How To Reimburse Medicine Payments Made to Hospital and Doctor - Filing and Procedure

A couple of years ago, my father was hospitalized in Cavite and I would just like to share to all PhilHealth member how I was able to reimburse the amount of covered benefit in cash equivalent from the total expenses we spent for hospitalization which includes both professional fees and medicine back in 2010.

At first since the very beneficiary is the same person who was hospitalized, I have to have my father write an authority letter allowing me to transact on his PhilHealth hospitalization benefits / reimbursement on his behalf. I had it notarized and got his ID to consider identity matters.


To file, you will have to get a form for medical reimbursement from the PhilHealth nearest to the hospital where your patient is. In my case, in Salitran, Cavite office. Fill up the form, bring it to the hospital for computation and from there, you will give it back to the PhilHealth office for verification. Afterwards, you will be given a file for your claim. Submit it to the hospital and it will again be computed and deducted to your hospital bill.

The deduction out of the reimbursement will include both the doctor's professional fees and a certain percentage for the full cost of the medicine.

Today, this is no longer how it works, the Philippine Health Insurance Corporation has changed how everything else works with respect to reimbursement. They have now set an ideal amount as to deduct or allowable amount which is now based from the type of illness, health service or hospitalization. There are now certain ailments wherein you cannot file for reimbursement. Ask the nearest PhilHealth office or branch regarding this matter before concluding about anything on their policies.