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Keep your official receipts for paid prenatal consultation and care, and then submit them to your accredited hospital/clinic/lying-in/maternity facility, so the receipts will be included in the Philhealth claim. The refund check will be in your name and will be sent to your address. If you’re Individual Payor, OFW or dependent, bring original and xerox copies. You can ask for this form from your employer, the hospital or from any Philhealth branch.

Many lying-in or maternity clinics require that your prenatal care services are done by them. Upon admission or during admission, ask the hospital about their Philhealth policies, so you have time to remedy if there are problems. If you’re a dependent, your name should be written in the MDR form as a dependent. If you’re employed, ask for a Certificate of Philhealth premium payments from your employer. Ask for two copies, the other is for your baby’s newborn care package. If you’re a dependent of your husband, bring your marriage certificate, in case the hospital asks. If you have pre-natal care receipts, bring them to the hospital/clinic and attach them to the claim forms.

No, if it’s already too late to pay for 3 months prior to delivery.

But if you can accept possible denial, you can go to the nearest Philhealth and ask if you can avail if you pay for 1 year in advance.

Direct filing by patients with Philhealth is no longer allowed, so submit your documents to your accredited health facility before discharge so that your maternity and newborn test cost benefits will be deducted from your hospital/clinic bill. Pre-natal care benefit is 1,500 pesos, if your ORs sum up to 1,500 pesos or more. Philhealth ID or any valid photo ID, in case the hospital asks for identification.

Now, only certain direct filing cases are allowed, such as filing for refund by overseas Filipinos giving birth abroad, by employees who are admitted and discharged during weekdays or holidays, and by patients who are asked by their government hospitals to buy medicines and supplies from pharmacies outside the hospitals. You CAN NOT avail of complicated maternity care in non-hospital facilities such as lying-in and maternity clinics.

Avail of complicated maternity services in hospitals.

Here are exclusions (both hospital and non-hospital facilities): – fifth normal delivery and subsequent deliveries – normal delivery after 1 breech delivery and 3 normal deliveries – normal delivery after 1 cesarean delivery and 3 normal deliveries – normal delivery after 1 preterm delivery and 3 normal deliveries – normal delivery after 1 stillbirth and 3 normal deliveries – normal delivery after 1 normal delivery, 1 abortion and 3 normal deliveries – normal delivery after 3 abortions and 4 normal deliveries Exclusions in non-hospital facilities: (You should go to a hospital) – you’re younger than 19 – you’re already 35 years old or older and this is your first time to give birth – multiple pregnancy – uterine or ovarian abnormalities, such as ovarian cysts and myoma uteri – placental abnormality, such as placenta previa – abnormal fetal presentation, such as breech – history of 3 or more miscarriages or abortion – history of 1 stillbirth – history of cesarean section (CS), or uterine myomectomy, or other major gynecologic or obstetric operation – history of hypertension, eclampsia, pre-eclampsia, diabetes, heart disease, asthma, epilepsy, bleeding disorders, renal diseases, thyroid disorder and morbid obesity – risky conditions that may arise during pregnancy such as vaginal bleeding and premature contractions CS will NOT be covered by Philhealth if it’s performed at a Level 1 hospital or maternity clinic.

Ask your doctor about it beforehand because the newborn tests must be performed within a certain number of hours after the baby’s birth in order for the tests to be paid by Philhealth. Find an obstetrics-gynecologist who is Philhealth-accredited, who works in a Philhealth-accredited hospital, and who is willing to help you get the maximum benefit starting from prenatal care up to newborn care.

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