27/12/2025
Hereโs how PhilHealth actually pays for our hospital bills:
๐๐ก๐ข๐ฅ๐๐๐๐ฅ๐ญ๐ก ๐ฎ๐ฌ๐๐ฌ ๐ ๐๐๐ฌ๐ ๐๐๐ญ๐ ๐ฌ๐ฒ๐ฌ๐ญ๐๐ฆ:
โข Each illness, diagnosis, or medical procedure has a fixed benefit amount.
โข This amount is pre-determined by PhilHealth.
โข It stays the same regardless of the hospital bill.
What this means for patients:
โข If your total hospital bill is higher than the PhilHealth case rate โ ๐ฎ๐ค๐ช ๐ฅ๐๐ฎ ๐ฉ๐๐ ๐๐๐๐๐๐ง๐๐ฃ๐๐.
โข If your bill is lower than the case rate โ ๐๐๐๐ก๐๐๐๐ก๐ฉ๐ ๐ค๐ฃ๐ก๐ฎ ๐ฅ๐๐ฎ๐จ ๐ช๐ฅ ๐ฉ๐ค ๐ฉ๐๐ ๐๐๐ฉ๐ช๐๐ก ๐๐๐ก๐ก, ๐ฃ๐ค๐ฉ ๐๐ญ๐ฉ๐ง๐.
Felt indebted to share this info I got from researching about Philhealthโs policies and recent updates long ago. Na-share ko na rin โyong link to the Medical Case Rates in one of my posts last year.
Some of my clients already know this, sharing not to discourage, but to inform, manage expectations, and help prepare better moving forward.
PhilHealth is meant to help, not fully cover hospital expenses.
We continue to hope for a time when healthcare will be a true priority of our government, because we contribute not only through our monthly PhilHealth payments, but also through our taxes.
Here are PhilHealthโs latest Medical Case Rates for some illness which also available on the internet:
https://www.philhealth.gov.ph/circulars/2024/0037/AnnexA-ListofMedicalCaseRates.pdf