For millions of Filipinos, the Philippine Health Insurance Corporation, commonly known as PhilHealth, plays a vital role in providing accessible and affordable healthcare services. As one of the country’s largest and most significant social health insurance programs, PhilHealth ensures that its members have access to essential medical services, safeguarding their health and protecting their financial stability in times of need.

From hospitalization and maternity care to outpatient treatments and preventive services, understanding these benefits empowers you to make informed healthcare decisions and secure a brighter, healthier future for yourself and your loved ones.

PhilHealth Benefits You Need to Know

1. Inpatient Benefits

Coverage for hospitalization expenses, room and board, medicines, laboratory tests, and other medical procedures while confined in an accredited PhilHealth hospital.

2. Outpatient Benefits

PhilHealth’s Outpatient Benefits cover the cost of certain outpatient care services, such as consultation fees, laboratory tests, and x-rays.

3. Z Benefit Packages

PhilHealth’s Z Benefit Packages are a set of comprehensive benefits that are designed to provide financial protection against illnesses that are considered to be medically and economically catastrophic. These illnesses include cancer, renal failure, and certain types of congenital anomalies.

4. Maternity Care Package

PhilHealth Maternity Care Package (MCP) is a benefit that covers the cost of essential healthcare services for women about to give birth throughout their pregnancy and normal delivery (during antenatal, intrapartum, and immediate postpartum periods). The services shall include antenatal care, intrapartum monitoring, assistance in normal delivery, and post-partum care within 72 hours and 7 days after delivery.

5. Newborn Care Package

PhilHealth Newborn Care Package (NCP) is a benefit that covers the cost of essential healthcare services for newborns during the first few days of life. It covers essential newborn care, newborn screening, and hearing screening tests.

6. Primary Care Benefit

PhilHealth Primary Care Benefit (PCB) is a benefit that covers the cost of essential healthcare services for members at the primary care level. It is designed to provide members with access to preventive, diagnostic, and treatment services that can help them stay healthy and manage their chronic conditions.

7. Animal Bite Package

The Animal Bite Treatment Package (ABT) is a benefit that covers the cost of post-exposure prophylaxis (PEP) treatment for animal bite victims. PEP is a series of vaccines and immunoglobulins that are given to people who have been bitten by animals that may be infected with rabies.

8. TB-DOTS Package

TB-DOTS Package is a benefit that covers the cost of treatment for tuberculosis (TB) under the Directly Observed Treatment, Short-course (DOTS) strategy. DOTS is a proven, effective way to treat TB and prevent the spread of the disease.

9. Hemodialysis Package

PhilHealth Hemodialysis Package is a benefit that covers the cost of hemodialysis treatment for people with end-stage renal disease (ESRD). ESRD is a condition in which the kidneys no longer function properly and require dialysis to remove waste products from the blood.

10. Outpatient Blood Program

PhilHealth Outpatient Blood Program (OBP) is a benefit that covers the cost of blood and blood components for outpatients. The program is designed to help reduce the financial burden of blood transfusions for PhilHealth members and their families.

Kindly note that these benefits are subject to specific guidelines, limitations, and requirements set by PhilHealth. The availability of benefits may also vary based on the member’s contributions and the type of membership.

For any concerns or inquiries regarding your PhilHealth matters, you can easily reach out for assistance. You can send an email to [email protected] or you can check our guide in other ways to contact Philhealth.

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