Are you curious to know about Philhealth maternity benefits? There are actually Philhealth maternity benefits for unemployed and employed. Read on to know more about how to avail Philhealth maternity benefits and when to file it.
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.
What is Philhealth maternity benefits for normal delivery or normal spontaneous delivery?
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 for maternity 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. There’s a difference between Philhealth maternity benefits for normal delivery and that of cesarean delivery.
Maternity Care Package
Philhealth maternity benefits for normal delivery
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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.
Cesarean Delivery Package and for other types of birth
PhilHealth benefits for maternity cover mothers who give birth via cesarean 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 cesarean section, PhilHealth covers primary and successive cesarean sections, as well as cesarean 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)
Newborn Care Package
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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
How to avail of Philhealth maternity benefits? In able to avail the Philhealth maternity benefits, you need to apply for them.
To apply for these PhilHealth maternity benefits, you must submit your updated PhilHealth Member Data Record and duly accomplished Claim Form to PhilHealth.
Aside from that, there’s another way how to avail of Philhealth maternity benefits. You can 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.
When to file Philhealth maternity benefits?
To avail of Philhealth maternity benefits, it’s important to know when to file it. So, when to file Philhealth maternity benefits? 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.
Philhealth maternity benefits for unemployed
As stated above, these benefits are not only for the employed expectant moms but also for the self-employed and unemployed soon-to-be-mommies. There are also Philhealth maternity benefits for the unemployed.
If you are unemployed, you can avail of Philhealth maternity benefits when you have at least nine posted monthly contributions before you avail the said benefits.
Aside from that, the 45-day regular limit should not have been used. In addition, you should be attended by a Philhealth-accredited doctor and admitted to a Philhealth-accredited facility.
Remember
Whether you are employed, self-employed, unemployed, or an OFW member, you can avail of the Philhealth benefits for maternity even if you fail to consistently pay your monthly premiums, as long as you meet the required minimum number of monthly contributions. That is stated in the Universal Healthcare Law.
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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) 1×1 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.
How to pay Philhealth contributions online?
As technology advances, our government offices also try to adopt digitalization in their processes. If you are an unemployed or self-employed individual, you can now pay your health insurance contributions online. You do not need to line up in a long queue in Philhealth’s branches.
Here’s what you have to do to pay your contributions online:
- Log in to the Philhealth member site and type in your Philhealth number and password.
- Once logged in, look for the “Payment Management” module.
- Generate your statement of premium account (SPA) at the portal’s payment management module. That will serve as your billing statement.
- Select the desired number of months that you will pay. You can choose from one month up to three years. After that, the module will automatically compute your total contributions for the desired payment range based on your declared income. It will also indicate your due date.
- Once your SPA is generated, you may proceed in choosing the accredited collecting agent (ACA) to process your payment. As of now, the agency’s payment partner is IPAY-MYEG Philippines Inc.
- Afterward, you will be directed to the ACA’s domain where you will make the payment. You can pay using a credit card, debit card, prepaid card, or GCash. Expect additional service fees for each transaction.
- If the payment is successful, you will receive an electronic Philhealth acknowledgment receipt (ePAR) and an email or SMS confirmation.
Mommies, aside from Philhealth benefits for maternity, you can also avail SSS maternity benefits. Check here on how you can avail of maternity benefits from your SSS contributions.
Additional information written by Jobelle Macayan
