Dependents can enjoy the same benefits as principal members. As per Implementing Rules and Regulations of the National Health Insurance Act of 2013¹, this includes the following: 

1. In-patient Care

• Room and board;
• Services of health care professionals;
• Diagnostic, laboratory, and other medical examination services;
• Use of surgical or medical equipment and facilities;
• Prescription drugs and biologicals, subject to the limitations of the Act; and,
• Health education.

2. Out-patient Medical and Surgical Care

• Services of health care professionals;
• Diagnostic, laboratory, and other medical services; 
• Personal preventive services; 
• Prescription drugs and biologicals, subject to the limitations of the Act; and, 
• Health education. 

3. Emergency and Transfer Services

4. Health Education Packages

5. Such Other Health Care Services That the Corporation and the DOH Shall Determine To Be Appropriate and Cost-Effective

Qualified dependents can enjoy a separate coverage of up to 45 days per calendar year. However, the 45 days allowance shall be shared among them.

PhilHealth may not cover health services deemed by PhilHealth and DOH as cost-ineffective through health technology assessment. PhilHealth may also put additional exclusions or limitations depending on how reasonable the service is and if it aligns with the Corporation’s objectives and protects its financial sustainability. 

Please remember that PhilHealth will not cover everything, especially in private hospitals or healthcare providers. 

If the principal member suddenly expires, the dependents will continue to be able to avail of the benefits of the unexpired portion of the coverage or until the end of the calendar year, whichever comes first.

Disclaimer: This article has been published for educational purposes only. Neither the author nor FilipiKnow is affiliated with PhilHealth, so specific queries about your membership and insurance benefits must be forwarded to the proper authority.

Return to the main article: How To Register in PhilHealth Online: A Complete Guide for New Members

Reference

1. Official Gazette. The Revised Implementing Rules and Regulations of the National Health Insurance Act (2013).