No Balance Billing Policy for Indigent Pregnant, Sponsored, Senior Citizens, Domestic Workers

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.

No Balance Billing Policy
PhilHealth Logo, Photo by Eryka Raton, Stephanie Ecate, Afif Kusuma

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.

Benefits Covered

  1. All case rates
  2. Z Benefits Package
  3. Primary Care Benefits
  4. Other Covered Benefits

Benefits Covered

  1. All accredited government health care institutions
  2. Accredited private health care institutions:
    1. Contracted facilities for Z Benefits Packages
    2. Ambulatory Surgical Clinics
    3. Free Standing Dialysis Center
    4. TB DOTS Center
    5. Birthing Home (NBB eligible members only)
    6. Infirmaries and Dispensaries
    7. Private hospital voluntarily implementing the NBB policy

Some of the services they can avail

  1. Medical consultations
  2. Regular blood pressure and body measurement
  3. Periodic clinical breast examination
  4. Cervical cancer screening
  5. Digital rectal examination
  6. Risk profiling for hypertension and diabetes
  7. Counselling for smoking cessation and lifestyle modification
  8. Oral check-up and prophylaxis for children 12 years old and below

Medicines and Drugs they can avail in PhilHealth accredited drug outlet

  1. Asthma
  2. Acute gastroenteritis
  3. Upper respiratory tract infection
  4. Pneumonia
  5. Urinary tract infection
  6. Diabetes mellitus
  7. Hypertension
  8. Dyslipidemia
  9. Deworming
  10. Ischemic heart disease

Diagnostic Exams when clinically necessary

  1. Complete blood count
  2. Blood typing
  3. Urinalysis
  4. Stool exam
  5. Chest x-ray
  6. Sputum microscopy
  7. Lipid profile
  8. Fasting blood sugar
  9. Creatinine
  10. Electrocardiogram
  11. Peak expiratory flow meter testing
  12. 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.

2 thoughts on “No Balance Billing Policy for Indigent Pregnant, Sponsored, Senior Citizens, Domestic Workers

  • May 5, 2021 at 10:03 pm

    Hi good day po ask ko lng po kung pwede ako mag avail ng indengent sa panganganak ko Due date ko po ngayong August 15,2021 wala po akong work sa ngayon ang live in partner ko naman po ay stop working kaya hindi ko kayang mahulugan ang philhealth ko maraming salamat po sa sasagot.

    • May 7, 2021 at 8:15 am

      Hi ma’am. Enrolled na po ba kayo sa Philhealth dati? Or eto po ang first time na mag reregister kayo sa philhealth? Kailangan po mam di pa kayo registered sa Philhealth eversince, para may possibility na pwede kayo masama as indigent member. Pero meron din ibang rules na pwede din po mag apply as indigent member kahit may Philhealth na kayo dati, depende sa rules and regulations ng LGU mam. Better to go to your brgy hall mam, and ask niyo po officials dun regarding sa rules para maging member ng indigent philhealth.


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