Professional Documents
Culture Documents
ON PHILHEALTH
BENEFITS, AVAILMENTS and RESPONSIBILITIES
Contents
What can PhilHealth do for you? ..................................................... 4
How will the family know if they are enrolled with
PhilHealth or not? ................................................................................ 4
Section I. THE FAMILY IS PHILHEALTH ENROLLED......... 4
1.
2.
3.
5.
member? ............................................................................................... 13
6.
8.
1.
2.
3.
even if the family is not NHTS and not qualified for the
Sponsored Program? ......................................................................... 18
4.
PhilHealth? ........................................................................................... 18
Appendix A
(PMRF, front)
20
Appendix B
(PMRF, back)
21
Appendix C
Appendix D
Appendix F.
1.
2.
Step children
below 21 yrs
Required document*
Clear copy of Marriage Certificate with
registry number
Clear copy of the Affidavit of Marriage from
the Office of Muslim Affairs with NSO
registry number
Clear copy of Birth Certificate with registry
number or Baptismal Certificate, with name
of member as parent
Court Decree/ Resolution of Adoption
Clear copy of parents Birth Certificate with
NSO Registry number OR
Senior Citizen ID with birthdate appearing
in the ID
AND clear copy of the members Birth
Certificate with NSO Registry number
Clear copy of the Marriage Certificate, with
registry number, between biological
parents and step-father/mother
AND Birth Certificate/s of step children
with registry number
Dependent
Mentally or
physicallydisabled children,
21 yrs old and
above
Required document*
Clear copy of the Birth Certificate with
registry number
to Doctor/
Professional
to Member/
dependent
SURGICAL CASES
1.
2.
3.
4.
Maternity Care
Package** (MCP)
3,900
2,600
NSD Package in
Level 1 Hospitals
3,900
2,600
NSD Package in
Levels 2 to 4
Hospitals
3,000
2,000
Appendectomy
Cataract surgery
Cesarean Section
14,400
11,200
11,400
9,600
4,800
7,600
up to 1,500
(actual
expenses for
pre-natal
services)
up to 1,500
(actual
expenses for
pre-natal
services)
up to 1,500
(actual
expenses for
pre-natal
services)
None
None
None
PhilHealth Payment
(in pesos)
Condition
to facility
5.
6.
Cholecystectomy
Dilatation and
Curettage
7. Hemodialysis
8. Herniorrhaphy
9. Hysterectomy
10. Mastectomy
11. Radiotherapy
12. Thyroidectomy
MEDICAL CASES
1. Acute
Gastroenteritis
(AGE)
2. Asthma
3. Cerebral Infarction
(CVA I)
4. Cerebral
Hemorrhage (CVA
II)
5. Dengue I (Dengue
Fever and DHF
Grades I & II)
6. Dengue II
(DHF Grades III &
IV)
7. Essential
Hypertension
8. Newborn Care
Package** in
Hospitals and
to Doctor/
Professional
to Member/
dependent
18,600
6,600
12,400
4,400
None
None
3,500
12,600
18,000
13,200
1,800
18,600
500
8,400
12,000
8,800
1,200
12,400
None
None
None
None
None
None
4,200
1,800
None
6,300
19,600
2,700
8,400
None
None
26,600
11,400
None
5,600
2,400
None
11,200
4,800
None
6,300
2,700
None
1,225
525
None
PhilHealth Payment
(in pesos)
Condition
to facility
Lying in Clinics
9. Pneumonia I
(Moderate Risk)
10. Pneumonia II
(High Risk)
11. Typhoid Fever
to Doctor/
Professional
to Member/
dependent
10,500
4,500
None
22,400
9,600
None
9,800
4,200
None
**The NBB policy also applies to other member types in all accredited MCP nonhospital providers (PhilHealth Circular No. 011-2011).
10
PhilHealth payment
(in pesos)
to member/
to facility
dependent
300 per
family per
year
none
11
Condition
PhilHealth payment
(in pesos)
to member/
to facility
dependent
SURGICAL CASES
1. Voluntary Surgical Contraception
Vasectomy, including no-scalpel
vasectomy (NSV)
Ligation or transection of
fallopian tube(s), abdominal or
vaginal approach
2. Outpatient Blood Transfusion
Benefit (available only in hospitals)
4,000
none
none
4,000
none
Level 1 =
14,500
Level 2 =
19,300
Level 3 and
4 = 25,700
none
none
12
For NHTS families, the head of the family and his qualified
dependents are qualified to avail of PhilHealth benefits
immediately from the day of enrolment until the last day of
December of the current year when their PhilHealth ID expires.
The PhilHealth IDs of indigent families enrolled as Sponsored
Program members but are not NHTS families may have other
validity dates. Families must check their IDs before each use of
PhilHealth benefits.
6.
13
14
2.
3.
4.
5.
6.
15
Patient is discharged
2.
3.
16
17
Appendices A and B). The LGU then pays for the premium. A
PhilHealth ID will be provided to the family once enrolled.
3.
Individually Paying
Low
Professional
Overseas
Employed
Worker
Income
How
much?
P1,200 for
P100
P300
P900 for
2.5% of
1 year
monthly
monthly
1 year
monthly
salary of
member
18
Sponsored
Member
Individually Paying
Low
Professional
Overseas
Employed
Worker
Income
(1.25%
member
and 1.25%
employer)
Who
Sponsor or
pays?
donor
When
Every year
to
pay?
Member
Member
Member
Employer
Every 3
Every 3 or 6
Every
Every
or 6
months; or
year
month
months;
every year
or every
year
19
Appendix A
PhilHealth ID number
Place
name of head of family
other details of head of
family
names and details of
additional dependents
signature of head of
family and date
20
Appendix B
21
Appendix C
Family PhilHealth ID
number and
information about the
head of family
___________________________/\/\/\_____________________
22
Appendix D
12-digit
permanent
PhilHealth
Identification
Number (PIN)
Complete name
of head of family
Signature of head
of family
1"x 1"
photograph of
head of family
Effectivity date
pertaining to validity
period of coverage
23
Appendix E
(MDR)
The MDR is generated by the PhilHealth Service Office. It lists
information about the enrolled family head of the family and
his/ her qualified dependents.
Below is a sample of how the MDR looks like.
24
Appendix F.
PhilHealth Offices
Rochelle Ann L.
San Pedro
Address:
Days available:
Monday-Friday
8:00am 5:00pm
4/F, Marc I Bldg., 1971
Arceli C.
Aguilar
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F Remcor Bldg.,
Ma. Elena L.
Castisimo
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Liberty Boni Bldg.; #94
Rolando
Gonzales
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Mezzanine Floor,
25
Quezon City
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Adoracion S
Manaulit
Address:
Days available:
Monday-Friday
8:00am 5:00pm
#337 ITC Bldg., Sen. Gil
26
REGION CAR
Abra Service Office
Contact person: Leonora A.
Days available:
Sobrevilla
8:00am 5:00pm
Address:
Monday-Friday
Telephone: (074)-752-7924
0999-7776100
Janet M. Palaez
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Als Buidling., Km 6, La
Trinidad, Benguet
Reynald B.
Bimuyag
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F JDT Bldg.,
Rommel A.
Aranca
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F Richmond Bldg.,
Tabuk City
Jose P. Safawi
Days available:
Monday-Friday
8:00am 5:00pm
27
Address:
Telephone: (074)446-0371;
(074)444-8361
Tues-Fri: (074) 444-5345
0949-9765454, 0915-3229599
28
REGION I
Western Pangasinan Service Office
Contact person:
Abraham A.
Ballares
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F Perez Bldg., Marcos
Orlando
Pangilinan
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Jommel Bldg., A.
Marife G.
Banlaoi
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Juanita Commercial
Francis Canosa
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Galleria De Vigan,
29
Eduardo U.
Days available:
Dulatre
Address:
Monday-Friday
8:00am 5:00pm
3/F Sanctuary Bldg. Mc
656-2030
Chester Joseph
C. Canto
Address:
Days available:
Monday-Friday
8:00am 5:00pm
M.H. Del Pilar St.,
Dagupan City
Pangasinan
30
REGION II
Tuguegarao City Service Office
Contact person: Clino Nonito
Days available:
Mallillin
8:00am 5:00pm
Address:
Monday-Friday
Telephone: (078)-846-1111
Rosanna
Viernes
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F Ryan Mall, Rizal St.,
Alexander
Arellano
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Abarca Bldg., V. Cureg
Cesar Sales
Days available:
Monday-Friday
8:00am 5:00pm
Address:
AK Fotohaus Bldg.,
Lanaida Castillo
Days available:
Monday-Friday
8:00am 5:00pm
Address:
2/F Consumer
31
32
REGION III
PhilHealth Regional Office III - Branch A
Contact person:
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Annabelle B.
Imana
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F Nepo Mart II, Nepo
Ma. Elizabeth
B. Capuli
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F Zabala Bldg., Don
Leny D. Fajardo
Days available:
Monday-Friday
8:00am 5:00pm
Address:
City
33
Ma. Fleurdeliz
V. Dallo
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Unit 203 2/F LC Bldg.,
Tarlac City
Robert C.
Padron
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F RHOI Building,
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Feliza Jazza
Marvy Robledo
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Telephone: 0920-9009803
34
Angelito N.
Creencia
Address:
Days available:
Monday-Friday
8:00am 5:00pm
3/F LCF Bldg., H.
Michael M.
Maglanque
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F Planters Plaza
Leo V Liwanag
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Bulacan
Zenaida D. Dela
Vega
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F Feliza Jazz
35
36
REGION IVA
Lucena Service Office
Contact person:
Ma. Theresa S.
Alba
Address:
Days available:
Monday-Friday
8:00am 5:00pm
AMCJ Square Bldg.
Eloisa B. Tagpo
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Arturo C.
Ardiente
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2nd Floor , HK Bldg. II,
Calamba City
Ma. Obelia M.
Fontanilla
Address:
Days available:
Monday-Friday
8:00am 5:00pm
MYP GBY Phil. Corp
37
Zenaida R. De
Vera
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2nd Floor, Cafe
Lucena City
38
REGION IVB
Lemery Service Office
Contact person:
Days available:
Monday-Friday
8:00am 5:00pm
Address:
2/F Humarang
Reynaldo
Dascil
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F PASIA Building,
Alberto G.
Gardiola
Address:
Days available:
Monday-Friday
8:00am 5:00pm
1/F Matheus Bldg.,
Enrico Cabrera
Days available:
Monday-Friday
8:00am 5:00pm
Address:
39
Jeffrey V.
Days available:
Huertas
Address:
Monday-Friday
8:00am 5:00pm
FETA Bldg., Magsaysay
8634641
Wilfred G.
Days available:
Hernandez
Monday-Friday
8:00am 5:00pm
Address:
Cabiguin Bldg.,
0917-5052886
City
Michelle V.
Days available:
Ilustre
Address:
Monday-Friday
8:00am 5:00pm
#34 National Road,
5052884
Virginia Abao
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Mindoro
Juan G.
Montana
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2nd Floor R&F Bldg.,
40
8634638
41
REGION V
Catanduanes Service Office
Contact person:
Maria Zaila A.
Bagadiong
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Rackdell Hotel, San
Alfredo J.
Jubilo
Address:
Days available:
Monday-Friday
8:00am 5:00pm
LJA Bldg. B, Flores St.,
Ireneo A.
Dacillo
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Caneba Bldg.,
Evelyn P. Logoc
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Norlinda C.
Days available:
Monday-Friday
8:00am 5:00pm
42
Address:
43
REGION VI
Capiz Service Office
Contact person:
Joe Frederick T.
Diaz
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F CAP Bldg., Plaridel
Junie C.
Sabusap
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F St. Nicholas
J'Roel F. del
Rosario
Address:
Days available:
Monday-Friday
8:00am 5:00pm
No. 165 Veterans
Marjorie A.
Cabrieto
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Ground Floor, CAP
Dinah P.
Days available:
Monday-
44
Gelvezon
Address:
Negros Occidental
Sagay Service Office
Contact person:
Marvin C.
Lastimoso
Address:
Days available:
Monday-
Ellen Mae
Chan
Address:
Days available:
Monday-
Romel A.
Dilag
Address:
Days available:
Monday-
45
Days available:
Address:
46
REGION VII
Mandaue Service Office
Contact person:
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Telephone:
Frances Mae R.
Evangelista
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Brgy. Perrelos, 6019
Carcar, Cebu
Pedro Leonard
Days available:
Monday-Friday
G. Castaneda
8:00am 5:00pm
Address:
City, Cebu
200-3827
Marcelino J.
Ocampo Jr.
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Vean Bldg., Roxas
Negros
Maritess E. Que
Days available:
Monday-Friday
47
8:00am 5:00pm
Address:
Mona Liza O.
De Veyra
Address:
Days available:
Monday-Friday
8:00am 5:00pm
MYX Bldg. J-Jimenez
Bohol
Ruhneb T.
Cabiara
Address:
Days available:
Monday-Friday
8:00am 5:00pm
3/F Annex Municipal
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Siquijor, Siquijor
48
Days available:
Address:
49
REGION VIII
Borongan Service Office
Contact person:
Josephine
Mosquisa
Address:
Days available:
Monday-
Romeo
Agus
Address:
Days available:
Monday-
Misaei
Paigan
Address:
Days available:
Monday-
Cristina
Laraya
Address:
Days available:
Monday-
50
Telephone: (053)325-3663;
(053)325-4056
51
REGION IX
Zamboanga City Service Office
Contact person:
Nadzmier A.
Sajili
Days available:
Monday-
Address:
Telephone: (062)992-1910;
(062)992-3569
Bernardino
Days available:
Monday-
G. Labastida, Jr.
Address:
Telephone: (062)333-5495
2/F Block B,
(telefax); 0920-9106915
Estrella S.
Manantan
Address:
Days available:
Monday-
Telephone: (062)214-4303 ;
(062)850-7205
Days available:
Monday-Friday
8:00am 5:00pm
Address:
52
53
REGION X
Bukidnon Service Office
Contact person:
Romulo M
Lapuz, Jr.
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F Candelaria Bldg.,
City, Bukidnon
Brick D.
Agcopra
Address:
Days available:
Monday-Friday
8:00am 5:00pm
G/F Trinidad Bldg.,
Antonio Arnaiz
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Christine Mae G.
Days available:
Monday-Friday
54
Magno
Address:
8:00am 5:00pm
G/F Gonzales-Gimeno
Iligan City
Luz Mecaros
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Archdioses Bldg.
Fetzy Gomilla
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Oroquieta Provincial
Marlon Jan
Balaba
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Mambajao Municipal
Lauro Labadan
Days available:
Monday-Friday
8:00am 5:00pm
Address:
55
Catalina Dano
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Telephone: 0921-2693318
Ida Paculanang
Days available:
Monday-Friday
8:00am 5:00pm
Address:
56
REGION XI
Digos Service Office
Contact person:
Mary Grace
Days available:
Monday-Friday
Socorro-Gonzalo
8:00am 5:00pm
Address:
Jonas Matthew
Pang
Address:
Days available:
Monday-Friday
8:00am 5:00pm
New Sunlite
Christopher R.
Molina
Address:
Days available:
Monday-Friday
8:00am 5:00pm
2/F CHO Building, LC
Salvador
Deocampo
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Gold City Complex,
57
Telephone:
58
REGION XII
General Santos Service Office
Contact person:
Nol S. Valila
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Santos City
Sharihana
Guerra Sol
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Door 3 F.A.Tan Bldg.,
Ivy E. Moderin
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Lea A. Espejo
Days available:
Monday-Friday
8:00am 5:00pm
Address:
59
Telephone:
60
REGION CARAGA
Butuan Service Office
Contact person:
Marilou M.
Ramirez
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Lynzee's Building, 766
Jocelyn E.
Canete
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Ragas Bldg., Del Pilar
Juliet A. Golez
Days available:
Monday-Friday
8:00am 5:00pm
Address:
Rodrigo D.
Ariar
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Yuipco-Lim Bldg.,
Ethyl L.
Yuchitco
Address:
Days available:
Monday-Friday
8:00am 5:00pm
VTP Bldg., Donasco St.,
61
211-4196
62
REGION ARMM
Marawi Service Office
Contact person:
Kassandra
Days available:
Monday-Friday
Louisa M. Mamainte
8:00am 5:00pm
Address:
Telephone: 0906-4658035
Genevieve N.
Pascua
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Samuel Tan Bldg., N.
Indang J.
Orense
Address:
Days available:
Monday-Friday
8:00am 5:00pm
B-6 HKI Bldg., Buyon
Jonaper N.
Kalbit
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Triple J's Square Bldg.,
Telephone: 0919-8742705
63
Pendalilay B.
Beda
Address:
Days available:
Monday-Friday
8:00am 5:00pm
Tomawis Bldg.,
Telephone: 0917-7215398
Telephone: 09285071910
64