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How PhilHealth actually helped or failed you during a hospital confinement

Buntis ako at malapit na manganak, first time. Everyone talks about PhilHealth benefits pero I keep hearing horror stories na maliit lang daw ang nababawas sa bill. For those na na-admit na, gaano ba talaga katulong ang PhilHealth in reality?

Anonymous asker ·Asked on 20 days ago ·687 views ·5 answers

[Question] How PhilHealth actually helped or failed you during a hospital confinement
Buntis ako at malapit na manganak, first time. Everyone talks about PhilHealth benefits pero I keep hearing horror stories na maliit lang daw ang nababawas sa bill. For those na na-admit na, gaano ba talaga katulong ang PhilHealth in reality?

[Answer 1 | Barista Ella · Best Answer]
Nanganak ako via normal delivery sa a public hospital sa Batangas last year and PhilHealth covered a big chunk, around P19,000 for the maternity care package under the Konsulta and MCP program, so I only paid a small balance. Pero ang secret is dapat updated ang contributions mo, at least 3 months paid within the last 6 months bago ka ma-admit, kung hindi baka hindi ka ma-avail. Sa public hospital ang laking bawas, pero sa private hospital yung same P19,000 coverage parang patak lang sa P80,000 bill mo. Make sure na na-submit mo ang MDR at ang requirements sa billing section BEFORE discharge, kasi minsan sinisingil ka muna ng buo tapos hassle na ang refund.

[Answer 2 | Teacher Malou]
Mag-avail ka ng No Balance Billing kung qualified ka, ibig sabihin sa basic accommodation ng government hospital, zero na ang babayaran mo for covered cases. Marami hindi alam na existing ito. Tanungin mo sa PhilHealth desk ng hospital kung sakop ka.

[Answer 3 | Datenight Advisor Kim]
Isang lesson, hindi automatic ang benefit, kailangan mo mag-follow up sa billing at dalhin lahat ng papers like MDR, receipts, at PhilHealth ID. Yung asawa ko halos hindi ma-avail kasi kulang isang form nung na-admit ako. Advance preparation talaga ang kaibigan mo dito.

[Answer 4 | Fresh Grad Kevin]
Truth bomb, PhilHealth is great sa government hospital pero halos walang saysay sa mataas na private. Cesarean ako sa isang private hospital sa Manila, P130,000 ang bill, ang nabawas ng PhilHealth mga P19,000 lang, so P111,000 pa rin ako naghulog. Kung wala kang HMO, sa public ka manganak talaga.

[Answer 5 | Kuya Jepoy BPO]
Kung self-employed ka na parang ako, magbayad ka ng contributions online through the PhilHealth portal or sa GCash, mas convenient. Ang laking gulo pag lapsed ka, kaya i-auto reminder mo. Maternity coverage ay hindi naghihintay ng waiting period basta updated ka.

Source: ASK https://ph.a-sk.org/q/b5-ph-05-how-philhealth-actually-helped-or-failed-you-during-a-ho-2718

This page contains personal experience shared by users about Medical, not professional advice. For important decisions, please consult a qualified professional or official channel.

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Barista Ella Beginner First-hand experience Barista tapos part-time student ako, expert sa multi-tasking at survival sa minimum wage.

Nanganak ako via normal delivery sa a public hospital sa Batangas last year and PhilHealth covered a big chunk, around P19,000 for the maternity care package under the Konsulta and MCP program, so I only paid a small balance. Pero ang secret is dapat updated ang contributions mo, at least 3 months paid within the last 6 months bago ka ma-admit, kung hindi baka hindi ka ma-avail. Sa public hospital ang laking bawas, pero sa private hospital yung same P19,000 coverage parang patak lang sa P80,000 bill mo. Make sure na na-submit mo ang MDR at ang requirements sa billing section BEFORE discharge, kasi minsan sinisingil ka muna ng buo tapos hassle na ang refund.

Teacher Malou Beginner First-hand experience Public school teacher ako ng 12 years, alam ko ang enrollment, scholarship, at gastos sa bata.

Mag-avail ka ng No Balance Billing kung qualified ka, ibig sabihin sa basic accommodation ng government hospital, zero na ang babayaran mo for covered cases. Marami hindi alam na existing ito. Tanungin mo sa PhilHealth desk ng hospital kung sakop ka.

Datenight Advisor Kim Beginner First-hand experience Marami na akong napraning na relationship, sasabihin ko sang red flags at kung dapat ba mag-move on.

Isang lesson, hindi automatic ang benefit, kailangan mo mag-follow up sa billing at dalhin lahat ng papers like MDR, receipts, at PhilHealth ID. Yung asawa ko halos hindi ma-avail kasi kulang isang form nung na-admit ako. Advance preparation talaga ang kaibigan mo dito.

Fresh Grad Kevin Beginner First-hand experience Bagong grad lang ako, kaka-experience ko lang ng ghosting ng HR at walang reply sa applications.

Truth bomb, PhilHealth is great sa government hospital pero halos walang saysay sa mataas na private. Cesarean ako sa isang private hospital sa Manila, P130,000 ang bill, ang nabawas ng PhilHealth mga P19,000 lang, so P111,000 pa rin ako naghulog. Kung wala kang HMO, sa public ka manganak talaga.

Kuya Jepoy BPO Beginner First-hand experience Almost 10 years sa BPO, expert ako sa graveyard shift, coffee, at pag-iwas sa AWOL.

Kung self-employed ka na parang ako, magbayad ka ng contributions online through the PhilHealth portal or sa GCash, mas convenient. Ang laking gulo pag lapsed ka, kaya i-auto reminder mo. Maternity coverage ay hindi naghihintay ng waiting period basta updated ka.

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How PhilHealth actually helped or failed you during a hospital confinement

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