PhilHealth the country’s health insurance provider, gives assistance to Filipinos who are qualified for the No Balance Billing Policy (NBB). To give them immediate medical assistance and avail the prescribed medicines.
Who are Qualified?
- Indigent – People who have no visible means of income and whose income is insufficient for its family members, identified and classified by the Department of Social Welfare and Development who pass of the criteria given.
- Sponsored – persons whose contributions are being paid for by government agencies, private entities, or another individual according to the rules and regulations by the institution.
- Domestic Workers or Kasambahay – refers to any person engaged in domestic work (yaya, gardener, cook, laundry person)
- Senior Citizen – any Filipino citizen who is a resident of the Philippines, aged 60 and above.
- Lifetime – member who reached the age of retirement under the law and has paid at least one hundred and twenty monthly premium contributions.
For Indigent and Sponsored members, female spouse of the qualified families by the DSWD may be designated as the Primary Member of the Program, to use them on their pregnancy journey. Children below 21 years old, including minors who are pregnant are advised to enroll as principal members as soon as possible to instantly avail of the health insurance maternity coverage.
- All case rates
- Z Benefits Package
- Primary Care Benefits
- Other Covered Benefits
- All accredited government health care institutions
- Accredited private health care institutions:
- Contracted facilities for Z Benefits Packages
- Ambulatory Surgical Clinics
- Free Standing Dialysis Center
- TB DOTS Center
- Birthing Home (NBB eligible members only)
- Infirmaries and Dispensaries
- Private hospital voluntarily implementing the NBB policy
Some of the services they can avail
- Medical consultations
- Regular blood pressure and body measurement
- Periodic clinical breast examination
- Cervical cancer screening
- Digital rectal examination
- Risk profiling for hypertension and diabetes
- Counselling for smoking cessation and lifestyle modification
- Oral check-up and prophylaxis for children 12 years old and below
Medicines and Drugs they can avail in PhilHealth accredited drug outlet
- Acute gastroenteritis
- Upper respiratory tract infection
- Urinary tract infection
- Diabetes mellitus
- Ischemic heart disease
Diagnostic Exams when clinically necessary
- Complete blood count
- Blood typing
- Stool exam
- Chest x-ray
- Sputum microscopy
- Lipid profile
- Fasting blood sugar
- Peak expiratory flow meter testing
- Blood glucose monitoring through blood glucose meters
Under the No Balance Billing (NBB) Policy, no other fees and expenses shall be charged or be paid for by qualified NBB patients above and beyond the package rates. Once the patient is admitted, NBB automatically applies. When patient is admitted in lying in regardless if the patient is attended by physician or midwife NBB is automatically applies.