Details about the PhilHealth Inpatient Benefits Coverage & Claim
PHILHEALTH INPATIENT BENEFITS – Here is a guide on the coverage and guidelines set by PhilHealth for hospitalizations.
In the Philippines, the state-run health insurance institution is the Philippine Health Insurance Corporation or more commonly called PhilHealth. Millions of Filipinos are members of PhilHealth. Undeniably, it is more affordable compared to private health insurance policies although the coverage may differ.
Many Pinoys secure their PhilHealth membership so they would have something to turn to in times of hospitalization and medical conditions. Most members submit their contributions either in a monthly or quarterly basis.
Among the benefits for members of the health insurance agency who have updated accounts are PhilHealth Inpatient Benefits or the assistance in hospital admission cases. The inpatient benefits include both the assistance in the payment of the hospital bill based on case rates and the charge of the attending physician.
According to PhilHealth, for hospitalization benefits, the benefits are paid to the accredited Health Care Institution (HCI) through all case rates. The amount of the case rate will be deducted by the HCI from the total hospital bill of the member. It includes professional fees and the charges of the attending physicians prior to the discharge.
PhilHealth stressed that only admissible cases will be reimbursed by the government agency. What are the requirements in claiming PhilHealth Inpatient Benefits?
- copy of Member Data Record or PhilHealth Benefit Eligibility Form (PBEF)
- duly-accomplished PhilHealth Claim Form 1
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