12/03/2014

How to Avail of Philhealth Benefits as Individual Payor or Voluntary

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To avail of Philhealth benefits as individual payor or Voluntary or Self-Employed, you should register first as Philhealth member.

HOW TO REGISTER for PHILHEALTH MEMBERSHIP

or HOW TO UPDATE your Philhealth Membership:

1.  Prepare your ID or any identification document and 600 pesos.

2.  If you are married, prepare your marriage certificate (orig and xerox).
     If you have children, prepare their birth certificates (orig and xerox).

3.  Go to the nearest Philhealth branch with the above documents.

4.  Fill up the PMRF form. (Philhealth Member Registration Form)

5.  Submit your PMRF and documents.

6.  Receive your MDR and Philhealth card.

7.  Pay 600 pesos for the current quarter.
     You can pay 1,200 pesos for 6 months
      or 2,400 pesos for 1 year.

     You ARE NOT ALLOWED to pay for the PAST QUARTER.

8.  Keep your receipt (original and xerox copies).
     Hospitals do not accept receipts that cannot be read due to damage.



HOW TO AVAIL of PHILHEALTH BENEFITS:

Present the following documents to the hospital or clinic BEFORE discharge:

1.  Clear and recent copy of your Member Data Record (MDR)

2.  Clear copy of your Philhealth premium payment receipt
     (Payment of at least 3 months within 6 months prior to hospitalization)

3.  Philhealth Claim Form 1
      (Fill up the form in CAPITAL LETTERS correctly and completely.
        Check appropriate boxes.)

4.  Clear copy of your Philhealth card or ID or any valid ID
      (Some hospitals require this)

5.  If you are a dependent, your name must be written in the MDR.
     (If MDR is not yet updated, you can present your birth certificate or marriage certificate, but many hospitals require updated MDRs).

6.  If the Philhealth member cannot be present to sign Claim Form 1 for the dependent patient, the member's spouse, child, parent, sibling or guardian can sign in behalf of the member.
     (Some hospitals require marriage certificate or birth certificate)

REMEMBER, present your Philhealth documents BEFORE DISCHARGE.
Make sure your Philhealth benefit has been deducted from your Hospital Bill BEFORE Discharge.

YOU CAN NO LONGER file for refund from Philhealth.  Philhealth NO longer allows Direct Filing by members at any Philhealth branch.

Only members confined OVERSEAS can file directly with Philhealth,
and only those with VALID reasons can file an appeal with Philhealth.


WHEN CAN YOU USE YOUR PHILHEALTH?

If you are a new member or newly updated, and you have paid for the current quarter, you can start using it on the third month of the quarter you paid and in the next quarter.
Example: You paid the premiums for July-August-September quarter.  You can use it starting September.

The rule is:  BEFORE confinement or treatment, you must have paid at least 3 of the 6 months PRIOR to hospitalization or treatment.  
Month of hospitalization is included in the counting of 6 months.
Premium payment on or after admission date is not accepted for current confinement.

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