Healthcare in the Philippines continues to evolve, and one of the most important pillars of affordable care is the PhilHealth program. As the national health insurance agency, PhilHealth provides financial support for Filipinos who need inpatient care, outpatient services, and other specialized health packages.
Knowing how to avail your PhilHealth benefits is essential for both financial security and peace of mind, especially in times of medical emergencies.
At Unihealth Southwoods Hospital, we take pride in being a PhilHealth-accredited hospital in Laguna. This means our patients can conveniently use their PhilHealth coverage for a wide range of treatments, from minor outpatient procedures to more difficult inpatient services procedures such as debridement.
Understanding PhilHealth in the Philippines
The Philippine Health Insurance Corporation (PHILHEALTH) was established to make healthcare more affordable and accessible for Filipinos. Membership is mandatory for all employed and self-employed individuals, as well as OFWs, indigents, and senior citizens.
Unemployed and non-working individuals may voluntarily enroll because PhilHealth has specific programs to ensure they have coverage.
Monthly contributions are pooled to provide financial coverage for hospitalizations, outpatient procedures, and preventive health services. You may even access PhilHealth online for updating your records, getting information on PhilHealth case rates and benefits packages and more.
PhilHealth’s mission is clear: to protect every Filipino from financial hardship caused by health-related expenses.
PhilHealth membership ensures you have access to accredited hospitals and clinics nationwide, whether you live in Metro Manila, provincial areas like Laguna, or abroad as an OFW.
Why PhilHealth Membership Matters
Being a PhilHealth member means you are entitled to subsidized healthcare costs. Hospital bills in the Philippines can be overwhelming, especially for major operations or long-term treatments. With PhilHealth coverage in the Philippines, families can significantly reduces these expenses, giving them more breathing room financially.
Additionally, PhilHealth supports preventive healthcare by offering programs like the
YAKAP or Konsulta Package, encouraging members to prioritize checkups before
illnesses worsen.
For those living in southern Luzon, hospitals like Unihealth Southwoods serve as a trusted healthcare partner in maximizing these benefits.
Types of PhilHealth Benefits
PhilHealth covers a broad range of medical needs, categorized into several benefit packages:
Inpatient Benefits
When admitted to a hospital, you can claim PhilHealth inpatient benefits. Members can receive financial support for room and board, drugs, medicines, laboratory exams, and professional fees.
Coverage depends on case rates, which are fixed amounts based on the illness or
procedure.
Outpatient Benefits
PhilHealth also supports patients who don’t need hospital confinement.
These include day surgeries, dialysis sessions, cancer treatment procedures, cardiac rehabilitation and primary care consultations under accredited facilities.
Special PhilHealth Packages
Some medical needs require dedicated programs. PhilHealth provides:
YAKAP, previously known as Konsulta Package
The YAKAP or Konsulta program covers preventive and promotive healthcare such as medical checkups, laboratory tests, and medicines for common illnesses like diabetes and hypertension.
Maternity Care Package
Financial support for mothers giving birth in accredited hospitals or birthing facilities.
Requirements for Availing PhilHealth Benefits
Patients can conveniently avail of PhilHealth benefits in Laguna hospitals such as Unihealth Southwoods, which is an accredited healthcare facility.
To use your PhilHealth benefits, you need to present the following:
- PhilHealth ID and Member Data Record (MDR)
- Proof of contributions (latest payment receipt, if required)
- Valid government-issued ID
- PhilHealth Claim Form (provided by the hospital)
For dependents, proof of relationship (e.g., birth certificate, marriage certificate) is necessary. At Unihealth Southwoods Hospital, our staff assists patients in processing these documents to avoid delays.
Step-by-Step Guide on How to Avail PhilHealth Benefits
How to apply PhilHealth for inpatient
Hospital Admission with PhilHealth:
- Get admitted to a PhilHealth-accredited hospital like Unihealth Southwoods.
- Present your PhilHealth ID, MDR, and valid ID.
- Fill out the PhilHealth Benefit Eligibility Form (PBEF) at the admitting office.
- Patient/relative would be advised on additional documents, if needed.
Hospital Discharge with PhilHealth:
- The patient’s chart would be evaluated (diagnosis, case rate, and criteria).
- The PhilHealth coverage amount will be deducted from the total bill.
- The deduction will be forwarded to billing.
- Once processed, the final bill will be given to the patient/relative.
- Accomplish and submit required PhilHealth forms prior settlement of payment.
How to apply PhilHealth for outpatient
- Visit an accredited outpatient facility or hospital.
- Submit your requirements and undergo evaluation.
- PhilHealth coverage is directly applied to your medical bill.
Unihealth Southwoods Hospital Outpatient Procedures:
- Extracorporeal Shock Wave Lithrotripsy (ESWL)
- Cystoscopy
- Arteriovenous Fistula (AVF) Creation
- Internal Jugular (IJ) Catheter
- Saline Infusion Sonohysterography (SISH)
- Bone Marrow Aspiration with Biopsy
- Excision Biopsy
- Cervical Lymphadenectomy
- Chemotherapy
- Closed Reduction/Closed Treatment
- Casting
- Colonoscopy
- Esophagogastroduodenoscopy (EGD)
- Wound debridement
- Fasciectomy
- Ungiectomy
- Nasal Endoscopy
- Flexible Laryngoscopy
- Vasectomy
- Cataract
- Pterygium Treatment
- Laser Iridotomy
- YAG Capsulotomy
- Injection of Vitreous Substitute Intravitreal Injection
Cardiac Catheterization Laboratory (CATHLAB)
- Coronary Angiogram (CA)
- Angioplasty (PCI)
- Pulmonary Angiography with Percutaneous Endo vascular Intervention
- Percutaneous Transhepatic Biliary Drainage (PTBD)
- Cerebral Angiography with Stenting/Coiling
- Peripheral Angiogram
- Mesentic Angiogram with Embolization
How Unihealth Southwoods Hospital Supports PhilHealth Members
Accredited PhilHealth Facility
Unihealth Southwoods is the best place you can maximize your PhilHealth benefits in the South. Being fully accredited by PhilHealth, we ensure that members can access their benefits without hassle.
Assistance with Claims and PhilHealth Requirements
Our administrative team helps patients prepare all necessary forms, from claim documents to contribution validation.
Accessible Healthcare for Laguna and Nearby Areas
Unihealth Southwoods serves patients from surrounding areas, making PhilHealth benefits in Laguna easier to claim for residents.
Tips to Maximize Your PhilHealth Benefits
- Always keep your PhilHealth contributions updated.
- You may also access the PhilHealth portal for the PhilHealth MDR form, and other membership information.
- Register your qualified dependents.
- Choose accredited hospitals and clinics like Unihealth Southwoods Hospital.
- Familiarize yourself with the PhilHealth case rates to know your expected coverage.
- Take advantage of preventive services under the Konsulta Package.
Common Challenges When Availing PhilHealth Benefits
Some members encounter delays due to incomplete documents or outdated contributions. Others are unaware of their dependents’ eligibility.
You may seek assistance from hospitals like Unihealth Southwoods, to discuss your eligibility for different PhilHealth programs, depending on your case.
Who can get PhilHealth Benefits in the Philippines
PhilHealth provides healthcare coverage to various sectors of society, from employees and freelancers to OFWs and senior citizens. Here’s an overview of who is entitled to PhilHealth coverage in the Philippines.
PhilHealth Benefits for OFWs and Their Families
Overseas Filipino Workers (OFWs) are automatically covered by PhilHealth through their contributions abroad. Their legal dependents in the Philippines can also avail of benefits.
PhilHealth Benefits for Employees
All private and government employees in the Philippines are mandatorily enrolled in PhilHealth. Contributions are typically shared between the employer and employee,
making healthcare coverage more accessible.
Employees and their qualified dependents can avail of PhilHealth benefits during hospitalization, outpatient procedures, and other covered medical services.
PhilHealth Benefits for Freelancers
Self-employed individuals, freelancers, and professionals without a fixed employer can also enjoy PhilHealth coverage by paying their contributions directly. This ensures that even those working independently or in the gig economy have access to healthcare benefits. Freelancers can register under the “Informal Economy” category and include their dependents for broader protection.
PhilHealth Benefits for Senior Citizens
Under Republic Act 10645, all Filipino senior citizens aged 60 and above are automatically covered by PhilHealth, even if they have never contributed before. Senior citizens in the Philippines can avail of inpatient, outpatient, and special benefit packages in PhilHealth accredited hospitals and clinics, making healthcare more accessible in their retirement years.
Conclusion
PhilHealth benefits serve as a lifeline for millions of Filipinos, ensuring access to affordable healthcare services such as inpatient, outpatient, and specialized packages. With accredited facilities like Unihealth Southwoods Hospital in Laguna, members can easily claim these benefits and focus on recovery instead of worrying about costs.
By keeping contributions updated and seeking assistance from trusted healthcare providers, every Filipino can maximize their PhilHealth coverage for a healthier, more secure future.
Get the most out of your PhilHealth benefits by availing of our comprehensive medical services at Unihealth Southwoods Hospital.
FAQs
1. What illnesses are covered by PhilHealth inpatient benefits?
PhilHealth covers a wide range of illnesses, each with a fixed case rate, including pneumonia, dengue, appendectomy, and maternal care.
2. Does Unihealth Southwoods accept PhilHealth for emergency cases?
Yes. As a PhilHealth-accredited hospital, Unihealth Southwoods processes claims even for Emergency and urgent cases only.
3. Can senior citizens avail PhilHealth benefits without contributions?
Yes. All Filipino senior citizens are automatically covered by PhilHealth. To ensure they can avail PhilHealth benefits, please make sure they are registered PhilHealth members.
4. How do I update my dependents in PhilHealth?
Submit supporting documents such as marriage or birth certificates at a PhilHealth office or online portal.