Documents to Claim Philhealth Maternity Benefit — Individual Payor

If you are an Individual Payor, either Self-Employed or Voluntary,  here are the documents that you need to submit to claim your Philhealth maternity benefit:

Submit Documents to the Hospital before Discharge to get Immediate Deduction:

1.  Updated MDR or Member Data Record  (Get this from Philhealth)

2.  Copy of Receipts of Premium Payments  (Bring Original Copies)

3.  Philhealth Claim Form 1  (for your maternity benefit claim)

4.  Philhealth Claim form 1  (for your newborn care package claim)

5.  Just in case the hospital requires an ID, bring your Philhealth ID, if you have.  Bring another ID if you don’t have a Philhealth ID.

 
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Direct Filing at the nearest Philhealth Branch

If you were not able to submit documents to the hospital, file at the nearest Philhealth branch within 60 days after your date of discharge.  File the following documents:

—  The same documents in the list above

—  PhilHealth Claim Form 2  (Filled up by the hospital and attending physicians)

—  Official receipts issued by the hospital  (or waiver by the hospital and doctors)

—  Operative record (if surgical procedures were performed)

Updated: January 2, 2017 — 1:27 pm

70 Comments

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  1. Hi Ms. Nora this is Arnalyn pregnant me duedate ko sa November 4, 2019. May hulog yung until May 2019 ko kasi nagresign ako ngayon hindi ko alam na may due date pala yung payment ng June mahahabol ko pa po kaya bayaran yun … magagamit ko pa din kaya Phil Health benefits ko kahit may laktaw na isa or dalawa month????

  2. hellow po maam..ask ko lng po kng mag kaiba ba yong philheath na binabawas sa hospital at yong philhealth maternity benefits na inaapplayan??

  3. Hi eds, sorry hindi na tatanggapin ang payments for past years and past quarters. Since malamang hindi na siya makakabuo ng required na 9 prior monthly payments, pumunta siya sa hospital o clinic kung saan siya manganganak at magtanong about “Women about to give birth program” para maturuan siya what months to pay and when to pay.

  4. hi miss nora i would like to ask if pwede po bang bayaran ung late payment ng asawa ko po for the year 2018 since manganganak cya po ngayon and we will need the maternity package of philhealth….thanks po

  5. Hi Ms. Nora recently unemployed po ako, ang due ko po is on October 2018 and ang last hulog ko po is June 2018. Maa avail ko po ba ang maternity benefits ko? And kung mag vovoluntary member po ako need ko lang po ba pumunta sa malapit na Philhealth at magbayad? Thanks po and Godbless!

  6. Hello po. Ang Due date ko po is January 15,2019. Magbabayad po ako ng july-december 2018. Magagamit ko po ba ang philhealth ko sa pangangank? Salamat.

  7. Hi Shirley, usually hindi nila inilalagay ang recent payment sa MDR. Ang titingnan ng hospital o clinic ay ang payment receipt mo.

  8. Hello Mam Nora nagbayad po ako ng 1year contribution ko last april 30,2018 yhru Bayad Center but pagkuha ko ng MDR dipa din included ung payment ko this year.but on my contribution included naman po ung payment ko Till ,March 2019.im about to give birth this month magagamit kopa din poba ang philhealth ko kahit di update MDR ko?

  9. Hi Micah, yes, you can continue paying. Sorry hindi na puedeng bayaran yong past quarters. Start paying July to Sep, then Oct to Dec, and so on. Sa Philhealth ka muna magbayad para matanong mo rin sila about paying past quarters.

  10. Micah Joy Caunga

    Hello! Ask lang po ako kasi nag stop na akonh mag work since january 2018, nag stop din ang contribution sa philhealth.. pwd ko pa po bang icontinue ang pag contribute?? Pwd ko pa ba mabayaran yung past months na hindi ako naka pag bayad?? Thanks!

  11. Hi claudine, 9 months of past payments na ang required starting Oct 1, so pay ASAP for Apr May June (600 pesos, payment deadline is June 29 sa Philhealth, June 30 sa Bayad Center or SM), then in July or Aug, pay for July to Sep, then in Oct, pay for Oct to Dec. Puede ring bayaran mo na one time yong Apr to Dec.

  12. Hi mae, pay for April to December, kasi payment for past 9 months na ang required starting Oct 1. This June (payment deadline June 30), pay for April May June (600 pesos). Make sure to pay asap kasi hindi na tatanggapin ang bayad mo after June 30. June 29 Friday ang deadline kung sa Philhealth ka magbabayad. For July to Sep, payment deadline is Sep 30. For Oct to Dec, pay in Oct or Nov para ready na for Dec delivery. Keep your receipts.

  13. hai po.march 31 2018 po ang last day q sa work tpos nalaman ko pong buntis aq..tpos ung hulog q ng philhealth ay hnggng april lng.hnggng kailan po aq mghuhulog pra mkakuha ng maternity benefits?wla na po aqng work sa ngaun.thanks po

  14. hi ms nora tanong ko lang po nanganak po ako last 2016 then ang hulog ko lang po na nacover is 1year then na stop po kase financial problem then ngayon po buntis ulit ako and dec po ang due date ko kung huhulugan ko po ba ung mga naliban na months or almost a year mgagamit ko pa din po kya si philhealth kasi may remaining balance pako?

  15. Hi Karen, one time lang yong payment privilege given to women about to give birth. So hindi na yong program na yan ang gagamitin mo. It’s good for you na March ang due date mo. Pay Jan to March 2018 asap, then use this receipt for your March 2018 delivery. Pinostpone ng Philhealth yong implementation ng new 9-over-12 months na eligibility rule, so puede mo pang gamitin yong 3-over-6 months rule. Sa Oct 1, 2018 pa iimplement yong 9-over-12. Where did you try to pay 2,400? Sa Philhealth ba? Nagtaka naman ako na they did not suggest paying Jan to March. Pay Jan to March, then ask your hospital about it para sure. Pero dapat alam nila yong pagka-postpone ng implementation of the 9-over-12 rule.

  16. Hi Mrs Nora, i’d like to ask what should i do in order to use my philhealth this march 9, 2018. I had my philhealth last January, 2016 because i gave birth to my daughter (women about to give birth) and paid for a year to use it (P2,400) it got expired last january 2017 and i was unable to renew my account because of financial problems. I was about to update my philhealth this February 2018 but they refused to accept my payment(P2,400). What should i do to have a discount on my hospital bills with the help of philhealth? My duedate is until march 9,2018. Hoping to get your reply soon.

  17. Hi po.. ask ko lang po if ang isang ofw ay nagkaroon ng miscarriage abroad may makukuha po ba sya benefit sa philhealth and paano po?

  18. Hello po. Manganganak po ako ng last week ng sept2017 or first week ng oct2017. Hinulugan ko ung july hanggang dec. Magagamit ko po b ang philhealth ko?
    Sana masagot po salamat

  19. Hi po, due date ko na sa december 18,2017 ask ko lng po if pwede ko ba hulugan yung philhealth ko kht 3months lng.

  20. Hi ms nora june 14 2017 po due date ko pede pa po kaya ako magbayad ng philhealth ko..member na po ksi ako and last na hulog ko pa is nung ngtatrabho pa ako..mga 2006 po yta un.salamat

  21. Hi glhendalyn, to change your surname, go to Philhealth with your marriage cert (orig and xerox) and ID. Fill up the registration form.
    About paggamit ng Philhealth: Fixed ang mga coverage amounts, depende sa sakit or procedure. Pare-pareho ang benefit amount for every illness or procedure, ke nagamit na noon, or hindi pa, or employed or unemployed or indigent. Meron lang 90-day rule: Kung naospital ang member due to the same illness within 90 days, yong isang confinement lang ang mako-cover. Halimbawa, pneumonia this March, and then pneumonia uli in April, isa lang ang mako-cover.

  22. Hi po..panu po i update ung philhealth k nung dalaga ako s my aswa nku..chnge status po gnun..tska pg ngmit nb philhealth in 1year..tas ggmtin ulit mas mbba b ung kakaltas ng hospital..dlwng gmtin s isang taon..ynxs po

  23. Hi Cj, naka-depende sa diagnosis o treatment. Fixed ang coverage. Pare-pareho ang Philhealth coverage for all types of members. Halimbawa, kung pneumonia I ang diagnosis at 15k ang coverage nito, 15k ang coverage para sa lahat, kahit yong sa nagbayad ng 200 pesos per month or sa nagbayad ng 400 pesos per month.
    If you’re no longer working, puede namang dependent ka na ng husband mo para hindi ka na nagbabayad pa. Pa-update lang ng husband mo yong MDR nia.

  24. hi, good day! ask ko lang sana if nakadepende po ba ang benefits or deduction sa hospital bill sa amount po ng hulog monthly? Im an active Philhealth member at ganon din po si husband. Ayun nga lamang mas malaki ang contribution ni Husband kesa sa kin. Kung sakali po kasi ayun na lang kay husband na lamang ang gagamitin ko, at i-inactive ko ang account ko bilang wala naman na po akong trabaho. Thank you po sa inyong kasagutan.

  25. Hi Theresse Diane, meron nang circular ang Philhealth na puede nang magbayad ng monthly, pero kung kaya din lang naman, mas okay pa ring magbayad ng quarterly, or every 6 months. Yes, you can pay your Jan to March quarter in Jan 2017. Sa Bayad Center, hingi ka lang ng transaction form. Fill up the form (2 copies), write your name, address, Biller: Philhealth, Date, Philhealth ID No., Payment type: Contribution, Payor type: VM, Applicable Months, Total Amount, check Cash, Cash PhP, Total PhP, and signature. Keep your transaction form as your receipt. God bless too

  26. Theresse Diane L.Mondreza

    Hi po, monthly po ba ang hulog ng contribution as a voluntary contributor? Nagbayad po ako nung october 17,2016 ang binayaran ko po ay for the month of october 1 to Dec 31,2016. January na po ba next na hulog ko? And pano po ba magbayad ng philhealth sa bayad center? Thanks po and God bless

  27. Hi Maria Isabelle, yes. Submit a correction. Accomplish another RF-1 form (or the corresponding form, if there’s a new one). Look for the Report Type and check “Deduction to Previous RF-1”. Kung yong total amount lang ang mali, then correct the total amount. If overpayments are with some employee payments, then write only the names with incorrect amounts, and then write only the difference between the correct amounts and incorrect amounts. Your total will be the total of amount of overpayment. I think you can use the overpayment as part of your payment for the next month. Contact Philhealth.

  28. Hi gud eve! tanong ko lang po..paano kung nagkamali ng bayad sa philhealth..overpayment. kumbaga mali kase un naiestate na amount kesa dun sa actual na dapat bayadan. mairerefind pa ba yun ng employer?
    thanks!

  29. Hi pwede ko po bang ma avail ang philhealth ko kahit ang nbayaran ko lng is jan-june 2016?if manganak ako dis sept.2016 maari po bang mkaavail kahit d pa ako nkapagcontribute nang july-sept. 2016?

  30. Hi Anne, you said you paid Jan to June. Yes, you can avail of Philhealth in July for your delivery. You can avail in July even if you have not paid for July yet. To be sure, ask your clinic or hospital.

  31. hi po Ms.Nora can i ask if i am qualify to avail maternity benefits.im individual payor i will gve birth on july..i already pay Jan.-June ..i just worrying bcause i thought my duedate is this month of june but my ultrasound EDD is on july 05.Should i need to pay for july to avail benefits or i can still avail?

  32. hi again mrs nora, 6 months pa din poba ang pwede ko hulugan if ever july 30 po ako mag babayad sa philhealth?

  33. Hi bunny, yes. Make sure you have paid the 2nd quarter (Apr to June). Pay also July to Aug for continued coverage.

  34. gud day po, It was only last March 31, 2016 that my husband became a member. I’ll give birth this August or September. Can I avail of maternity benefits? thanks po..

  35. Hi marivic, you can go to Philhealth with your ID and marriage certificate and fill up registration form. Check FOR UPDATING. Use your new surname. Bring your husband’s death cert in case your records show your first husband’s name. Get your new MDR. Since your due is Oct, it’s important you’re able to pay for July to Sep. But pay also this Apr to June so you’re always covered.

  36. marivic cruz salazar

    Hi,i would like to ask what I should do. with my philhealth, I’m still married to my late hubby, but then I was widowed last april 2012. This year january I got married again and im pregnant right now and with continous contribution. What should I do to avail of my maternity benefits? Due date is Oct.

  37. Hi April, is this about your Philhealth payment? Voluntary and Self-Employed are basically the same. How did you know about your history of contributions? Just keep your Oct to Dec receipt. Pay also for Jan to Marcha and then get your MDR from Philhealth — you’ll qualify for Philhealth in March.

  38. Hi. is Voluntary different from Self-Employed? I paid contributions last dec15 for oct-dec2015. until now my payments have not been posted in my history of contributions. I guess they are not yet posted because they were marked voluntary in my receipt. I’m self-employed. I’ll be giving birth march 2016.

  39. Hi Abi, when you go to Philhealth, fill up the registration form, check “FOR UPDATING”. When Philhealth sees that you already have a valid Philhealth no., they will give you your valid Philhealth no. Your contributions for the past quarters and past years can no longer be used for availing of benefits. Sad, but that’s how hospitalization insurance works. Just like accident or fire insurance or car insurance. Philhealth says that you can get lifetime-free Philhealth membership when you turn 60 years old if you paid at least 120 premiums; but there’s already free senior-citizen Philhealth membership, so just treat your past Philhealth payments as “thanks, I didn’t get sick and I didn’t have to use Philhealth.”

  40. Hi nora, what would happen on my previous philhealth Number and contributions?

  41. Hi abi, yes, you can apply online here: http://www.philhealth.gov.ph/services/ Find Electronic Registration and click Register

  42. Hi Nora, Thanks for the answer. What if I don’t know my philhealth number. can I get a new one?

    thank you.

  43. Hi abi, yes. Do you know your Philhealth no.? You can pay your Philhealth from Dec 2015 to Dec 2016 (2,400 pesos) or Dec 2015 to May 2016 (1,200 pesos) as OFW, so you can avail in Feb 2016. Look for IRemit, or Ventaja, or the remittance partners of Landbank, DBP, Bank of Commerce and Veterans Bank, so you can pay there abroad. You can also ask your family to pay for you in the Philippines if you know your Philhealth no.

  44. Hi, April 2014 I resigned from my employer in Pilipinas. I became an OFW in June 2014. Since I left the country, I haven’t paid my Philhealth. Expected delivery date is February 21, 2016. Can I avail of philhealth maternity benefit? and how po? Thank you.

  45. Hi amie, pay for Oct to Dec 2015 at 200 pesos per month, so pay 600 pesos. Then pay 600 every quarter onwards. Pay at Philhealth, update your registration with your ID, so you can get your MDR and ID.

  46. hi how much will I pay? I had online registration with philhealth last year but was not able to pay. if i want to pay this time how much po?

  47. May philhealth na po ako sa trabaho KO then nag stop na po ako kasi buntis ako kilangan KO po yung philhealth sa panganganak KO ngaung last November kaya aasikasuhin KO anu po ba kilangan KO Gawain babayaran KO po nang kabuuan ng isang taon panu po ba ang kalakaran nito….mgknu po ba and whole year nya…tnxxx..txbk asap

  48. Hi madianne, yes. Go asap to Philhealth with your ID. Fill up form. Pay for July to Dec 2015. Get your MDR and card.

  49. Good day Ms Nora,my delivery will be on the last week of November 2015, I plan to be a philhealth member and my doctor advised me to have a cs because of my condition. Can I avail of maternity benefits if I pay for the whole year? thanks po.

  50. Tnx Ms. Nora,. I already paid my monthly contributions from Jan.- Sept. 2015.. i’ll be having a CS section this coming September..

  51. Hi Grace, it’s okay. Informal sector is a type of individual payor. just make sure you’re updated in your payments

  52. Hi Ms. Nora, is it okay that informal sector was written on my MDR? and not individually Paying Member? I’m Voluntary member. Will I have a problem or won’t the hospital question it? tnx in advance.

  53. Hi Krys, pay your Philhealth premiums asap for July to Sep, so you can use it in September.

  54. Hi po Ms. Nora. I just want to ask if I can still pay my contributions to PhilHealth and if so, can I use it for my delivery in September? I’ve been a member of Philhealth since 2011 but my MDR does not show any contributions from my employer as I was with them for only 3 months. Since then, I did not pay, I got my ID and MDR last April 2015.

  55. Hi Jisa, yes, you can avail. If your MDR or member data form is old and not clear, you should update your data to get a newer MDR.

  56. Jisa Cogonon Gomez

    Hi ms nora, I paid for Jan-June 2015 voluntary. I don’t know if it’s under Informal Sector, can I avail of my mat. benefits? Or do I need to update my data? Thanks

  57. Hi claire, sorry, the clinic must be accredited. She can appeal if she can prove it’s emergency and she’s in a remote place where there’s no Philhealth-accredited clinic that can be reached within a certain no. of hours.

  58. hi ms.nora. my friend gave birth at a lying in not accredited by philhealth. Is there a chance she can reimburse ? she’s updated in her philhealth payment.thanks.

  59. Another thing ms.nora….do i still have to pay from january-march? I already pay oct-dec. And march will be my delivery.

  60. Hi Meng, you’re an Individual Payor, so you sign your own claim form 1. Your former employer will not sign your claim form 1 because you’re no longer their employee. What you can request is a certification of premium payments with OR nos. but you don’t need those. What you can present to your lying-in is more than enough (your receipts for paying March to Sep 2014). That’s 7 months; you only need 3 of the 6 months to qualify. Pay July to Sep or months before Oct that you have’t paid yet and then get your updated MDR and then go to your lying-in and ask again, to be sure. You submit your prenatal ORs to your lying-in (no direct filing with Philhealth); they’ll submit those to Philhealth together with your maternity claim. Philhealth will send you your prenatal refund check.

  61. Hi, im individual payor since march2014, sept2013-feb2014 employer ko po ang nghulog.
    Oct ung due date ko sa lying in po ako mnga2nak. Yung req. po sa pHealth n pinakuha sken is CF1 signed w/ employer.
    Bakit po kelangan sa employer p ko kumuha nun di nman na po ako employed na, alam po un ng lying in. Di prin po ako tumwag sa dti kong employer, ganun po b tlga yun? Tsaka regarding sa reinbursement sa pre-natal package pwede po b un idirect sa pHealth branch ? O kung accredited yung lying in dpat cla ndn ung mag.file nun? Accredited nman po sila.
    Ty.

  62. Hi Ranie, she should have paid 3 months within Feb to July 2014 before June 30. The payment deadline for these months has passed. If she wants, she can go to Philhealth and ask if she can pay 1 year in advance to be able to avail.

  63. Ranie Cristo Juntilano

    Mangangank po kc ung hipag q s august2014… d p po kc xia ember ng philhealth… ano po ang dpat nyang gwin pra mkpg avail p xia ng philhealth bgo xia mangank…

  64. Hi shiela, yes, but look for a lying-in that offers no cash-out Philhealth package because not all lying-in clinics offer this no-payment package.

  65. Hi po!
    Totoo po bang no payment policy pag philhealth member at sa Lying-in clinic manganganak?
    Paano po mag apply pag ganun? Thanks!

  66. Hi alyssa, thank you very much for sharing important info to others.

  67. ang bagong rule ngayon ay dapat may payment ng at least 3 mos within 6 mos prior to your month of delivery. ex. manganganak ka april 2014,dapat jan-march 2014 nakapaghulog ka.kung nakapanganak ka na at wala kang philhealth o matagal ng di nahulugan,bayaran lang ang buong 2014 worth 2400.00 pwede ng maka.avail

  68. yung due date ko po april 2014. nagbayad na po ko ng hanggang june 2014. kkparegister ko lang po nitong february. ma- aavail ko prin po kaya yung maternity benefits ko?

  69. Hi jola, yes, update asap, this month, your MDR para ang category mo ay Individual Payor – Informal Sector at a Philhealth branch and then pay Oct Nov and Dec 2013. Kasi sabi nila puede na ang payment of 3 months for the Informal Sector. Tanungin mo rin doon. The other option is to pay for 1 year – Oct 2013 to Sep 2014.

  70. what if my due date is january 2014 at last contribution ko ay january 2013 qualified pa kaya ako? or pwede kaya ako humabol maka bayad para ma avail ko ung service ng philhealth? salamat po

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