Guide on PhilHealth Inpatient Benefits Coverage & Claims
PHILHEALTH INPATIENT BENEFITS – Here is a guide on the coverage of PhilHealth for inpatient hospitalizations and how to process your claim.
Many Filipinos are members of PhilHealth or the Philippine Health Insurance Corporation. It is a state-run health insurance institution that assists its members with updated accounts on both inpatient and outpatient hospitalization situations.
With regards to the PhilHealth Inpatient Benefits for members with updated accounts, the health insurance institution has set case rate amounts which will be deducted from the total bill of the member. Only admissible cases will be reimbursed by the health agency and the patient must be admitted in an accredited Health Care Institution (HCI)
How to Process your Claim for PhilHealth Assistance?
- Step 1 – There are documents that you need to prepare and it is a case-to-case basis depending on the type of benefit you need to claim (inpatient, outpatient, or Z benefits). In the case of claiming a PhilHealth Inpatient Benefits, you should prepare the following:
- Step 2 – Present your document to the billing office of the accredited hospital or Health Care Institution (HCI) where you got confined or operated. The case rate amount will be deducted by the HCI from your total bill. The deduction includes both the case rate and the charges or professional fees of the attending physician(s).
- Step 3 – Pay for the remaining hospital bill.
It is important to keep your PhilHealth account updated to secure a turn to in times of medical emergencies and even on non-emergency situations relating to health. It does not only benefit the account holder but as well as the beneficiaries – the spouse, children, parents of the account owner.
You can apply for PhilHealth membership online. To check on the online application process, you may visit – How To Apply for PhilHealth Membership Online & the Requirements to Submit.
