PhilHealth Guide: Records, Contributions and Benefits

Start here: your PhilHealth account and records

In fact, most PhilHealth problems at the hospital come from records, not from the benefit itself. So set up your Member Portal account first, and check your records before you need them.

• Registering for PhilHealth online, if your employer does not do it for you.
• Logging in to the PhilHealth Member Portal, and what to do inside.
• Downloading and printing your MDR, the record hospitals ask for.
• Checking your PhilHealth contributions online.
• Checking if you are eligible for benefits right now.
• Getting your PhilHealth ID card, including the OFW proxy option.

Paying your contributions

If no employer pays for you, then you pay on your own. Meanwhile, the rules differ for the self-employed, voluntary members, seniors and PWDs.

• Rules for self-employed, voluntary and senior members: how much you pay and when.
• Generating your SPA before every payment.
• Where to pay online: GCash, Maya, bank apps and payment centers.
• What happens if your contributions lapse, and how to fix it.
• Whether self-employed members can deduct PhilHealth from their taxes.
• PhilHealth for PWDs, including the new rule for employed PWDs.

Your family’s coverage

Your spouse, children and qualified parents can also use your PhilHealth. However, they must be listed in your record first, or the hospital cannot use your benefits for them.

• Who counts as a qualified dependent, and how to add them to your record.

Using your benefits

Instead of paying you, PhilHealth pays the hospital or clinic directly. Therefore, knowing what each package covers helps you avoid a surprise bill at discharge.

Check-ups and outpatient care

• The YAKAP program: free consultations, medicines, lab tests, cancer screening and preventive dental care.
• The emergency room benefit, even if you are not admitted.
• Mental health coverage, and what it does not pay for.

Hospital stays and big illnesses

• How much PhilHealth covers in a private versus a public hospital.
• Maternity benefits for normal and cesarean delivery, plus newborn care.
• Dialysis coverage: sessions per year and what you pay.
• The Z Benefit package for cancer, transplants and other costly illnesses.

Filing a claim

• The documents you need to file a PhilHealth claim.
• Using PhilHealth and an HMO together without a surprise bill.

Also on WisePH: our SSS guide and Pag-IBIG guide. For the newest PhilHealth updates, see the latest PhilHealth posts.