02/09/2025
๐ช๐ต๐ ๐ฌ๐ผ๐ ๐ก๐ฒ๐ฒ๐ฑ ๐๐ผ ๐จ๐ป๐ฑ๐ฒ๐ฟ๐๐๐ฎ๐ป๐ฑ ๐๐ผ๐ ๐ฌ๐ผ๐๐ฟ ๐ฃ๐๐๐๐๐๐๐๐ง๐ ๐ช๐ผ๐ฟ๐ธ๐
Last May 2024, my wife underwent surgery for an ovarian cyst.
It was an ovarian cystectomy... a procedure where the cyst on the o***y is removed.
Totally unexpected.
Very stressful.
Thank God, the surgery was successful. ๐
But then came the bill.
--- Total Bill: โฑ170,613.20
Thankfully, the hospital staff told us:
โThis is covered by PhilHealth.โ
We thought that was a huge relief.
Then we actually saw the breakdown:
PhilHealth Coverage:
โฑ13,910.00 โ Room for 4 days + Medicines
โฑ16,380.00 โ Professional Fees
= โฑ30,290.00 Total Coverage
I literally scratched my head.
So I started diggingโฆ and hereโs what I found. ๐ฎ
___________
๐๐๐ฅ๐ฆ๐ง ๐ง๐๐๐ก๐: ๐ฃ๐๐๐๐๐๐๐๐ง๐ ๐๐ข๐๐ฆ ๐ก๐ข๐ง ๐๐ข๐ฉ๐๐ฅ ๐๐ฉ๐๐ฅ๐ฌ๐ง๐๐๐ก๐
PhilHealth uses a Case Rate System.
Every illness or procedure has a fixed coverage.
For example:
Pneumonia (moderate risk): โฑ15,000
Dengue: โฑ10,000
Cesarean Section: โฑ19,000
Hemodialysis: โฑ2,600 per session
(Full list here: https://www.philhealth.gov.ph/services/acr/
)
So if your bill is โฑ60,000 but the case rate is โฑ15,000...
โฑ15,000 is the max theyโll cover.
You shoulder the rest.
___________
PhilHealth isnโt like a typical HMO card.
You donโt just swipe and expect โfully covered.โ
Yes, it helpsโฆ
But if you donโt understand how it actually works,
you might get shocked when the bill comes.
TO GET THE FULL BENEFITS, YOU NEED CONSISTENT CONTRIBUTIONS
For employed or voluntary members:
โ
You must have at least 9 months of contributions in the last 12 months before confinement.
For senior citizens:
โ
They can be automatic members, but they still need to register and submit documents to be eligible.
___________
What You Can Do Today:
Check your contributions via the PhilHealth Member Portal.
If self-employed or an OFW, pay contributions consistently.
Ask your HR if your remittances are updated.
Always keep a copy of your Member Data Record (MDR) and a valid ID.
Reality Check: Donโt Expect Magic Coverage
Thereโs no such thing.
PhilHealth helps, but itโs not enough for large bills.
You still need:
๐ฐ Emergency Fund
๐ณ HMO (if possible)
๐ก๏ธ Critical Illness or Health Insurance
For years, I thought PhilHealth = Peace of Mind.
But now I know: PhilHealth = Partial Aid Only.
Still grateful, but also humbled.
___________
Letโs share this with others...especially those without HMO or insurance.
Because financial preparedness isnโt just about saving money.
Itโs about protecting your family when it matters most.
We all deserve peace of mind.
God bless everyone paying hospital bills. Stay strong! ๐
____________________
*No Balance Billing isnโt applicable at that time.
You can also check here all DOH hospitals accredited by NBB
https://www.facebook.com/DOHgovPH/posts/tingnan-listahan-ng-mga-doh-hospitals-sa-bansasa-doh-hospitals-bayad-na-ang-bill/1203553008478136/
