PhilHealth 101: 6 Benefits You May Not Know About

For many Filipinos, PhilHealth has served as a crucial lifeline when it comes to access to affordable healthcare. Especially with the rising costs of HMO benefit, many people prefer not availing an HMO owing to its high cost, about 59% according to a 2023 Capstone-Intel Corp. survey. 

PhilHealth offers standard hospitalization and medical coverage, but there are other lesser-known benefits that could make a huge difference in providing peace of mind in an event of an illness. Let’s talk about these benefits and how you can use them.

While mental health remains to be a taboo topic for most Filipino families, it is becoming a growing concern in society and must be given the same attention as physical health. Fortunately, PhilHealth offers a mental health benefits package which includes consultations, diagnostic follow-up, psychoeducation, and psychosocial support. General mental health service package costs P9,000 while the specialty mental health services packages costs P16,000 per person annually.

Did you know that there are estimated 1 million Filipinos that have active tuberculosis, and many not know that they have it? Tuberculosis is indeed a silent killer, and the treatment costs can go high without medical support. PhilHealth’s TB-DOTS (Directly Observed Treatment) offers accessible and affordable TB treatment at a fixed rate of P4,000, providing full coverage for diagnostic exams, consultation services, anti-TB medications, and counselling during TB treatment.

Nothing is more stressful than contracting a serious illness. Not only is it taxing to deal with the physical symptoms, but also the piling medical bills. PhilHealth’s answer is Z Benefits, which was launched to address major illnesses such as childhood acute lymphocytic leukemia (ALL), several types of cancer, prostate cancer, cervical cancer, colon cancer, rectal cancer, end-stage renal disease requiring kidney transplantation, to name a few.

Any PhilHealth member can avail the Z Benefits if their illness is part is covered by the package and they pass the required pre-authorization. The pre-authorization process determines whether the patient has been diagnosed and qualifies for the Z Benefits. Financial support varies depending on the illness. For breast cancer treatments, it can cover up to P1.4 million, P175,000 for cervical cancer and P600,000 end-stage renal disease requiring kidney transplantation. You can visit here for more details about the Z Benefits package. 

According to a data from the National Kidney and Transplant Institute (NKTI), approximately one Filipino develops chronic renal failure every hour, which is roughly 120 Filipinos million annually. To address this, PhilHealth provides hemodialysis coverage of P4,000/session. This package is increased from the previous P2,600/session, further easing the financial burden of long-term dialysis. 

PhilHealth’s Newborn Care Package (NCP) was designed to offer essential newborn health services to ensure that every infant receives the necessary medical care they need right from birth. This comprehensive package worth P2,950 includes screenings for hearing impairments, congenital hypothyroidism, and metabolic disorders, as well as the administration of Vitamin K to prevent bleeding. To be eligible for the NCP, members must meet certain criteria including:

•    The newborn must be a member of PhilHealth
•    The newborn must be born in a PhilHealth-accredited hospital

Since the onset of the COVID-19 pandemic, PhilHealth has offered several essential benefits related to testing, treatment, and hospitalization for COVID-19 patients. For COVID-19 testing, PhilHealth covers RT-PCR (Reverse Transcription Polymerase Chain Reaction) from P800 to P2,800; and Rapid Antigen Test for P500. With this benefit, Filipinos dealing with COVID-19 can assure proper care and medical support without the high cost. 

While it’s true that getting sick is expensive, services and programs like PhilHealth offer more affordable and convenient ways to get the right medical support you need. Aside from the medical benefits, having a PhilHealth ID grants you a powerful primary valid ID that can be used for many government and business transactions such opening a bank account or applying for Home Credit installments.

In case you have other questions on the health benefits you can avail, you may call PhilHealth at (02) 8662-2588. So go on and make the most of your PhilHealth membership—it might just save you or your family in ways you didn’t expect.