How Many Months of Contribution to Avail Philhealth Maternity
Among benefit of PhilHealth Maternity, the main is providing help to Filipino mothers during childbirth, covering the costs of prenatal care, hospital delivery, and postnatal services. To avail of these benefits, members must meet specific contribution requirements. Today we just discuss how many months of contributions you need to access PhilHealth maternity benefits, how to ensure your eligibility, and how to file for these benefits.
PhilHealth Maternity Benefit
Most of PhilHealth maternity benefits are plan to help reduce the financial burden of childbirth by covering the costs associated with pregnancy and delivery. These benefits include coverage for normal deliveries, cesarean sections, and related medical expenses like prenatal and postnatal care.
By confirming that women have access to these healthcare services, PhilHealth has clear contribution in supporting maternal health in the Philippines.
Who Can Avail of PhilHealth Maternity Benefits?
PhilHealth maternity benefits are available to:
- Female members who are either employed, self-employed, or voluntary contributors.
- Dependent spouses of male PhilHealth members, allow their legally married wives to avail of maternity benefits even if they do not have their own PhilHealth membership.
- Indigent members and beneficiaries of PhilHealth’s sponsored programs.
How Many Months of Contribution Are Required?
To avail of PhilHealth maternity benefits, members must have contributed for at least 9 months within the 12 months before the expected date of delivery. This means you need to have made contributions for at least nine of the twelve months leading up to the month of childbirth. Ensuring you meet this requirement is crucial to qualify for the maternity benefits.
Key Points:
- 9 months of contributions are required within the 12-month period prior to the delivery date.
- Contributions must be made before the delivery month to be eligible.
Checking PhilHealth Contributions
When unsure that met the required contributions, follow these steps to check your PhilHealth contributions:
- Log in to the PhilHealth Member Portal: Visit the official PhilHealth website and log in to the Member Portal using your PhilHealth number and password.
- Navigate to the Contribution History: Once logged in, click on the Contribution History section to view your payment records.
- Verify Contributions: Review your contributions to ensure that you have paid at least 9 months’ worth within the 12-month period before your delivery.
How to Ensure Eligibility for Maternity Benefits
It’s important to stay proactive to ensure you qualify for PhilHealth maternity benefits. Here’s how you can maintain eligibility:
Keep Contributions Up to Date
Regularly check that your contributions are paid on time. If you are employed, ensure your employer is remitting your contributions regularly. For voluntary or self-employed members, make sure you pay your premiums consistently to meet the eligibility requirements.
Voluntary Contributions for Self-Employed or OFWs
If you’re self-employed or an Overseas Filipino Worker (OFW), you can make voluntary contributions. It’s advisable to pay contributions in advance to avoid lapses that could affect your eligibility for maternity benefits.
For Employed Members
Employers are required to remit your PhilHealth contributions regularly. As an employed member, make sure to monitor your contributions through the PhilHealth Member Portal to ensure they are up to date.
What Happens If You Don’t Meet the Contribution Requirement?
If you fail to meet the required 9 months of contributions within the 12-month period before delivery, you will not be eligible for PhilHealth maternity benefits. Unfortunately, there is no option for catch-up payments to make up for missed contributions during this period. It’s crucial to stay consistent with your payments to avoid missing out on these essential benefits.
How to File for Maternity Benefits
Once you have confirmed that you are eligible for PhilHealth maternity benefits, follow these steps to file your claim:
Prepare Necessary Documents
- PhilHealth Claim Form 1: This is the primary form for filing maternity claims.
- PhilHealth ID and MDR (Member Data Record): Make sure your details are up to date in PhilHealth’s database.
- Proof of Delivery: This can be a birth certificate or hospital records confirming the date and details of delivery.
Submit Documents to the Hospital
- Submit the required documents to the hospital’s billing or claims department during your admission.
- The hospital will process your claim directly with PhilHealth, and the benefits will be deducted from your bill.
Processing and Reimbursement
- PhilHealth will reimburse the hospital directly for covered maternity expenses.
- Make sure all documents are complete to avoid delays in processing your claim.
What Is the Coverage Amount for Maternity Benefits?
PhilHealth provides a fixed amount of coverage for maternity benefits:
- Normal delivery: Around PHP 6,500 for accredited healthcare facilities.
- Cesarean section: Up to PHP 19,000 for hospital expenses.
- Prenatal and Postnatal Care: PhilHealth also covers prenatal check-ups and postnatal services.
Can I Avail of Maternity Benefits More Than Once?
Yes, you can avail of PhilHealth maternity benefits for each pregnancy, provided you meet the required number of contributions for each pregnancy.
What Happens If I Switch Jobs During Pregnancy?
If you switch jobs, ensure that your contributions continue without interruption. You can request your new employer to continue deducting your PhilHealth premiums, or you can make voluntary contributions if there is a gap.
Can I Avail of Benefits for Home Births?
PhilHealth generally applies maternity benefits to accredited healthcare facilities, but you should check with directly to confirm whether they cover home births under certain conditions.
Maintaining the required 9 months of contributions within the 12 months before delivery is essential to avail of PhilHealth maternity benefits. These benefits significantly reduce the financial burden of childbirth, ensuring mothers receive proper prenatal, delivery, and postnatal care. It’s crucial to regularly check your contribution status to avoid any lapses in coverage. If you are an expecting mother or planning a pregnancy, now is the time to ensure your PhilHealth contributions are up to date to fully enjoy the maternity benefits available to you.