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March 20, 2021 By iSensey

The Benefits I Got From Philhealth for Operations and Hospitalizations

Become/stay as an active PhilHealth member. This agency can help if one is hospitalized by sharing some of the financial burden. Hospitalization cost takes a big toll on the family’s finances, so if one can find ways to lessen the out of pocket expense during confinement, go for it. 

Do continue paying PhilHealth contribution.

This suggestion is especially for those working outside of the formal sector like self-employed individuals, market vendors, online freelancers, stay at home individuals, online sellers, puv drivers, digital workers, events organizers, sari-sari store owners, etc. 

PhilHealth is beset with corruption allegations. That’s true. But even so, we at iSensey recommend that you continue on paying your PhilHealth contribution. Why? This government health insurer can help if you are hospitalized or have to undergo certain medical procedures. 

The next part is a personal testimony of iSensey founder, CJ, on the benefits she got for her operations and hospitalizations. PhilHealth can help! 

Back in 2015, my husband was hospitalized with 5 days in ICU. We did not have any medical coverage then, not even PhilHealth. So we paid for the whole hospital bill out of our pocket. That P192K paid to the hospital hurt our finances deeply.  And it made us realized that we must become active PhilHealth members again because we never know when we need this agency’s help. 

A few months after his discharged, we went to a PhilHealth branch to reactivate our membership and has continued paying contributions since then. I am the principal PhilHealth member, my husband is my dependent. I changed membership status from ’employed’ to ‘self-employed’ since I have quit corporate work. 

PhilHealth is there to help.

In 2019, it turns out I have health issues. Because of these medical issues, I underwent 1 minor medical procedure and 2 major operations that year. Then last January 2021, I was rushed to the ER and stayed 3 days in the hospital. I’m now okay. But I want to point out that in all those procedures and hospital confinements, PhilHealth was there to ease a bit the financial burden of hospitalization, that we are very thankful for. 

2019 PhilHealth Share in Hospital Expenses

1 minor procedure – P18,000 all shouldered by PhilHealth, no personal cash-out.

1st major surgery – P53,400 share of PhilHealth from total bill of P188,084.15.

2nd major surgery – P23,373 share of PhilHealth from total bill of P165,828.6.

2021 PhilHealth Share in Hospital Expenses

emergency hospitalization – P6,800 share of PhilHealth from total bill of 34,583.84.

 Total paid by PhilHealth – P101,573 

Imagine if we did not have PhilHealth, we would have paid P100K+ more for my surgeries and confinements. 

These are the two txt messages I received for the PhilHealth benefit payment notice. Until now, I did not receive sms yet about the 2nd surgery and the more recent confinement, but all my hospital bills were deducted by the amount of the case rate.

PhilHealth Benefit Payment Notice sms, amount paid to the hospital

How much is the share of PhilHealth in the hospital bill?

The amount that PhilHealth will pay will depend on the case rate for a particular illness or health issue. PhilHealth will directly pay the hospital. You can use the case rate search on the official website, just input the diagnosis or the medical procedure. 

We cannot predict health emergencies, we’ve got to be ready for it at all times. This is where PhilHealth comes in. They can shoulder a percentage of the bill and thus helps its members financially. 

How much is the premium contribution? 

It starts at P300 monthly for those under the informal sector and self-employed membership, then premium goes up depending on the declared monthly income. 

For indigent individuals, go to the LGU or DSWD to request for sponsored membership. Senior citizens are automatically covered by PhilHealth.  

Get a PhilHealth number online to become a member. 

Take note that we can clamor for PhilHealth to address the issues surrounding the agency and to further improve their services, while at the same time continue to religiously pay the monthly contribution. 

By the way, before one can avail of PhilHealth benefits like hospitalization benefit, maternity care package, newborn care package, Z benefit package, etc., there are certain criteria that must be met like the member must have x number of contributions within a certain period to qualify. For inquiries, it’s best to visit a PhilHealth branch or check on the official website.

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Filed Under: Govt Services, Philhealth Tagged With: philhealth benefits, PhilHealth case rate, PhilHealth share in hospital bill

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