Philhealth Benefits — Case Rates Payments for Certain Medical and Surgical Cases

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  1. Hi question lang po. My father was diagnosed na may high risk pneumonia. Pero naintubate siya and naconfine ng 9 days.yung fixed rate lang ba ng pneumonia ang mababawas sa bill namin? Or may ibang rate yun pag naintubate sya. Thank you and Godbless.

  2. Hi Rosalie, your sister can avail of 90 sessions of hemodialysis per year, with a coverage of 2,600 pesos per session (equivalent to 2,600 x 90 sessions = 234k pesos per year. Yong hindi ma-cover ng 2,600, yon ang babayaran ninyo. Covered pa rin siya for confinements for other illnesses if needed (45 days per year), with fixed coverages depending on the diagnosis. Find a clinic offering a Philhealth dialysis package na konti na lang ang idagdag ninyo.
    If it’s peritoneal dialysis, every 4 days of dialysis is equivalent to 1 day na ibabawas sa 90-day allowance per year. The insertion of the cannula has a separate coverage.
    Some info here: Hemodialysis

  3. hi
    na confine ako for 2days due to pre term labor and infection sa uti.. ilang percent kaya ma dededuct sa total bill ko..kompleto naman kami ng naipasa sa philhealth bago p ako ma admit nasa 15k n kc ang bill nmin.

    thanks

  4. Hi yhen, fixed ang Philhealth deductions, depending on the illness. At isang illness lang ang kino-cover, yong more expensive. Kung UTI yong mas costly, at UTI during pregnancy ang diagnosis, 4k ang coverage (2,800 sa hospital; 1,200 sa doctor). Kapag admissible UTI ang diagnosis, 7,500 ang coverage.

  5. hi, nakaconfine po ako mag 3 days na. measles lang pala, ang problema ko po yung private duty nurse or special nurse ang mahal, hindi pa covered ng HMO ko, macocover po ba yun ng philhealth if ever?

  6. Hi po aask ko LNG po LNG sakop ba ng biophsy ang philhealth ..may breast lump po kasi aqo at need ko magpabiophsy …covered po ba xa ..a??at magkno magagastos po ???

  7. Hello, ang brother ko po ay nagdadialyis at nung 2016 naubos na po ung 90 sessions sa Philhealth. Naconfine po sya last December 2016 at malaki po ang naging bill nila sa hospital dahil hindi na binawasan ng Philhealth dahil ubos na raw po sa dialyis. Tama po ba yun? Thanks in advance for your reply.

  8. my father diagnosed with kidney stone and referred by doctor for operation and adviced to prepare 50k pesos. my father is a senior citizen and our family cannot afford for that amount, and my question is… is there anyway that my father be operated for free? thanks! please!

  9. Hi I am a dependent of my husband. I opted to have my surgery in a government hospital in Cebu Vicente Sotto Hospital. It’s to remove a mass or tumor in my tongue. How much should I expect to be deducted from my bill? And If I will choose my own specialist doctor, will Philhealth pay them as well? I am sure they will ask for a separate Professional fee too.Thanks.

  10. Hi Quennie, sorry I’m not sure of the amount. I can see only these 2 on the list: Excision of tongue lesion – coverage is 9,300. Excision of cyst or abscess – coverage is 5680. It’s better that you ask the billing dept. It’s most likely that you will pay the whole PF of your specialist doctor because you’re choosing him. It’s also a common practice among government hospitals to have the patient buy supplies or meds before the surgery if these are not available at the hospital. If this is the case there, have your receipts in your complete name and keep copies.

  11. Hello ask ko lng po if may possible surgery regarding sa extraction of third molloar inside the maxillary sinus… magkano po ung u ccover ng philhealth? thanks

  12. Ask ko lang po kung d po ba sakot anh doctors professioonal fee? Yung pmankin ko po was diagnosed with pneumonia and stayed at hospital fir 5 days.. ang mahal ng doctors fee umabot

  13. Hi,ask ko lng po bakit di tinanggap ng phihealth section sa hospital ang philhealth nmin kasi daw na aksidente ang asawa ko,bakit di po ba covered ng philhealth ang accident sa binabayaran nmin?thank you po in advance

  14. mam good evening,i want to ask about using philhealth within two times (JAN 14,2017 and FEB.3,THIS COMING FRIDAY)due to my wife kidney stone shockwave,first was made last Jan,14 in left side and on Feb 3 must under go shockwave again in right portion of kidney,is it possible covered by philhealth?

  15. Hi mam nora ofw po ako 2years kona po di na rerenue ang philhealth ko pwede ko po ba pabayaran sa family ko 2400 pesos.thanks po.

  16. Yong brother ko po nsa ospital ngaun nag undergo ng acute apedixites operation at umabot na ng 100k ang bills namin magkanu kaya ang cover ng philhealth nun…thank you po.

  17. Hi Jinky, total coverage for appendectomy is 24k pesos (14,400 pesos — for hospital expenses; 9,600 pesos — for doctor).

  18. hi ung anak ko po na admit last week sa Manila med 4 day my nomnya risk 1 itanung k lng po sa philhealth po ba may kahati ang doctor s na imbis nka discount po ako ng 15k ang philhealth po, naging 10,500 n lng po kc dw my Hati ang doctor sa halagang 4,500.

  19. hello po for operation kasi ang mother ko, hysterectomy and removal of cyst on the left side. sabi ng doctor around 150-170k ang magagastos, she has phil health and senior citizen ID. Gusto ko lng po malamaan if how much kaya ang discount na mababawas. salamat po

  20. Hi alex, yes, 38k ang Philhealth deduction kung CVA 2 or hemorrhagic stroke yong diagnosis sa father mo. Yong 38k coverage is allotted as 11,400 for doctor and 26,600 for hospital costs

  21. hi po for operation kasi ang mother ko, hysterectomy and removal of cyst on the left side. sabi ng doctor around 150-170k ang magagastos, she has phil health and senior citizen ID. Gusto ko lng po malamaan if how much kaya ang discount na mababawas. salamat po

  22. Hi mik, sorry konti lang ang mababawas compared to the total bill. Isang procedure lang ang iko-cover ng Philhealth at malamang it’s hysterectomy kasi it’s the costlier procedure. Philhealth’s coverage for abdominal hysterectomy is 30k lang (12k for doctor and 18k for hospital costs). Yong senior citizen ID ay makakakuha ng discount doon lang sa certain medicines. If you decide so, you can ask other hospitals or surgeons or ob-gynes.

  23. hi po,ask q lang po sana,kc yung father is 76 yrs old na po at need daw niya maoperahan sa ulo kasi may namoo na dugo sa utak nea,sa ngayon nasa hospital po siya,divine mercy hospital,dapat po sana sked ng surgery niya sa friday po,feb.10,pero mejo alanganin po kc need ng malaking pera,ask q lang po sana qng meron po ba aqng makukuhang financial na tulong at kung mag kaano po.ofw po aq d2 sa taiwan.maraming salamat po sa tutugon.bayad po aq ng philhealth contribution q ng 1year,mag eexpired po ngayong april.

  24. Hi lolita, sorry pero fixed ang coverage ng Philhealth at maliit lang na portion ang iko-cover compared sa total bill. Tanungin dapat sa doctor at hospital kung magkano ang total bill after Philhealth deduction para maka-decide ang family. Tanungin din kung merong PCSO liaison officer ang hospital para ma-estimate kung magkano ang mahihingi sa PCSO kung mag-apply for assistance. Take care and prayers for you for strength

  25. Gud day po sa inyo Sir/Madamme:my mother is a senior citizen and had a stoke(infarct),today is her 11th day in the ICU,complicated with pneumonia.If she were to stay in the hospital yet for a month or more,ma’am/sir,may we please know how much of her hospital bill can be covered?
    Thanks.

  26. Hi po. ask lang po ako. My husband po had undergone herniorraphy. But we had paid separately the doctor professional fee in cash. Possible po ba na mareinbursed po yung binayad sa doctor?

  27. Hi Cherrey, doon ba sa bill, walang Philhealth deduction for PF? If none, wait for the benefit payment notice from Philhealth, and check the allocation for PF, then present it to the hospital for refund, including all hospital docs. Pero it’s sad that many hospitals do not refund, at sasabihin nila dagdag pa yong galing sa Philhealth para sa PF ng doctor. Try nio lang.

  28. hi po. itatanong ko lang po sana kung maccover po ba ng philhealth ung confinement ng baby ko due to infection(high white blood cell).kaka’cs ko lang po nung 14, then feb15 po naconfine na po xa.. magkano po kaya ung deduction ng philhealth para po sa ganong case?
    fixed din po ba ung deduction kahit mas malaki po ung contribution?
    salamat po..

  29. Hi nikki, yes, covered siya kasi dependent mo siya, kahit sabay kayo, basta yong diagnosis niya ay nasa Philhealth list. Ask the nurse about the Philhealth form for your baby, or have someone ask the billing department. Yes, fixed din ang coverage, kahit higher yong contribution.

  30. Ask ko lng po sana kung magkano ang package rate ng philhealth for scoliosis surgery. Niece ko ho kc ay na ka sked for said surgery sa orthopedic. Voluntary member lng ang mother nya at 17 years old lng ho ang niece ko.

  31. Hello Maam.. Ask ko lng po sana kung magkano ho ang sagot ng philhealth for scoliosis surgery. Naka sked ho kc niece ko ng scoliosis surgery sa orthopedic hospital. 17 years old cya at voluntary member ng philhealth ang mother nya. Thank u po.

  32. gudam maam..my husband was admitted due to acute MI then he was also diagnosed for having moderate risk pneumonia..according to the philhealth representative in the hospital we could only avail the package benefits for MI and nothing for pneumonia..our bill reaches 83k excluding medicines we purchased outside which reach more or less 40k..is it right that we can’t avail the package for pneumonia?my husband needs to undergo angiogram procedure how much is the package for such procedure and how can we avail it..thank you..

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