Kaya pala philhealth.

𝗕𝗮𝗸𝗶𝘁 𝗸𝗮𝗶𝗹𝗮𝗻𝗴𝗮𝗻 𝗺𝗼𝗻𝗴 𝗮𝗹𝗮𝗺𝗶𝗻 𝗸𝘂𝗻𝗴 𝗽𝗮𝗻𝗼 𝗻𝗮𝗴𝘄𝗼𝘄𝗼𝗿𝗸 𝗮𝗻𝗴 𝗣𝗛𝗜𝗟𝗛𝗘𝗔𝗟𝗧𝗛 𝗺𝗼?

Last May 2024, naoperahan ang wife ko due to ovarian cyst.

It was an ovarian cystectomy...isang surgery na tatanggalin ang bukol sa ovary

That's so unexpected.

Nakakapraning.

Salamat sa Diyos, successful ang operation

Pero eto na, nung dumating yung bill.

Total Bill: ₱170,613.20

Buti nalang, sabi ng staff:

“Covered po kayo ng PhilHealth.”

Akala namin laking ginhawa na 'yun.

Then we saw the bill.

Total Bill: ₱170,613.20

PhilHealth Coverage:

₱13,910.00 - Room for 4 days and Medicines

₱16,380.00 - Professional Fees

₱30,290.00 - Total Philhealth Coverage

Napakamot talaga ako sa ulo.

So I started digging. And here’s what I found.

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𝗙𝗜𝗥𝗦𝗧 𝗧𝗛𝗜𝗡𝗚: 𝗣𝗛𝗜𝗟𝗛𝗘𝗔𝗟𝗧𝗛 𝗗𝗢𝗘𝗦 𝗡𝗢𝗧 𝗖𝗢𝗩𝗘𝗥 𝗘𝗩𝗘𝗥𝗬𝗧𝗛𝗜𝗡𝗚

PhilHealth has a Case Rate system.

Every illness or procedure has a fixed coverage.

For example:

*Pneumonia (moderate risk): ₱29,250

*Dengue: ₱10,000

*Cesarean Section: ₱37,050

*Cholecystectomy: ₱60,450

So kung bill mo ₱60,000 at ang case rate ay ₱15,000

That’s the max they’ll cover.

You shoulder the rest.

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PhilHealth isn’t like a typical health card.

You don’t swipe and expect "fully covered".

It helps, YES.... pero kung ‘di mo alam paano siya nagwowork,

pwede kang ma-shock sa bayarin.

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𝗧𝗢 𝗚𝗘𝗧 𝗧𝗛𝗘 𝗙𝗨𝗟𝗟 𝗕𝗘𝗡𝗘𝗙𝗜𝗧𝗦, 𝗗𝗜 𝗣𝗪𝗘𝗗𝗘 𝗟𝗔𝗡𝗚 𝗠𝗔𝗚𝗛𝗨𝗟𝗢𝗚 𝗞𝗔 𝗡𝗚𝗔𝗬𝗢𝗡

For employed or voluntary members:

You must have at least 9 months of contributions in the last 12 months before confinement.

Otherwise… sorry.

For senior citizens:

They can be automatic members, but they still need to register & submit docs to be eligible.

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Here's what you can do today:

Check your contributions sa PhilHealth Member Portal.

Kung self-employed or OFW ka, consistently maghulog.

Ask your HR kung updated ang remittance mo.

Prepare a Member Data Record (MDR) and valid ID palagi.

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Don't expect magic coverage. WALANG GANON.

PhilHealth is helpful, pero hindi sapat kung malaki ang bill.

You still need:

• Emergency fund

• HMO (if you can)

• Critical illness or health insurance

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For years, I thought PhilHealth = peace of mind.

Pero now I know: PhilHealth = partial aid lang.

Still thankful… and still humbled.

Let’s share this with others, lalo na yung mga walang HMO or insurance.

Because financial preparedness is not just for saving money...

It’s about protecting your family when it matters most.

We all deserve peace of mind.

God bless sa mga taga-bayad sa ospital.

Stay strong!!!

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*No Balance Billing not applicable.