What is PhilHealth and its benefits?

What is PhilHealth and How Does It Work?

Established in 1995, PhilHealth aims to financially help Filipinos with their medical expenses. Contributions made by members and funding from both local and national governments enable PhilHealth to operate and aid its contributing members.

The government requires all employees to become PhilHealth members. Self-employed individuals (also called voluntary members) can also apply.

PhilHealth works like an insurance company, except that it is mandated by the government. The agency can help cover your medical bills or parts of it. However, there are eligibility requirements you must meet before you can enjoy PhilHealth benefits.

What PhilHealth Benefits are Available?

PhilHealth subsidizes your hospital bills based on the amount you have incurred. The agency typically pay parts of doctor’s professional fees, laboratory tests, and other medical costs.

1. Inpatient benefits

If you are admitted to a hospital to receive care, you can get PhilHealth benefits. Part of your total bill will be shouldered by the agency, as long as the hospital where you were admitted is a PhilHealth partner.

2. Outpatient benefits

If you need medical care but do not need to be admitted, you can still benefit from PhilHealth. The agency can cover part or the entire cost of your day surgery, hemodialysis, radiotherapy, and other primary care. Doctor consultation is also covered as PhilHealth benefits for outpatients.

3. Z benefits

Treatment for leukemia, prostate cancer, breast cancer, and cervical cancer is also covered by PhilHealth. However, the agency doesn’t cover the entire amount of the treatment and you have to go to a PhilHealth partner hospital to get Z benefits.

4. SDG-related benefits

Animal bite, HIV-AIDs, outpatient anti-tuberculosis treatment are covered by PhilHealth’s SDG-related benefits. Just like its other cluster of benefits, PhilHealth should part of your treatment costs.

For a more complete list of PhilHealth benefits, click here.

PhilHealth Benefits for Foreign Citizens and Dual Citizens

Expats and foreign retirees in the Philippines, as well as Filipinos with dual citizenship, may now avail of PhilHealth benefits.

Foreigners and their qualified dependents can enjoy inpatient and outpatient benefits in any PhilHealth-accredited hospital or clinic in the Philippines. However, they cannot avail of the Z benefit packages and PhilHealth benefits for women who are about to give birth. They also cannot make reimbursement claims for hospital confinements abroad.

On the other hand, Filipinos with dual citizenship and their qualified dependents can have all PhilHealth benefits in accredited healthcare facilities nationwide and abroad. To qualify for benefits, they must pay at least three monthly PhilHealth contributions within six months before ailment.

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