayaran yung kulang sa advance payment ko nitong january to march 2014?

  387. maricar on January 28th, 2014 2:43 pm

    fallow up question pa po pala magagamit ko po ba ang philhealth ko sa panganganak ang due date ko po ay feb 6 2014 .. my hulog po ag last employer ko nung february 2013 to march 2013 at nag voluntary na po sa month ng july2013-december 2013 magagamit ko pa ba yun kahit hndi ako umabot ng 9months na hulog ? kailangan ko pa po ba magadvance payment ?

  388. Nora on January 28th, 2014 8:49 pm

    Hi maricar, bayaran mo ang Jan 2014 as Individual Payor, para makaipon ka ng 9 contributions at maging qualified ka. Ask cert of premium payment from your employer for Feb and Mar 2013.

  389. maricar on January 29th, 2014 9:45 am

    thanks ma’am nora for the reply ..
    actually po nagadvance nga po ng hulog for the month of jauary-march 2014 ang kaso po 450 lang po yung nabayaran ko hindi ko po kasi alam na tatatas na po pala yung premiums .. paano ko po kaya mababayaran yung underpayment ko? sa bayad center lang po kasi ako nagbabayad ..

  390. honeylene on January 29th, 2014 10:09 am

    good day ms.nora,

    ofw po ako since november 2013, direct po ako nakapagtrabaho dito sa dubai as receptionist sa isang hotel .. gusto ko po sana ipagpatuloy ang hulog ko sa philhealth dahil para na din po sa futire namin ng anak ko nasa pilipinas at alam ko po na magagamit nya yun incase of emergency .. paano ko po kaya maipagpapatuloy ang hulog ko sa philhealth ?

  391. Nora on January 29th, 2014 12:04 pm

    Hi maricar, ang alam ko dapat hindi muna nila tinanggap yong advance payment for Jan to Mar2014 at 150 per month noon. Since Bayad Center naman ang tumanggap ng payment, ask Bayad Center how you can add 50 pesos per month to your Jan to Mar payments. Bring your Bayad Center receipt for Jan to March.
    Actually, under the new rules, puede na ang 3 contributions before confinement, basta ang member category ay Informal Sector. Hindi lang clear kung yong 3 contributions ay immediately before or puedeng merong 1 month na gap.

  392. Nora on January 29th, 2014 12:11 pm

    Hi honeylene, puedeng magregister ka online sa philhealth.gov.ph. Pag meron ka nang Philhealth no., ask your family to pay for you at Bayad Center or at Philhealth. Sa form, dapat i-check na OFW. Email them proof that you are OFW, like job contract or foreign ID or passport with work visa, para maprint nila, kasi kalimitan hinahanap. Iba kasi ang eligibility ng OFW, so kelangan nila ng proof of OFW. ito ang payment form sa Bayad Center http://www.philhealth.gov.ph/circulars/2013/circ16_2013.pdf
    Rate: 200 pesos per month. Puedeng pay 1 year or 6 months in advance or any no. of months.

  393. JeffreyG. Eulalia on January 29th, 2014 4:54 pm

    Sir/Maam
    Good day, just want to ask what if my wife has also philhealth which she was an individual paying or member, and also she is my dependent member on my philhealth, can we avail at the same time our benifits if we file it on the day of delivery or confinement. thank you.

  394. Nora on January 29th, 2014 11:26 pm

    Hi Jeffrey, if your wife is also an active Philhealth member, she should use her own membership if she’s confined. She cannot use both. By the way, Philhealth says that one cannot be an active member and be also a dependent. Why does she still pay as an Individual Payor when she’s already your dependent? Parang sayang din kasi yong 2400 a year na premium. Or baka merong good reason?

  395. ranelle rempis on January 29th, 2014 11:38 pm

    Ask ko lng po pwede b magamit ang philhealht ng asaw ko para maavail ang maternity kaso hnd p kami kasal manganganak aq this march 2014

  396. Nora on January 30th, 2014 1:59 pm

    Hi ranelle, sori hindi ka pa puedeng dependent ng asawa mo kasi kelangan ang marriage cert para maregister ka as dependent. Ask Philhealth kung puede kang magregister as Individual Payor-Informal Sector and pay 1 year in advance (2400) para maka-avail ka ng Philhealth.

  397. kristine on January 31st, 2014 1:02 am

    Hi ms nors
    Nag file po ako ng reimbursement sa philhealth last December 2013 and fortunately na received ko today yung cheque but it was 11400 I’m expecting 19k since case rate ako I gave birth last september 2013 via cesarean section at chinese general Hospital. I paid all my hospital bill and I paid cash on doctors PF
    70k all in all for PF (50k sa ob 15k sa anesth and 5k sa pedia)
    Hmm saan po kaya napunta yung 7600?
    Anu po pwede ko gawen? Possible ba na marefund ko yun?

  398. Nora on January 31st, 2014 7:49 am

    Hi kristine, irefund mo yong 7600 sa Chinese Hospital. Most likely, sila ang payee ng Philhealth check na 7600. Bring your bill and ORs. I hope the doctors gave you ORs para maipakita mo sa Chinese Hosp. Xerox also for your own copy.

  399. Annabelle on February 3rd, 2014 4:59 am

    totoo po bang binalik na nila uli sa dati na after three months pa saka pwede maavail ang benefits maski binayaran mo ang buong taon para sa mga new members? nagregister po kasi ako noong January 14, IPM at binayaran ko po yung premium january to december 2014. kailangan ko pa man din kasi due na po ako sa february 10.

  400. Nora on February 3rd, 2014 7:42 am

    Hi Annabelle, wala pa naman silang new circular about that. Ang alam ko qualified ka kasi you paid for 1 year in advance. Make sure you have updated your member category to Informal Sector. Sabi ni new Philhealth CEO Padilla “Informal sector members who lack the three months “of qualifying contributions” will still be “eligible to benefits if they pay the whole year of their premium contributions.”

  401. Eloisa on February 4th, 2014 7:45 pm

    Hi ,
    How about ang OFW and philhealth member na nanganak abroad, pano PO nila ma reimberse ang gastos. For me po, na ang due date is July pano ko PO na claim ang spenses ko. Then pede ko PO ba ipa ayos ang mga requirements sa magulang ko or sister. ? Thanks

  402. Nora on February 5th, 2014 10:19 am

    Hi Eloisa, send a copy of your OEC (with Philhealth payment) to your family. Your delivery date should be within the validity dates in your Philhealth receipt. Docs for filing: claim form for you, claim form for baby, MDR from Philhealth, OEC/Philhealth receipt, medical cert from hospital abroad, hospital bill/statement of account and OR, birth cert of baby (for newborn care package)

  403. edz on February 15th, 2014 10:01 pm

    hi,
    may question po ako medyo hndi ko po kasi alam kung entitled po ako sa maternity benefits, employed po ako dati, since 2010 – july 2013, last august 2013 nag resign na po ako, hndi ko po napag patuloy ang bayad, so may lapse po ako nung august and september,pero nung october – december 2013 binayaran ko na po as voluntary and ngayong jan.- march 2014 bayad ko na rin po, entitile pa rin po ba ako kahit may lapse akong 2 motnhs. which is ung august and september. due date ko po nagyung march 2014.

  404. Nora on February 16th, 2014 1:35 pm

    Hi edz, yes, you’re eligible. Sa new rules, 3 contributions within 6 months before month of delivery na lang ang kelangan for Individual Payor-Informal Sector.

  405. Nora on February 17th, 2014 6:34 am

    Hi edz, puede na ngayon ang 3 contributions lang for Individual Payor-Informal Sector, basta itong 3 contributions ay nabayaran within the 6 months before March 2014.

  406. Lee on February 22nd, 2014 6:19 pm

    Good afternoon po! Just want to ask if i will be eligible for philhealth maternity benefit. My last job was from jan 27, 2012- nov 7, 2013. I dont have work from nov 8,2013- jan26,2014. I just got back to work Jan 27 2014. I failed to pay the contributions for the said time frame. Looking forward to hear from you, god bless

  407. Nora on February 22nd, 2014 11:10 pm

    Hi Lee, do you mean 3 months ang unpaid o 3-month gap? Yes, you’re eligible. Kapag employed, ang required lang is 3 contributions paid within the 6 months immediately before month of delivery.

  408. Joyce on February 27th, 2014 4:48 pm

    Hi there! Thanks for the informative blog! Btw, I’m an OFW Philhealth member. I paid last January 2013 for 1 year coverage. When my 1 year coverage was about to expire, I asked a staff from Philhealth if I still need to pay my premiums even if I’m already declared as dependent on my husband’s MDR. He said that I don’t need to pay my premiums because I’m already covered in my husband’s Philhealth. I’ll be giving birth next month. And I kept my pre-natal care receipts for reimbursement. Can I go to philhealth and claim it or I can only claim it at the hospital where I will give birth? And my husband paid his 2014-2015 premium last November but with philhealth’s previous premium which is 1,200php for OFWs. Is he required to add the premium payment? Thanks so much. God bless!

  409. Nora on February 28th, 2014 7:06 am

    Hi Joyce, ang alam ko kelangang dagdagan ng husband mo ang payment niya for 2014 and 2015 to be able to comply with the 2400 per year rate. I suggest you bring your husband’s premium OR to Philhealth and pay additional 100 per month kahit Jan 2014 to March 2014 lang muna (if you give birth in March) or Jan to June 2014 na, or you can authorize someone to pay for you. God bless din. About your prenatal package, submit your prenatal ORs to the hospital so they can include your prenatal claim in the maternity claim. The hospital will not deduct prenatal coverage from your bill; Philhealth will send you the check.

  410. remy on March 1st, 2014 12:16 pm

    hello ma’am Nors, during my prenatal check up, they did not give me receipts. Can i still ask for the receipts for my past check up and submit it to philhealth for refund?thank You po.

  411. solange on March 1st, 2014 12:31 pm

    hi ms. nors.. im 37weeks pregnant na.. philhealth member ako since 2002.. employed ako hanggang nov. 2013, pero last january, nag-update ako to indivual payor pero january-march lang binayaran ko.. magagamit ko ba ang philhealth ko? kasi sa lying-in na panganganakan ko, pagginamit ko ang philhealth package (NSD only) wala akong babayaran sa kanila o yung No bill balance.. pero pag yung maternity package nila na worth 12k (2days room accom., NSD, painless, OB & anesthesiologist) ang iaavail ko, hindi ko daw pwede gamitin yung philhealth ko.. medyo naguguluhan ako..

  412. Nora on March 1st, 2014 3:13 pm

    Hi remy, depende na sa ob mo kung gusto niyang magbigay for past check-ups. Subukan mong humingi. Kasi yong iba pababayaran sa iyo yong tax kung hihingi ka ng OR.

  413. Nora on March 1st, 2014 3:37 pm

    Hi solange, yes, you’re eligible for maternity benefit. Sori hindi ko sure kung bakit ganon ang policy nila. Puedeng Philhealth-accredited yong midwife or OB nila for the No-balance package at puedeng hindi Philhealth-accredited yong OB nila for the 12k package.

  414. Jean on March 3rd, 2014 9:23 pm

    Gud pm ms nors! Im 14 weeks preg. Yung sa pre natal benefit po . Kasi yung OB ko po ay sonographist narin po so ang pre natal checkap ko po is done with ultrasound agad .. 300 consultation + 550 ang ultrasound.. So if ever ma claim k po ba ito..?? So mangyayari 2 receit of pre natal lang ang maisusubmit k na covered??? Thank u po..

  415. Nora on March 4th, 2014 8:12 am

    Hi Jean, puedeng idagdag mo yong additional consultation fees mo later on para at least worth 1500 pesos ang ORs. Puede ring prenatal med ORs; bahala na ang Philhealth kung anong OR ang inconsider nila

  416. Yen on March 7th, 2014 12:08 pm

    Hello..pwede ko ba magamit ang phic maternity benefits if ang status nilagay ko doon ay single?manganganak po ako by nov 2014. May tanong pa po ako i was employed last 2009 at binayaran ng company ko ng i think 2 months lng then after 3 months nagbayad ako as self employed for 1 quarter only..then nov 2011 umalis ako ng bansa at sabi ng agency namin binayaran daw nila phic ko for 1 yr..can i avail the benefits coz im going to deliver here in ph . i need to pay phic this month before ako babalik sa work abroad. Pls advise..thank you

  417. Nora on March 7th, 2014 5:10 pm

    Hi Yen, yes, maka-avail ka kahit single ang status mo kasi you have your own Philhealth membership. If your status with Philhealth is OFW, you need to pay Mar to Dec 2014 or Mar 2014 to Mar 2015 so you can avail. For OFWs, the validity dates on your premium receipt must cover the date of your delivery. If your status is Individual Payor-Informal Sector, pay Mar to Nov 2014 so you can be covered. Or pay for 1 year na lang — Mar 2014 to Mar 2015.

  418. Hanny on March 10th, 2014 8:01 pm

    Hello!
    Ask ko lng po.. I am an ofw. I paid my phic today at nakalagay don march 10,2014 to march 9, 2015..due ko po by nov 2014.. Maaavail ko ba yung philhealth maternity benefits ko kasi dito ako sa pinas manganganak. Yung jan 2013 to feb 2014 hindi ko yun nabayaran.. Am i eligible?
    Thank you

  419. Nora on March 10th, 2014 11:24 pm

    Hi Hanny, yes, eligible ka. Pag OFW, dapat ang due date ay within your premium validity dates — na tama naman in your case. kahit Individual Payor ka, eligible ka pa rin, kasi meron kang 3 paid contributions within 6 months before Nov 2014.

  420. ruth on March 13th, 2014 2:24 pm

    Good day po. Ask ko lang kung okay lang po ba na dependent ako ng mister ko kahit employed ako and have my own philhealth kase nag early leave without pay ako sa work kaya di ko mababayaran ng last 2 months ko prior to delivery.

  421. Nora on March 13th, 2014 10:04 pm

    Hi ruth, hindi puedeng dependent ang active member. I-cancel mo muna ang membership mo bago ka maging dependent. Eligible ka kung 2 or 3 months lang ang hindi mo nabayaran prior to delivery, meaning meron kang at least 3 contributions within sa 6 months before your delivery.

  422. Nana on March 27th, 2014 7:03 pm

    Hi po, ask ko lang. April 4, 2014 po ako manganganak. Nagbayad ako ng Jan to March 2014 ng P600 sa Philhealth tapos nagpa-update rin ako ng status from employed to voluntary kasi nagstop ako magwork nung June 2013. Humingi po ako ng MDR taposng informal sector yung nakalagay. Makukuha ko ba yung maternity benefit ko sa pag-anak ko ngaun April?

  423. Nora on March 28th, 2014 11:43 am

    Hi, yes, you can avail in April because you paid for the 3 months immediately before your month of delivery.

  424. diel songalia laguidao on March 28th, 2014 5:38 pm

    Hi .. I’m giving birth na po on April,2014 .. Nakapg contribute po ako when I’m employed during month of march-july 2013 then nag end contract na po ako .. If I change my status to voluntary can I pay those months na HND ako nakapag contribute ngayong march2014 example po bayaran KO na yung august3013-march2014 all at once .. Can I do that to avail the maternity package ? Plz reply thank in advance !

  425. diel songalia laguidao on March 28th, 2014 6:22 pm

    hello po.. kapg nagbayad po ba ako sa monday (march 31 2014) ng annual contributions ma a-avail ko po ba ang maternity package ng philhealth kc ang due date q po may 2014 pero mga april 20 onwards pwede na q manganak .. pero nakapag contribute na po ako last year nung employed pa ako.. during march-july 2013 ..mag change aq to voluntary .. makakahabol pa po ba ako ? plz reply tnx –

  426. Nora on March 29th, 2014 7:39 am

    Hi diel, you can no longer pay for 2013. Ang gawin mo is to register as Individual Payor-Informal Sector and then pay for Jan to Dec 2014 (1 year para sure, kasi March na). Puede pa siguro yong Jan to Mar 2014, 3 months lang, pero hindi ako sure, kasi March na, so magtanong ka na lang sa Philhealth.

  427. samantha on March 29th, 2014 9:04 am

    Hello po ma’am, just wanna ask po kung covered pa po ng Philhealth itong pregnancy ko ngayon, i have three normal deliveries na po, at nakunan po ako noong 2011 at this time po pangfifth pregnancy ko na, maavail ko pa po kaya ang maternity benefits ma’am. Thanks po.

  428. samantha on March 29th, 2014 9:10 am

    Nagamit ko lang po yong philhealth ng asawa ko for the first time nung nakunan ako ma’am nung 2011 and that was already my fourth pregnancy, as regards the first three normal deliveries di ko po ginamit ang philhealth kasi sa bahay lang po ako nanganak noon. At itong 5th pregnancy ko ma’am gusto ko sana iavail ang Philhealth Maternity Benefits if i am still allowed po.

  429. Nora on March 29th, 2014 11:13 pm

    Hi samantha, yes, puede mo pang ma-avail for your current pregnancy, kasi miscarriage yong 4th. Nakasulat sa rule ng Philhealth na: Pregnancies resulting to abortion are not covered by the limitation of coverage of vaginal deliveries of the first four births.
    Ang miscarriage is the same as spontaneous abortion. Ask others too.

  430. Nora on March 31st, 2014 8:41 am

    Hi samantha, yes, you can avail for this current pregnancy, kasi pang-4th normal delivery mo pa naman. Hindi counted na delivery yong miscarriage.

  431. Gerrymae on April 6th, 2014 7:04 pm

    I just want to ask..my sister in law will gave birth of her first baby by this month..can she already use her philhealth maternity membership already if she just started her membership she paid already there months and for this quarterly payment we want to pay already her 1 year membership..can she already used it if we can pay the 1 year payment..thanks

  432. Nora on April 7th, 2014 3:01 pm

    Hi Gerry, pay Apr 2014 to May 2015 so she can avail. Register as Individual Payor-Informal Sector. Puede sana 3 months lang, pero hindi na kasi puedeng bayaran ang Jan to Mar 2014.

  433. analyn cajurai on April 10th, 2014 2:02 pm

    Hi nor im analyn how to file my maternity benefits im pregnant and employe my employer paid the contribution from march to sept. Can i avail my bebefits ang what is the requirments

  434. Nora on April 10th, 2014 8:15 pm

    Hi analyn, ask your employer to continue paying your Philhealth. You should have paid at least 3 of the 6 months immediately BEFORE your delivery month.

  435. ladyssel on April 15th, 2014 4:59 pm

    Hi Po ask ko lang po pang 5th na pagbubuntis eto nka avail n ako ng 2 normal delivery at 2 CS delivery ung pangatlo ko po e 8mos plang nanganak na ako at after 2 weeks namatay din.mkaka avail prin kya ako ? Dependent lang ako ng husband ko.thanks so much po

  436. Kate Marie Beronilla on April 16th, 2014 12:08 pm

    Hi,I am Kate a 21 year old.It’s my first time unexpected pregnancy and because it’s unexpected I just want to know If I may be able to get any benefit from Philhealth,I am currently working right now but the only contribution that I get into it was just 10 months ,a 3 months from my previous company & a 7 months on my company right away.Can I still able to get benefit on it????

  437. Nora on April 16th, 2014 1:06 pm

    Hi Kate, yes, you’re eligible. Since you’re employed, you only need to pay at least 3 of the 6 months immediately before your month of delivery. Note that Philhealth coverage is only 5k, regardless if you go to an expensive or less expensive hospital.

  438. Nora on April 17th, 2014 9:02 am

    Hi ladyssel, if normal delivery itong 5th mo, palagay ko, hindi na, kasi pang-5th birth mo na. If CS, covered pa rin. Pero para sure, ask your hospital.

  439. carla on April 17th, 2014 1:09 pm

    hi po maan nors nanganak po aq last april 7 2014 sa usang level 2 hospital accrefdited by philhealth,ob ko and pedia ng baby both philhealth accredited..preterm po ung baby ko kc na-CS po on the 37th wik plang..my questions are…binayaran ko po nang buo ung 7k plus n para sa pedia po ng baby kasi dpo naihabol birth certificate nia nung kelangang iupdate ung beneficiaries ko sa philhealth nkapagfile n po bale pirma n lng ng ob ang kulang…ang tanong ko po ang hospital po b ang magrereimburse samin o ang philhealth po pag po naisubmit n birth certificate ng baby ko..at marereimburse po b the whole 7k..one ting mur po unwell baby po baby ko nung pinanganak magkaiba po b ang benefit ng unwell at well baby?thank you po ang God Bless…

  440. Janine on April 17th, 2014 9:58 pm

    hi po, i am 6 mos. pregnant po ngaun, expected delivery is on july. nag start ako magbayad sa philhealth july last year nung mag start ako dito sa first job ko. ask ko lang po kung qualified na ba ko sa maternity benefits and how to claim po? tnx :)

  441. Nora on April 18th, 2014 7:59 pm

    Hi carla, ang refund amount mo ay depende sa code na isusulat ng pedia; kung newborn care lang or merong certain illness na na-treat (example ay jaundice or low birth weight complications). Ang refund ay puedeng check in your name or refund thru hospital; wait for your benefit payment notice. God bless din.

  442. Nora on April 18th, 2014 8:09 pm

    Hi Janine, yes, you’re qualified. For employed, the requirement is payment of 3 months within the 6 months prior to delivery. Submit updated MDR, employer-signed claim form 1, employer cert of premium payments with OR nos. to the hospital before discharge.

Leave a Reply




THANK YOU FOR YOUR COMMENTS .
Please...NO TEXT SPEAK ... it takes time to understand. Thank you.