5 PhilHealth Benefits You May Not Know for You and Your Newborn
ParenTeam Philippines
Many parents will tell you that going through pregnancy and childbirth turns you into a budgeting expert, whether you plan to be or not. You'll quickly learn just how much those expenses add up, from prenatal visits and doctor's fees to the cost of the delivery itself. Thankfully, expectant parents can get some financial help through PhilHealth benefits.
PhilHealth Maternity Packages
PhilHealth offers five maternity packages*, including ones for newborns and premature infants.
1. Maternity Care Package
This benefit covers essential healthcare services throughout your pregnancy up to your childbirth in PhilHealth-accredited health institutions. It includes prenatal checkups and postpartum care (follow-up visits within 72 hours and one week after delivery).
The Maternity Care Package provides the following financial benefits:
- ₱6,500 – Hospital
- ₱8,000 – Birthing homes, lying-in clinics, infirmaries/dispensaries, maternity clinics
To avail of the Maternity Care Package, PhilHealth requires at least four prenatal visits at the PhilHealth-accredited hospital or facility where you will give birth.
2. Normal Spontaneous Delivery (NSD) Package
This benefit includes follow-up visits to your doctor three to seven days after giving birth. NSD Package covers:
- ₱6,500 – Hospital
- ₱8,000 – Birthing homes, Lying-in clinics, Infirmaries/Dispensaries, Maternity Clinics
3. Antenatal Care Package
This PhilHealth benefit caters to prenatal care, including checkups, maternal nutrition, immunizations, and breastfeeding counseling.
To use this package, you should have a total of four prenatal checkups:
- 3 checkups within the first six months of pregnancy (first and second trimester)
- 1 checkup within the last three months of pregnancy (third trimester)
You are eligible for ₱1,500 under the Antenatal Care Package, regardless of the hospital or medical facility where you receive consultations and procedures. However, you can only claim this benefit if you receive prenatal care from a facility different from the one where you will give birth. You cannot claim this benefit if you already have the Maternity Care Package.
4. Newborn Care Package
PhilHealth provides coverage for postpartum checkups and newborn care.
This PhilHealth benefit provides ₱2,950 to help cover essential newborn care, including the Newborn Screening Test and the Newborn Hearing Screening Test. It also offers the following for your newborn:
- Vitamin K
- Eye ointment
- Hepatitis B and BCG vaccines
5. Z Benefits for Premature and Small Newborns
Pregnant women who are at risk of giving birth at 24 weeks to less than 37 weeks of gestation can use this package upon hospitalization. Z Benefits provide:
- ₱600 – for preventing complications of preterm delivery with other high-risk conditions such as preterm labor, vaginal bleeding, and multifetal pregnancy
- ₱1,500 – for preventing complications of preterm delivery with preterm pre-labor rupture of membranes (pPROM)
- ₱3,000 – for preventing of complications of preterm delivery with severe preeclampsia or eclampsia
- ₱4,000 – for coordinated referral and transfer from a referring facility
The Z Benefit package ranges from ₱35,000 to ₱135,000 for premature and small newborns who are 24 weeks to less than 32 weeks in fetal age.
Moms of babies 32 weeks to less than 37 weeks in fetal age are entitled to ₱24,000 to ₱71,000 worth of benefits as long as care is provided in a PhilHealth-accredited hospital.
FAQs on PhilHealth Benefits for Moms
Members and their qualified dependents may avail of different PhilHealth benefits but must meet the required number of contributions.
PhilHealth benefits are open to all members and their qualified dependents. However, you must meet the required number of contributions to be eligible for the benefits.
How do I qualify for PhilHealth benefits?
PhilHealth is mandatory for all Filipino employees. There are two types of membership: formal and informal economy.
Formal economy members:
- Employed by the government
- Employed in the private sector
Informal economy members:
- Migrant workers
- Filipino citizens in the informal sector
- Self-earning individuals
- Filipinos with dual citizenship
- Naturalized Filipino citizens
- Citizens of other countries working or residing in the Philippines
How many months of contribution are required to receive PhilHealth benefits?
You should have paid at least nine months of premium contributions within the immediate 12-month period before the first day of your confinement.
I haven't paid my PhilHealth because I resigned. What are my options?
You can reactivate your membership and become eligible for benefits by paying one month’s premium contributions. This option also applies to employed members shifting to informal economy membership or vice versa.
For example, you decide to become a freelancer after you resign. You have a three-month grace period to pay at least one month of premium contribution to avail of PhilHealth benefits.
What are the requirements for claiming PhilHealth maternity benefits?
The hospital can check if you're eligible based on the amount of your PhilHealth contributions. It will deduct your PhilHealth benefits from your hospital bill.
If you’re self-employed or an OFW, the hospital may ask you for the following documents:
- PhilHealth Member Data Record
- Proof of contributions (e.g., official receipt of your last PhilHealth contribution)
- PhilHealth ID or any valid government ID
Does PhilHealth only cover normal delivery?
No, PhilHealth covers other types of delivery as long as you gave birth in a PhilHealth-accredited hospital. Here’s the coverage:
- ₱19,000 – Cesarean section
- ₱9,700 – Complicated vaginal delivery
- ₱12,120 – Vaginal birth after C-section (VBAC)
- ₱12,120 – Breech extraction
Can I reimburse my PhilHealth benefits after I give birth?
No, you cannot reimburse your PhilHealth maternity benefits, unlike GSIS or SSS maternity benefits. The covered amount is usually deducted from your hospital bill, including your doctor’s professional fees. The hospital or facility will process the claim directly with PhilHealth.
Will PhilHealth cover baby’s first checkup?
You are entitled to two follow-up visits to your doctor under the Maternity Care and NSD packages. The first checkup is within 72 hours, and the second one is a week after delivery.
Tips on Maximizing Your PhilHealth Benefits
To get the most out of your PhilHealth membership, make sure to take note of the following:
- Verify your membership or apply to be a member. Try to accomplish this during the early stages of your pregnancy so you won’t have a problem come delivery day.
- Pay your contributions. If you are not up to date with your PhilHealth premiums, make sure to leave ample time to pay the dues and be eligible for the PhilHealth maternity benefits.
- Choose a PhilHealth-accredited hospital or birth care center. Not all private hospitals automatically deduct PhilHealth benefits, so inquire about the process before your delivery.
Having a baby is exciting but it can get financially heavy. So, while PhilHealth benefits may not cover all your expenses, it goes a long way in lightening the load. Know your options and start paying those contributions. Every bit of help counts!
Did you use your PhilHealth benefits during pregnancy? Share your experience on ParenTeam’s Facebook group!
*All prices and policies are subject to change without notice.
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