A guide to PhilHealth benefits

It’s important for businesses in the Philippines to ensure the health and happiness of their employees. To help them do just that, PhilHealth is providing them with the recommended assistance in the aspect of healthcare.

 

The first thing for employers to do is to make sure their employees are registered with PhilHealth. Premium contribution payments should be paid regularly and on time. Businesses must also notify their employees regarding any updates on PhilHealth policies and benefits.

 

Read on to find out more on how businesses can help their employees get the most out of their PhilHealth benefits:

 

How can businesses assist their employees in taking advantage of PhilHealth benefits?

 

Employers should be ready with the correct supporting documents even before their employees begin to apply for these benefits. These include documents that need to be submitted before an employee is discharged from the hospital.

 

Preparing the necessary requirements early on will help your employees in getting their benefits easier and without stress.

 

A typical requirement for businesses is properly answering and certifying Claim Form 1. The form requires the following data:

  • Member information
  • Patient information (if the patient is a dependent)
  • Member certification
  • Employer’s certification

 

Here are some key reminders when filling out the Claim Form:

  • Only use pens
  • Only use capital letters
  • All dates should follow the MONTH-DAY-YEAR (MM-DD-YYYY) format
  • Names should be written starting with the last name, then first name, followed by any extensions (e.g. Jr., Sr., III, etc.), and lastly, the middle name

 

For more in depth instructions on how to fill out Claim Form 1, take a look at PhilHealth’s guidelines here.

 

For any questions and concerns regarding benefits and/or requirements, go to any PhilHealth office or contact them at info@philheath.gov.ph. PhilHealth also has a call center available 24/7. Members can call at (02) 441-7442.  

 

What benefits require Claim Form 1?

 

Only inpatient benefits, day surgeries or outpatient surgeries, and SDG related medical procedures require Claim Form 1.

 

For a member to be eligible for the inpatient benefits, they should have made six months of contributions before the three months of qualifying contributions. These should have been made within a 12-month period. Aside from Claim Form 1, they also need a copy of the Member Data Record or PhilHealth Benefit Eligibility Form.

 

Day surgeries or outpatient surgeries are outpatient procedures that only include elective surgeries and don’t require outpatient care. A member should have at least six contributions preceding the three month qualifying contribution within a 12-month period before being confined.

 

SGD-related procedures and packages include the following:

  • Outpatient malaria package
  • Outpatient HIV-AIDS package
  • Outpatient anti-tuberculosis treatment
  • Voluntary surgical contraception procedures
  • Animal bite treatment packages.

 

Member also need a copy of their Member Data Record for outpatient surgeries and SGD-related procedures and packages.

 

Looking after the wellbeing of your employees will create a better working environment and increased productivity.

 

If you want to learn more about how you can assist in ensuring that your employees get all their PhilHealth benefits, give FilePino a call today at +1.806.553.6552 (USA) or +63.917.892.2337 (Philippines). You can also browse the website for other helpful articles about government-mandated benefits for employees.