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PhilHealth Maternity Benefits: How to Claim, Requirements, and Coverage for Normal & Cesarean Delivery

4 min read
PhilHealth Maternity Benefits: How to Claim, Requirements, and Coverage for Normal & Cesarean Delivery

Learn how to claim your PhilHealth maternity benefits in 2025. Get the latest requirements, benefit amounts, and steps for normal and cesarean delivery coverage.

Giving birth can be both joyful and overwhelming, especially when it comes to the expenses involved. Thankfully, PhilHealth continues to offer financial support through its maternity benefits program for both normal and cesarean deliveries.

This updated guide explains how much assistance you can expect, who can avail of it, and how to claim your benefits step-by-step, so you can focus on what truly matters: welcoming your baby into the world.

Talaan ng Nilalaman

  • What Are PhilHealth Maternity Benefits?
  • Newborn Care Package
  • Z Benefits for Premature or Small Newborns
  • How to Avail of PhilHealth Maternity Benefits
  • Who Can Avail?
  • Tips to Maximize Your PhilHealth Maternity Benefits
  • How to Register as a PhilHealth Member
  • PhilHealth Contribution Rates (2025)
  • How to Pay Contributions Online (For Self-Employed or Unemployed)
  • Final Reminder for Moms

What Are PhilHealth Maternity Benefits?

PhilHealth offers several packages to help ease the financial burden of childbirth:

1. Maternity Care Package

  • For normal deliveries at accredited birthing homes, maternity clinics, lying-in clinics, infirmaries, and dispensaries.
  • Total Coverage: Php 8,000
    • Prenatal checkups
    • Delivery and postpartum care
    • Room and board
    • Medicines, labs, and procedures
    • Tetanus immunization
    • Follow-up checkups (3–7 days after birth)

2. Normal Spontaneous Delivery (NSD) Package

  • For normal deliveries in accredited hospitals or non-hospital facilities.
  • Total Coverage: Php 6,500
    • Php 3,000 for the facility
    • Php 2,500 for the doctor
    • Php 1,000 for prenatal care

3. Cesarean Section Package

  • Total Coverage: Php 19,000
    • Php 11,400 for the hospital
    • Php 7,600 for the doctor

4. Other Covered Deliveries

  • Vaginal delivery after C-section or breech extraction – Php 12,120
  • Complicated vaginal delivery – Php 9,700

Newborn Care Package

PhilHealth also offers Php 2,950 for newborn care, which includes:

  • Newborn supplies (Vitamin K, eye ointment, BCG, hepatitis B vaccine)
  • Doctor’s fee
  • Expanded Newborn Screening (ENBS)
  • Newborn Hearing Screening (NHST)

Z Benefits for Premature or Small Newborns

For preterm delivery and premature babies:

  • Mothers at risk of preterm delivery: Php 600–Php 4,000
  • Babies born 24–<32 weeks: Php 35,000–Php 135,000
  • Babies born 32–<37 weeks: Php 24,000–Php 71,000

How to Avail of PhilHealth Maternity Benefits

philhealth maternity benefits

PhilHealth Maternity Benefits: How to Claim, Requirements, and Coverage for Normal & Cesarean Delivery

Requirements:

  • Updated PhilHealth Member Data Record (MDR)
  • PhilHealth Claim Form 1 (signed by member and employer, if employed)
  • Proof of contributions
  • Valid ID
  • Clinical or medical records

Process:

  1. Before admission: Prepare all documents.
  2. During admission: Submit documents to the hospital.
  3. After discharge: The hospital files the claim.

Note: Only PhilHealth-accredited facilities and professionals are eligible.

When to File Claims

  • Submit within 60 days after discharge.

Who Can Avail?

Employed:

  • At least 3 contributions within the last 6 months.

Voluntary/Unemployed:

  • At least 9 contributions within the last 12 months.

OFWs and Sponsored Members:

  • Membership must be active during availment.

Tips to Maximize Your PhilHealth Maternity Benefits

  1. Go to a PhilHealth-accredited provider early in pregnancy.
  2. Attend regular prenatal checkups and keep your mother’s book.
  3. Keep contributions updated.
  4. Choose a PhilHealth-accredited facility for delivery.

How to Register as a PhilHealth Member

  1. Visit the nearest PhilHealth office or Express outlet.
  2. Fill out two PMRF forms.
  3. Submit with two 1×1 ID photos and valid IDs.
  4. Receive your Member Data Record and ID.
  5. Pay the premium using your PhilHealth number.

PhilHealth Contribution Rates (2025)

Employed:

  • Based on salary:
    • Php 10,000 and below: Php 500
    • Php 10,000.01 to Php 90,000.00: Up to Php 4,500
  • Shared equally by employee and employer.

Voluntary/Self-Employed:

  • Same rates based on declared income.

How to Pay Contributions Online (For Self-Employed or Unemployed)

  1. Visit https://www.philhealth.gov.ph
  2. Go to “Payment Management.”
  3. Generate your Statement of Premium Account (SPA).
  4. Choose payment period.
  5. Select a payment partner (e.g., IPAY-MYEG).
  6. Pay using card or GCash.
  7. Get your ePAR and confirmation.

 

Final Reminder for Moms

PhilHealth’s maternity benefits can significantly ease the financial burden of childbirth. Whether you’re having a normal or cesarean delivery, knowing your entitlements, requirements, and how to file your claim ensures you don’t miss out on this helpful support.

If you meet all the qualifications and follow the steps carefully, you can maximize your benefits and worry less about hospital bills. It will give you peace of mind as you care for your newborn.

You may still qualify for benefits under the Universal Healthcare Law as long as you meet the contribution requirements, even if you’re unemployed.

Bonus Tip: Check if You’re Also Eligible for SSS Maternity Benefits

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Sinulat ni

Patricia de Castro-Cuyugan

Maging Contributor

Inedit ni:

Irish Mae Manlapaz

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