What Are the Diseases Covered by PhilHealth? Quick Guide to PhilHealth Case Rates
PhilHealth implements a case rate payment system where the amount that PhilHealth will reimburse the patient depends on the specific illness/case. This coverage includes healthcare professional fees and facility charges.
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.
Dengue is among the cases covered by PhilHealth. Dengue fever with and without warning signs is covered up to ₱10,000 while Severe Dengue is covered up to ₱16,000.
Listed below are other common illnesses covered by PhilHealth and their case rates. Take note that this is not a complete list. Complete case rate information can be searched in the Philhealth Portal.
| Illness | Coverage |
| Acute Gastroenteritis Amoebiasis | ₱6,000 |
| Acute Renal Failure | ₱19,300 |
| Allergic Reactions | ₱6,200 |
| Anaphylactic Shock (Severe Allergic Reactions) | ₱7,600 |
| Anemia | ₱10,000 |
| Arthritis (Infectious) | ₱9,700 |
| Asthma (In Acute Exacerbation) | ₱9,000 |
| Back Pain, Radiculopathy, Sciatica | ₱6,400 |
| Bleeding Disorders/Hemorrhagic Conditions | ₱12,800 |
| Brain Injury/Intracranial Injury | ₱8,800 |
| Breast Cancer/Malignancy | ₱11,800 |
| Cancer/Malignancy (Depends on Affected Organs), Examples: Bone and Cartilage Case Rate Range for Malignancy Central Nervous System Digestive Organs | ₱16,500 ₱11,000-₱16,900 ₱16,900 ₱14,200 |
| Cardiac Arrhythmia and Cardiomyopathy | ₱13,400 |
| Cellulitis | ₱9,600 |
| Chikungunya and Other Arthropod-Borne Viral Fever | ₱8,100 |
| Cholecystitis | ₱11,300 |
| Chronic Heart Disease Without Complication | ₱4,000 |
| Chronic Obstructive Pulmonary Disease | ₱12,200 |
| Chronic Kidney Disease | ₱14,500 |
| COVID-19 Moderate Without Pneumonia With Risk Factors for Progression COVID-19 Moderate With Pneumonia COVID-19 Severe COVID-19 Critical | ₱43,997 ₱143, 267 ₱333,519 ₱786,384 |
| Dengue Fever Dengue, Severe | ₱10,000 ₱16,000 |
| Diabetes Mellitus With Complications Other Than Coma or Ketosis | ₱12,600 |
| Diabetes Mellitus With Coma or Ketosis | ₱15,800 |
| Dehydration (Moderate-Severe) | ₱4,000 |
| Ebola Virus Disease | ₱110,000 up to ₱222,000 |
| Epilepsy | ₱7,800 |
| Glaucoma | ₱6,500 |
| Heart Failure | ₱15,500 |
| Heat Stroke and Other Heat Exhaustion | ₱6,500 |
| Hydrocephalus | ₱17,300 |
| Hypertensive Urgency/Emergency | ₱9,000 |
| Hyperthyroidism | ₱8,500 |
| Hypoglycemia | ₱4,000 |
| Hypothyroidism | ₱8,100 |
| Inflammatory Bowel Disease | ₱9,100 |
| Inflammatory Diseases of the Central Nervous System (Encephalitis, Myelitis, etc.) | ₱21,600 |
| Inflammatory Disease of the Heart (Endocarditis, Myocarditis, etc.) | ₱14,400 |
| Influenza | ₱6,000 |
| Injuries to Muscle, Tendons, and Joints | ₱7,200 |
| Intestinal Obstruction | ₱10,100 |
| Ischemic Heart Disease With Myocardial Infarction Ischemic Heart Disease Without Myocardial Infarction | ₱18,900 ₱12,000 |
| Leptospirosis Moderate to Severe | ₱11,000 |
| Liver Failure | ₱20,600 |
| Malnutrition | ₱11,700 |
| Meningitis | ₱25,700 |
| Meningococcemia | ₱19,800 |
| Mental and Behavioral Disorders | ₱7,800 |
| Middle East Respiratory Syndrome (MERS-CoV) | ₱50,000-₱100,000 |
| Migraine and Headache Syndromes | ₱5,500 |
| Miscarriage If With Complications | ₱5,000 ₱6,900 |
| Newborn Sepsis | ₱11,700 |
| Nutritional Disorder | ₱9,200 |
| Osteoporosis and Disorders of Bone Density and Structure | ₱7,900 |
| Otitis Media | ₱7,800 |
| Pancreatitis and Diseases of the Pancreas | ₱12,600 |
| Parasitic Infection Without Complications (Ex. Malaria, Schistosomiasis) | ₱4,000 |
| Peptic Ulcer With Hemorrhage Peptic Ulcer Without Hemorrhage | ₱12,800 ₱6,100 |
| Perinatal Infections | ₱12,700 |
| Pneumonia High Risk Moderate Risk | ₱32,000 ₱15,000 |
| Postpartum Complications | ₱9,300 |
| Pregnancy/Maternal Comorbidities | ₱6,800 |
| Pyelonephritis | ₱10,900 |
| Rheumatic Heart Disease | ₱12,800 |
| Sepsis | ₱32,000 |
| Skin Infections | ₱4,000 |
| Stroke-Hemorrhagic Stroke-Infarction | ₱38,000 ₱28,000 |
| Systemic Lupus Erythematosus | ₱11,900 |
| Tetanus | ₱16,500 |
| Tuberculosis (Extrapulmonary) TB (Miliary) TB (Pulmonary) | ₱11,900 ₱11,900 ₱9,800 |
| Typhoid Fever | ₱10,000 |
| Upper Respiratory Tract Infection (Acute Bronchitis) | ₱4,000 |
| Urinary Tract Infection or UTI (Admissible) | ₱7,500 |
| Urolithiasis | ₱4,000 |
| Viral Hepatitis | ₱11,800 |
| Viral Infection (Ex. Measles) (Admissible) | ₱7,700 |
| Viral Infection of the Nervous System | ₱21,100 |
| Zika Virus | ₱8,100 |
Return to the main article: How To Register in PhilHealth Online: A Complete Guide for New Members
Camille Lamera, MD
Camille Lamera is a medical doctor with clinical and government work experience. She has always been passionate about health education and public service, having worked in two government offices and as a part-time educator in Preventive and Community Medicine. She is currently working as a doctor in public health while also doing freelance academic and scientific writing.
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