Healthcare Maternity benefits - Philhealth vs SSS

I just realize the importance of having a health care insurance now.

I went out earlier to process  my health care for my maternity benefits since i can't reached the hotline number of the main health center to clarify things (i've been calling the hotline number for a couple of days now but still unreachable). Anyway, I used to be a member in our government healthcare and i was hoping that i can still use it even though i failed to continue paying it as a voluntary member after i lost my job last October of 2009. So from October up to now i didn't make any payment.

I went to the main office and they told me that im not qualified. I was very disappointed for the fact that im just wasting my time going there and yet i only heard those words. According to them, for me to be eligible i should at least make 9 payments within 12 months prior to delivery. So if i give birth by August i should at least have 9 payments from July 2009. I really felt bad coz i've been paying the membership fee ever since and i never used it even once since i normally use my medicard issued by our employer since the total coverage is more higher.

I was not aware about this things as i though the minimum is 3 months only and not 9 months.  Though they told me to try SSS or Social Security System as they only required 3 months payment to qualified for maternity benefits. Luckily i continue to make payments with my SSS as a voluntary member after i lost my job so i know i am more than qualified for it. I went to SSS Office and i've got positive result. And they offer better maternity benefits in terms of financial assistance than Philhealth but unfortunately you can only reimburse the money after giving birth and after submitting all the requirements though in Philhealth it can be deducted from your total hospital bills upon check out.

SSS basis for computation is your 6 highest monthly salary credit.
So if your highest salary is 15,000*6 months = 90,000/180 days = 500.00 will be your daily maternity allowance.

Total maternity benefits to reimburse would be:
Normal delivery 500.00*60 days = 30,000
Ceasarean deliver 500*78 days = 39,000

SSS requirements for maternity benefits:

- SSS form MAT-1 (Maternity notification) duly stamped and received by SSS. If your employed then ask anyone from Human Resources Department for more information, but if your a voluntary member then you need to file the form directly to any SSS office.

- SSS form MAT-2 (Maternity Reimbursement) you can only accomplished this after giving birth together with the other documents.

- Other documents
Normal delivery - Certified true copy or authenticated copy of duly registered birth certificate.
Caesarean Delivery - Certified copy of birth certificate and certified copy of operating room record/surgical memorandum.
Miscarriage or abortion - Obstetrician history stating the number of pregnancy certified by the attending physician. Pregnancy test before and after abortion with age of gestation and hystopath report.

- SSS digitized ID or E-6 with 2 valid ID

Its so nice to have health care insurance as you know that you can use it in case of emergency, like if you lost your job and other things.

193 comments:

  1. I suggest you go to their website and research about the benefits, in SSS i think they will give your maternity benefit, in healthcare if you are an active member, you should continue paying the quarterly contribution and inform them in advance about your pregnancy. good luck!

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