PhilHealth hikes maternity benefits

MANILA, Philippines - Philippine Health Insurance Corp. (PhilHealth) announced yesterday that effective today the benefit package for normal childbirth or “spontaneous delivery” done in accredited hospitals and maternity clinics will be increased from P4,500 to P6,500.

PhilHealth president and chief executive officer Dr. Rey Aquino said the mark-up in benefits applies only to the first four low-risk normal spontaneous deliveries of (PhilHealth) members and their qualified dependents.

“The enhancement is being made to substantially cover the attendant hospital charges, professional fees and costs of prenatal care,” said Aquino who attributed the increase in PhilHealth benefit to Resolution No. 1282.

Under the new compensation package, PhilHealth will pay up to P2,500 each to the hospital and the professional fee and P1,500 for prenatal care services if giving birth in hospital facilities.

In non-hospital settings such as lying-in and maternity clinics, P5,000 goes to the facility while P1,500 goes to prenatal care.

The payment for the facility covers room and board, drugs and medicines, laboratories, supplies, ancillary procedures like labor, delivery and recovery rooms, and other medically necessary charges for delivery and postpartum care.

Aquino claimed the attending physicians would be paid for the actual delivery, immediate postpartum care and counseling for reproductive health, breastfeeding and newborn care.

The new package will allow PhilHealth to reimburse the necessary prenatal care for members giving birth in hospital facilities, a feature that used to be enjoyed only by those seeking deliveries in accredited maternity and lying-in clinics.

Members should present valid official receipts to refund part of their prenatal expenses that should include consultations.

To avail of the benefits, individually paying members (IPMs) should have already paid their premium for at least nine months within the immediate 12 months prior to the month of availment.

Employed members and IPMs enrolled under the KASAPI (Kalusugang Sigurado at Abot-kaya sa PhilHealth Insurance) will be required at least three months of paid contributions within the immediate six months prior to actual availment.

Aquino added that sponsored and overseas Filipino workers who are PhilHealth members could avail of the package within the validity period of their coverage as stated in their Family Health Cards and Member Data Records, respectively.

Lifetime members and their qualified dependents will have to present their PhilHealth identification cards to avail of the benefits.