philhealth

How to Apply for Health Insurance in the Philippines

Health insurance is something that can save you from financial headaches after a medical emergency, but only if you invest in one early enough.

It is an act of foresight that you will thank your past self for once the need for it does arise, and that is something not enough people believe in until it is too late.

With that in mind, here are a few things you need to know about health insurance.

Why Would You Need Health Insurance

The fundamental fact with human beings is that we all get sick and we will eventually die. Our mortal bodies are not impervious to sickness and calamity, thus the need for medicine and health care.

Those who were young and seemingly invincible later become old and fragile, and it is only a matter of time until you too will need to go to a hospital to seek treatment for something ailing you.

This is why investing in health insurance is the smart thing to do. If there ever is something that catches people off-guard more than anything else, it’s how expensive medical bills can be.

You can never know when a medical emergency can happen, and being caught unprepared can land you in dire straits even if you do make a full physical recovery from an illness or accident.

The landscape of health insurance in the Philippines can seem intimidating to a lot of people, but it is not hard to navigate at all once you understand how the general process of getting one works and the fundamental differences between different health insurance programs.

Where to Get Health Insurance in the Philippines

PhilHealth

There is PhilHealth, which is the national health insurance program in the Philippines, and there are various private health insurance programs made available by insurance companies.

PhilHealth is the cheapest and most readily available option to the most number of people in the country due to it being a government institution.

Meanwhile, private health insurance programs are preferred by those who are able to afford them due to better coverage and benefits.

Enrolling in PhilHealth entails a benefit automatically, which is that you won’t have to pay up front for admission into an accredited hospital.

That shows one reason why having health insurance is smart—it tells the hospital that you can afford one, so you should be able to afford your medical expenses as well. Thus, they should let you in right away to be attended to if you are having a medical emergency.

PhilHealth is available to clients who may be classified in one of two primary categories—formal worker, wherein you and your employer pay 50/50; and Individual Paying Program for those who are self-employed. Accredited hospitals, both public (39%) and private (61%), are covered by this program.

Other Health Insurance Providers

Meanwhile, private health insurance programs offered by local or international providers have coverage that is more costly but bring more options and benefits to the table.

If you wish to enroll in one of the many private health insurance programs out there for those benefits, you should look carefully at their requirements and conditions.

Consider if the particular program you are eying at the moment has age limits, if they allow repatriation and family members to travel with you, coverage for chronic conditions, coverage for sports injuries, transfer of coverage upon emigration, maternity coverage, dental plan, and so on.

philhealth

How to Claim PhilHealth Benefits

If you wish to apply for PhilHealth benefits, then you must meet the following conditions:

  • At least 3 months’ worth of premiums paid within the first 6 months of confinement.
  • For pregnancies (availing newborn care package), dialysis, chemotherapy, radiotherapy, and selected surgical procedures, 9 months’ worth of premiums within the last 12 months.
  • Confinement in an accredited hospital for 24 hours due to an illness requiring hospitalization, attended to by an accredited physician.
  • Claim within 45-day allowance for room and board.

If these conditions are met, you must then assemble the following documents that are required for application.

  • Clear and updated copy of your Member Data Record (MDR). If you are a dependent, you must be listed in the MDR as such.
  • Original copy of PhilHealth Claim Form 1, signed by the employer.
  • Receipt of premium payments. Employees are only required to submit the Certificate of Premium Payments with OR numbers.
  • PhilHealth ID or any other valid ID.

Submit the aforementioned documents to the hospital before the end of your stay for automatic deduction of benefits from the total bill.

You should then receive a benefit payment notice from PhilHealth through the address indicated on your MDR.

Be sure to keep PhilHealth up to date on your personal and contact information.

Conclusion

As a long-term investment, health insurance is all about the one thing more important than wealth. Nothing is more important than one’s own health as it is what everything else in life is reliant on.

Getting health insurance is not just a favor for yourself, but also for your family and loved ones as it gives them one or more fewer things to worry about.

1 thought on “How to Apply for Health Insurance in the Philippines”

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