TamangSagot (TS) - Philippine Health Insurance Corporation

Can I choose not to activate my UMID card with PhilHealth? ......................................................................................................... 32
What does „card activation‟ mean? .............................................................................................................................................................. 32
What are the requirements to activate my UMID card with PhilHealth? ..................................................................................... 32
Where can I activate my UMID card with PhilHealth? ......................................................................................................................... 32
If I missed the schedule of card activation in our office premises, can I proceed to any PhilHealth Branch to have
my UMID card activated? ................................................................................................................................................................................. 32
How long does the card activation process take? ................................................................................................................................. 32
Can I update my MDR on the day of card activation through the UMID Mobile Team? ..................................................... 33
What are the card activation procedures? ................................................................................................................................................ 33
How will I use my PhilHealth-activated UMID cards? .......................................................................................................................... 33
What are the contact numbers if I have further questions regarding the UMID card activation?.................................... 33
H. BENEFITS AND BENEFITS AVAILMENT .............................................................................................................................. 33
What benefits can a member avail himself of under the NHIP? .................................................................................................................. 33
Where can these benefits be availed of?................................................................................................................................................................ 39
How can these benefits be availed of? .................................................................................................................................................................... 39
Do legal dependents enjoy the same benefits as the member? .................................................................................................................. 40
What documents must a member submit to be able to avail of the benefits? ..................................................................................... 40
Where and when should these documents be submitted? ............................................................................................................................ 40
How can the member avail himself of PhilHealth benefits if he has an existing coverage with a health maintenance
organization? ...................................................................................................................................................................................................................... 40
Can a senior citizen avail himself of both the PhilHealth benefits and his senior citizen privilege when confined? ............. 40
Can overseas Filipino worker-members reimburse their hospitalization expenses with PhilHealth? ........................................... 40
I‟ve been paying my premiums regularly, but I still haven‟t availed of any benefits. When will I be able to benefit from
my membership? .............................................................................................................................................................................................................. 40
Situationers: Benefits and Benefits Availment .................................................................................................... 41
How will the member know if the PhilHealth benefit deducted from his total hospital bill is correct? ......................... 41
What if the amount deducted as PhilHealth benefit is less than what PhilHealth actually paid to the provider for
the member‟s confinement? ........................................................................................................................................................................... 41
If siblings are all active members, can each of them file a claim for the confinement of their parents? ....................... 41
If both spouses are members, can each of them file a claim for the confinement of their children? ............................. 41
If the spouse‟s, child‟s or parent‟s name is not listed in the member‟s MDR at the time of confinement, how can
the member avail himself of the benefits? ............................................................................................................................................... 41
How can members separated or resigned from employment avail themselves of maternity benefits? ........................ 41
I. SPECIAL SECTION: CASE RATES FOR 23 MEDICAL AND SURGICAL PROCEDURES ........................................................ 42
What is case payment? .................................................................................................................................................................................................. 42
How is this different from the old system? ........................................................................................................................................................... 42
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