Being an overseas Filipino worker (OFW) is hard enough without the additional burden of being hospitalized with no support. It is for this very reason that PhilHealth extended its programs with additional benefits for Filipinos based outside the Philippines who are PhilHealth members.
Like active PhilHealth members who are living in the Philippines, OFWs can also file a PhilHealth claim abroad if hospitalized or receiving medications for certain medical conditions. To do that, here is a complete guide that details all the requirements and procedures for filing a PhilHealth claim.
Documentary requirements
If you are an active member hospitalized abroad and you wish to file a PhilHealth claim, you will need to submit the following documents through email or via overseas courier to the PhilHealth Regional Office or Local Health Insurance office closest to your Philippine address:
- A Medical abstract, medical record written in English, or copy of Medical Certificate with the doctor’s final diagnosis, confinement period, and medical services rendered.
- If an operation was performed, a copy of the operative record written in English.
- A Statement of Account (SOA) which lists the breakdown of costs of medication, hospital fees, professional fees, medicines, and all expenses related to the medical procedure.
- Since most patients hospitalized overseas shoulders the expenses, a reimbursement can be filed but you will need to present the Official Receipt issued by the hospital and doctor, which will serve as a basis for computation of benefits.
- Duly accomplished PhilHealth Claim Form 1, which can be downloaded from the PhilHealth website.
Note that these requirements should be mailed within 180 days from the date the patient, either an active member or dependent, was discharged from the hospital.
There are also a few other things you would want to check before filing a claim for hospitalization benefits:
- Make sure that you are an active member.
- Once done, check that you are filing for a claim within the validity period of 180 days for OFWs.
- Make sure you have not used up the 45-day annual maximum limit for hospital room and board allowance.
If you satisfy these criteria and can provide the documents, then you are all set to file for a hospitalization benefits from PhilHealth.
If you haven’t yet joined PhilHealth as a member, you can register for membership. This used to be available online, through PhilHealth e-service option, though as of writing time, the website is still under construction.