Are you curious to know about Philhealth maternity benefits? Read on to know more.
What can you read in this article?
- What are the Philhealth maternity benefits?
- How to apply for PhilHealth maternity benefits
They say that a baby is always a blessing, and so families often receive pregnancies with much excitement and infanticipation. At the same time, starting from day one of pregnancy, health and medical expenses are already present.
The best way to ease and address the financial burden that comes with carrying a child is to become fully aware of your benefits and entitlements and make the most out of them.
For its members, for example, PhilHealth Benefits include a Normal Spontaneous Delivery (NSD) and a Maternity Care Package. The NSD Package is applicable for births in accredited hospitals. The Maternity Care Package is for births in birthing homes, midwife clinics, and lying-in clinics.
What are the Philhealth maternity benefits?
Expectant moms may expect PhilHealth benefits of varied coverage, depending on the type of delivery, whether normal or cesarean. It also depends on the type of hospital or medical facility where the procedure takes place.
Maternity Care Package
Woman photo created by valuavitaly - www.freepik.com
For women who give birth via normal delivery in maternity clinics, lying-in clinic, dispensaries, infirmaries, birthing homes, and other accredited non-hospital facilities, the total coverage amounts to Php8,000. This will cover fees for the medical facility and professional handling the case, as well as prenatal care.
The P8,000 PhilHealth maternity care package includes the following:
- Pre-natal care
- Professional fees for accredited doctors and fees for facilities mothers use for delivery and postpartum care, and reproductive health, breastfeeding, and newborn screening counseling.
- Room and board at the hospital or medical facility
- Necessary medicine
- Laboratory fees, supplies, and other additional procedures
- Immunization for tetanus
- Follow-up checkups from three to seven days after childbirth
Normal Spontaneous Delivery Package
For normal deliveries in PhilHealth accredited hospitals and accredited non-hospital facilities the Philhealth maternity benefits are the same as those stated above. But the total receivable amount is only P6,500. However, this is broken down into three parts: P3,000 for the medical facility, P2,500 for the professional fee, and P1,000 for prenatal care expenses.
Caesarean Delivery Package and for other types of birth
PhilHealth maternity benefits cover mothers who give birth via caesarean section, with a total fixed amount of P19,000. PhilHealth divides this amount in two parts: P11,400 for hospital and medical fees and P7,600 for doctors’ fees. This benefit only covers the first four normal delivery births.
In the case of a caesarean section, PhilHealth covers primary and successive caesarean sections, as well as caesarean delivery resulting from an unsuccessful vaginal delivery for those who previously gave birth via c-section.
PhilHealth also has maternity benefit packages for other types of birth such as the following:
- P12,120 for vaginal delivery after C-section/breech extraction
- P9,700 for complicated vaginal delivery)
READ:
6 Best Maternity Insurance in the Philippines
Maternity hospitals in Manila for 2021: Maternity packages and rates
Lahat ng kailangan mong malaman kung paano mag-claim ng SSS maternity benefit
Newborn Care Package
Baby photo created by KamranAydinov - www.freepik.com
PhilHealth also offers Newborn Care Package amounting to P2,950 which includes the following:
- Essential newborn care supplies such as Vitamin K, eye ointment, vaccines for hepatitis B and BCG
- Doctor's professional fee
- Expanded Newborn Screening Test or ENBS
- Newborn Hearing Screening Test or NHST
Z Benefits for Premature and Small Newborns
Another maternity benefit that PhilHealth offers is the Z Benefit for premature and small newborns. This includes a benefit package for preterm delivery prevention that amounts from P600 to P4,000. The package can be availed by pregnant women who are in their 24 to 36 and 6/7 weeks of gestation who are at risk of pre-term delivery.
While the benefit package for a premature newborn with a fetal age of 24 weeks to less than 32 weeks amounts from P35,000 to P135,000. Then P24,000 to P71,000 for premature newborns with a fetal age of 32 weeks to less than 37 weeks.
How to apply for PhilHealth maternity benefits
To apply for these PhilHealth maternity benefits, you must submit your updated PhilHealth Member Data Record and duly accomplished Claim Form to PhilHealth.
You can also check your PhilHealth contribution online so you won't need to visit the nearest PhilHealth office to check.
You will also need to include some necessary documentary attachments, such as official receipts, marriage certificates, and proof of identification. This must be done within 60 days from your hospital discharge date.
Requirements for PhilHealth maternity benefits
In order to become eligible to avail of Philhealth maternity benefits, members should meet a required number of contributions prior to the month when this is to be availed.
1. For Employed members, the requirement is at least three months of contributions within the 6 months immediately before availment.
2. For Individually Paying members, a total of 9 months’ contributions must be made within the 12 months prior to availing it.
3. For sponsored and OFW members, this benefit may be enjoyed as long as the date of availment falls within the membership validity period.
How can a pregnant woman receive the full benefits for PhilHealth maternity packages?
According to PhilHealth, in order to avail the full benefits of their maternity packages, a pregnant woman should do the following:
- She should consult a PhilHealth accredited health care provider upon the first signs and symptoms of pregnancy. Through this, she will be given the necessary health services and the status of her PhilHealth membership will be verified and updated.
- The pregnant woman should regularly consult her health care provider. She should also secure a mother's book with records of her consultation.
- Aside from updating her PhilHealth membership, the pregnant woman should also ensure that she pays her premium contributions on time.
- She should also make sure that she'll give birth to a PhilHealth accredited health care institution.
Steps on how to be a PhilHealth member
If you are planning to get pregnant anytime soon and want to avail yourself of PhilHealth maternity benefits, here are the steps you need to take to become a PhilHealth member.
- First, visit any PhilHealth Insurance Offices or Express outlets near you.
- In the PhilHealth office or outlet, you will be instructed to fill out 2 copies, of the PhilHealth Member Registration Form (PMRF)
- After filling up the registration form submit it to the PhilHealth officer together with your Two (2) 1x1 latest ID picture and 2 valid IDs.
- Wait for your printed Member Data Record (MDR) and PhilHealth ID Card
- Pay the necessary premium contribution using your PhilHealth ID number.
How much is PhilHealth's premium contribution?
As of the moment, the monthly PhilHealth contribution rate for employed members has increased as part of the full implementation of the Universal Health Care (UHC) Law.
For employed members with a salary of P10,000 and below, the fixed monthly contribution is P350. While for those who are earning a salary of P10,000.01 to P69,999.99 per month, the monthly contribution is P350 to P2,449.99. And for those who are earning P70,000 and above, the fixed monthly contribution is P2,450.
The monthly premium for employed members will be shared equally between the employee and the employer.
The voluntary or self-employed PhilHealth members will also follow the same PhilHealth premium rate based on their monthly income.
For ease of transaction, especially at this time of the pandemic, you can take advantage of PhilHealth online services by visiting their website www.philhealth.gov.ph.
Source:
PhilHealth
ABOUT THE AUTHOR: Patricia Cuyugan
Edited by: Irish Mae Manlapaz
