PhilHealth Package Benefits

The Philippine Health Insurance Corporation (PhilHealth) offers an array of healthcare packages designed to provide essential medical protection for Filipinos. These packages cater to different needs and budget, ensuring financial risk protection especially during hospital confinement. Let's delve into the key benefits and features of PhilHealth packages that make it an invaluable asset to every Filipino family.

PhilHealth packages primarily cover In-Patient (IP) and Out-Patient services, as well as family planning procedures. The amount paid for premium contributions dictates the benefits and coverage of each package. Here are the main schemes you should know about.

Indgang Program

The Indgang Program is PhilHealth's flagship plan, catering to the majority of the Filipino workforce and self-employed individuals. It offers comprehensive coverage for the insured's primary life and their dependents.

A wide range of in-patient and out-patient services are covered under this package, including major surgeries, confinement, diagnostic procedures, and preventive check-ups. However, certain non-covered services such as dental, optical, and rehabilitation are not included.

Indgang A

Indgang A is the base plan for employed and self-employed individuals without dependents. It provides a daily IP accommodation benefit of PHP 1,200 and a Z-benefit of PHP 3,000 for poor members.

On top of IP services, it also covers a share of the PhilHealth-adjudicated professional fees for out-patient and diagnostic services. This includes PHP 1,000 for members with intact bleeding, PHP 500 for emergency care, and PHP 300 per facilitated delivery.

Indgang B

Indgang B caters to employed and self-employed individuals with up to four dependents. It offers a daily IP accommodation benefit of PHP 2,100, Z-benefit of PHP 7,000 for poor members, and an additional PHP 2,000 max for CSSD (catastrophic) cases.

Additionally, it provides PHP 1,200 for pregnancy out-patient expenses, including pre- and post-natal check-ups. It also covers PHP 1,500 for outpatient benefit for indigenous people and foreigners.

Senior Citizens Program

The Senior Citizens Program (SCP) offers a PHP 3,000 per day IP accommodation benefit for senior citizens, as well as benefits for Z benefit (PHP 7,000) and Z plus (PHP 10,000) for poor senior citizens.

This program also provides benefits for Milims and senior citizens afflicted with Breast and Cervical cancer, with P15,000 coverage for determined cases and an additional P15,000 for Bsatong, Dilatation, and Curettage (D&C) procedures.

Captive Program

The Captive Program is designed for employees of a company or agency and/or their dependents enrolled by their employers. It offers a higher daily IP accommodation benefit compared to Indgang, ranging from PHP 2,500 to PHP 7,000 depending on the coverage level.

Outpatient services benefit ranges from PHP 600 to PHP 1,500 depending on the coverage level, with CSSD coverage ranging from PHP 4,000 to PHP 15,000.

Contributions to PhilHealth packages vary according to income and employment status. Premiums are regularly reviewed to keep pace with inflation and other benefits' costs. The package you choose should ultimately depend on your healthcare needs and financial capability. Regularly review your PhilHealth eligibility and update your records to ensure maximum benefits. To know more about the different PhilHealth packages and their corresponding benefits, always check PhilHealth's official website or contact your local PhilHealth office.