When I was working in the call center, my family enjoyed the benefits of a Maxicare insurance. It covered both outpatient services as well as admissions. The maximum benefit is an eye popping half a million for me, i just don’t remember the exact figure for my dependents but it’s a solid health plan for all of us at that time. And I tell you, some of my coworkers did love the fact that when they get sick, they will be in a private room accommodation without any worries about the bill. That is of course different now.

When I shifted to online work, I have only managed to keep my Philhealth contributions. For the past 3 years, I have been relying solely on Philhealth for medical insurance. I pay an annual fee of Php 1,200 and it’s been a sound choice. Last year, when my wife gave birth to our daughter Deborah, we were able to receive over Php 14,000 in refund from Philhealth, which is almost half the amount we paid.

Philhealth Benefits and Coverage

There is no question that Philhealth contribution is a sound investment. It gives you a sense of security that at least you’ll have something to ease your financial worries when health problems happen or in case of medical emergencies. I’d highly recommend that you make sure you allot some of your earnings to pay for your Philhealth contribution. Whether quarterly, semi annual or annual, it will always come in handy to have something like Philhealth. And if you are still unsure what you actually get for those contributions, here’s a quick roundup of the benefits you can get with your contribution.

For inpatient services, PhilHealth provides subsidy for:

  • room and board,
  • drugs and medicines,
  • laboratory exam,
  • use of operating room complex
  • and professional fees for confinements of not less than 24 hours.
Outpatient Coverage

Day surgeries, dialysis and cancer treatment procedures such as chemotherapy and radiotherapy in accredited hospitals and free-standing clinics.

Special Benefit Packages
Exclusions

The following shall not be covered except when, after actuarial studies, PhilHealth recommends their inclusion subject to approval of its Board of Directors:

  • Fifth and subsequent normal obstetrical deliveries
  • Non-prescription drugs and devices
  • Alcohol abuse or dependency treatment
  • Cosmetic surgery
  • Optometric services
  • Other cost-ineffective procedures as defined by PhilHealth

You can also visit the Philhealth website for more details. Now let’s go back to the heart of the story.

If Philhealth is that good, then why is there a need for another health insurance? Here a few things to consider:

1. Hospital Deposits

One of the main things that really made me choose to get an insurance is the admission fee. Nowadays, if for some reason you need to be admitted in Hospitals like Chong Hua or Cebu Doctors Hospital, you will need a deposit of about Php10,000 either in cash or use a credit card. If you have an HMO, you just show your card. No need to worry about pulling your savings out of the bank just to get admitted. The last thing you’d like to think is worrying about where to get the money instead of taking care of your patient.

2. Oral health services

According to the Department of Health, “Right now, only oral health illness that requires hospitalization like oral-maxillofacial surgeries such as removal of cysts, fractures, removal of impacted tooth and the likes are part of the benefit.”  Oral health services (out-patient benefits) such as oral prophylaxis, fillings and extraction are still not part of the benefit package.

3. Shared Allowance between dependents

Another thing to consider is that while Philhealth has 45 days allowance for your dependents, it’s actually shared among the dependents. Well, there is a good side to that because basically you are only paying for one, but your dependents can still enjoy it. However, if you have declared your three kids and your wife, God forbid that they don’t use up the allocated 45 days right away, otherwise, the rest won’t have any more to use. And therefore, you’ll have to shoulder the fees yourself.

4. At least 9 months payment to be eligible

For individually paying members at least nine (9) months contributions within twelve (12) months prior to the month of availment for all confinements including availment of outpatient benefits). When my wife gave birth to our daughter Denise, I’ve learned the painful lesson of this eligibility clause. Unfortunately, at that time I am only paid up for 8 months which is one month short. So I had to pay about Php14,000 which I was suppose to enjoy had it been that I was able to reach the minimum 9 months contribution prior to my wife’s delivery.

The main point i’m trying to bring out in this post is that you can better protect yourself and your family if you augment your Philhealth with other health insurance services. It’s a sound investment and it’s probably one of the best ways to use your hard earned money than just splurging on gadgets that depreciates in value the moment you get your hands on it. And if you share the sentiment, I’d be happy to hear your ideas and thoughts about health insurance for freelancers.

On my next post, I’m going to share with you my personal choice for a health insurance and what made this my stand out choice. So keep an eye on this space.