List of PhilHealth Cash Benefits For A Specific Illness

List of PhilHealth Cash Benefits For A Specific Illness

Being a member of PhilHealth has benefits, but do you know that there are specific cash benefits for different kinds of illness? Well, you should know it to get the most of your membership. This article is perfect to let you know about this matter, this also include eligibility, coverage, and guidelines for a specific disease.

Requirements

  1. The member must have at least three (3) months’ premium contributions within the immediate six (6) months before the month of availment.
  2. An aspiring member also needs to submit:

1 copy of Member Data Record or PhilHealth Benefit Eligibility Form (PBEF)

A duly accomplished PhilHealth Claim Form 1

For more information regarding the requirements, you can go to the PhilHealth website. Alternatively, you can contact them at:

Trunkline (02) 441-7444

Call Center (02) 441-7442

  • Case Rate for Hemodialysis = Php2, 600.00 per session
  • Case Rate for Outpatient Blood Transfusion = Php3, 640.00 (one or more units)
  • Thyroidectomy (Total or Complete Cash Benefits) = Php31, 000.00
  • Ovarian Cystectomy (Unilateral or Bilateral) = Php23, 300.00
  • Pneumonia
  • Moderate Risk Pneumonia: Php15, 000.00
  • High Risk Pneumonia: Php32, 00.00
  • Primary Care Moderate Risk Pneumonia: Php10, 500.00
  • Tonsillectomy (Primary or Secondary) = Php18, 000.00
  • Normal Spontaneous Delivery (NSD)
  • Lying in: = Php6, 500
  • Hospitals: =  Php5, 000.00
  • Pre-Natal:=  Php 1, 500.00
  • Tubal Ligation = Php4, 000.00

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For IN PATIENTS benefits:

Benefits are paid ONLY to accredited Health Care Institutions (HCI)

The case rate amount is to be deducted by the Institution (HCI) from the member’s total bill. Inclusive of professional fees of physicians BEFORE your discharge

Member must have at least three (3) months’ premium contributions within the immediate six (6) months prior to the event

The case rate amount is inclusive of hospital charges and professional fees of attending physician/s

  • Intrauterine Device Insertion or IUD = Php2,000 =
  • Vasectomy (Unilateral or Bilateral) = Php4,000
  • Viral Hepatitis = Php11,800
  • Rheumatic Fever = Php10,100
  • Intrauterine Device Insertion (IUD) = Php2, 000
  • Breech Extraction = Php12, 120
  • Appendectomy = Php24, 000
  • Cerebral Infarction = Php28, 000
  • Cerebral Palsy = Php9, 500
  • Cellulitis = Php9, 600
  • Cataract Surgery = Php16, 000
  • Cholecysectomy = Php31, 000
  • Cholecystitis = Php11, 300
  • Caesarian Section = Php19, 000
  • Congenital Anemia = Php15, 200
  • Newborn Care Package = Php1, 750
  • Emphysema = Php11, 400
  • Upper Respiratory Tract Infection (URTI)
  • Hospitals: Php4, 000
  • Primary Care Facilities: Php2, 800
  • Dengue
  • Dengue Fever: Php10, 000
  • Severe Case of Dengue: Php16, 000
  • Chronic Obstructive Pulmonary Disease =  (COPD Php12, 200
  • Congenital Syphilis = Php12, 800
  • Diabetes Mellitus
  • **With complications other than Coma and Ketosis: Php12, 600
  • Asthma
  • Asthma in acute exacerbation for hospitals: Php9, 000
  • In primary care facilities: Php6, 300
  • Congenital Hypothyroidism = Php9, 900

PhilHealth Z Benefits

Aside from the benefits to the diseases mentioned above, PhilHealth extends its help furthermore. The Z Benefit Package is a program of PhilHealth to its members to address health conditions that trigger expensive treatments. In addition to that, it also aids illnesses and diseases that promote prolonged hospitalization.

The conditions under type Z are the farthest end of the spectrum. Moreover, these are the cases “perceived as economically and medically catastrophic” due to the seriousness of each.

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What type of illnesses are covered?

  1. Z001 Acute lymphocytic leukemia, standard risk (for children)
  2. Z002 Early breast cancer, stage 0 to IIIA
  3. Z003 Prostate cancer, low to intermediate risk
  4. Z004 Kidney transplantation for end stage kidney disease, standard risk
  5. Z005 Coronary artery bypass graft surgery, standard risk
  6. Z006 Total correction of Tetralogy of Fallot (for children)
  7. Z007 Closure of ventricular septal defect (for children)
  8. Z008 Cervical Cancer, stage I to IV
  9. Z009 The Z MORPH (Mobility, Orthosis, Rehabilitation and Prosthesis Help)
  10. Who are eligible for this Z-Type package?

Members covered are all eligible PhilHealth members whether:

  • Employed
  • Individually paying (Voluntary)
  • Lifetime member program
  • Sponsored program
  • Overseas worker program

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