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PhilHealth

Inpatient Benefits

These benefits are paid to the accredited Health Care Institution (HCI) through All Case
Rates

The case rate amount shall be deducted by the HCI from the members total bill, which
shall include professional fees of attending physicians, prior to discharge

The case rate amount is inclusive of hospital charges and professional fees of attending
physician

Availment condition: Member must have at least three (3) months premium contributions
within the immediate six (6) months prior to the month of availment

Documents needed: copy of Member Data Record or PhilHealth Benefit Eligibility Form
(PBEF) and duly accomplished PhilHealth Claim Form 1

Where available: all accredited HCIs*


*Different case rate amounts for selected medical conditions are being implemented
when done in Primary Care facilities (PhilHealth Circular 14, s-2013)

Only admissible cases shall be reimbursed

Outpatient Benefits
1. Day surgeries (ambulatory or outpatient surgeries) are services that include elective (nonemergency) surgical procedures ranging from minor to major operations, where patients
are safely sent home within the same day for post-operative care
2. Radiotherapy
3. Hemodialysis
4. Outpatient Blood Transfusion
5. Tamang Serbisyo Para sa Kalusugan ng Pamilya (TSeKaP)
Preventive Services

Consultation
Visual inspection with

Diagnostic Examinations (as


recommended by the doctor)

Complete blood count


Urinalysis

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Drugs and Medicines

Asthma including
nebulisation services

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acetic acid
Regular BP
measurements
Breastfeeding
program education
Periodic clinical
breast examinations
Counseling for
lifestyle modification
Counseling for
smoking cessation
Body measurements
Digital rectal
examination

Fecalysis
Sputum microscopy
Fasting blood sugar
Lipid Profile
Chest x-ray

Acute Gastroenteritis
(AGE) with no or
mild dehydration
Upper Respiratory
Tract Infection
(URTI)/Pneumonia
(minimal and low
risk)
Urinary Tract
Infection (UTI)

PhilHealth also has Z Benefit Package to help cure some cases of cancer and other serious
illnesses in the Philippines and Millennium Development Goal-related packages.
Pag-IBIG
Provident (Savings) Benefit Claim
Pag-IBIG Fund guarantees the refund of member's total accumulated savings (TAV), which
consists of the member's accumulated contributions, the employer counterpart contributions, if
any, and the dividend earnings credited to the member's account upon occurrence of any of the
following grounds for withdrawal:
1. Membership maturity. The member must have remitted at least 240 monthly membership
contributions with the Fund. For Pag-IBIG Overseas Program (POP) members,
membership with the Fund shall be at the end of five (5), ten (10), fifteen (15), or twenty
(20) years depending on the option of the member upon membership registration.
2. Retirement. The member shall be compulsorily retired upon reaching age 65. He may
however, opt to retire upon the occurrence of any of the following:

Actual retirement from the SSS, the GSIS or a separate employer


provident/retirement plan, provided the member has at least reached age 45.

Upon reaching age 60.

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3. Permanent and Total Disability or Insanity. The following disabilities shall be deemed
total and permanent:

Temporary total disability lasting continuously for more than 120 days;

Complete loss of sight of both eyes;

Loss of two limbs at or over the ankle or wrist;

Permanent complete paralysis of two limbs;

Brain injury resulting in incurable imbecility or insanity; and

Such other cases which are adjudged to be total and permanent disability by a
duly licensed physician and approved by the Board of Trustees.

4. Separation from the service due to health reason


5. Permanent departure from the country
6. Death. In case of death, the Fund benefits shall be divided among the member's legal
heirs in accordance with the New Civil Code as amended by the New Family Code.
Multipurpose Loan
This program aims to provide financial assistance to Pag-IBIG
members for purposes of minor home improvement, livelihood,
medical, educational, purchase of appliance and furniture and
other needs.
Borrower Eligibility
New Loan
1. With at least twenty-four (24) monthly contributions.
2. An active member at the time of loan application,
with at least five (5) monthly contributions for the last
six (6) months.
3. Member-applicants net take home pay shall not fall
below the minimum requirement of the General
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Appropriations Act (GAA) or company policy,


whichever is applicable.
4. If with existing calamity loan, a member shall be
allowed to avail of the MPL only after payment of at
least six (6) monthly amortizations. The outstanding
balance, together with any accrued interests, penalties
and charges, shall be deducted from the proceeds of
the MPL.
Loan Renewal
1. With payment of at least six (6) monthly
amortizations. The outstanding balance, together with
any accumulated interests, penalties and charges, shall
be deducted from the proceeds of the new loan.
2. An active member at the time of loan application,
with at least five (5) monthly contributions for the last
six (6) months.
3. Member-applicants net take home pay shall not fall
below the minimum requirement of the General
Appropriations Act (GAA) or company policy,
whichever is applicable.
Calamity Loan
1. Who are eligible? The calamity loan program is open to any Pag-IBIG member who:
1. Has made at least 24 monthly savings;
2. Is an active member with at least 5 monthly savings for the last 6 months as of
month prior to the date of loan application; and
3. Resides in an area which is declared by the Office of the President or the Local
Sanggunian concerned as under a state of calamity. If the member has an existing
Housing Loan, Multi-Purpose Loan (MPL) and/or Calamity Loan, the account
must not be in default as of date of loan application.

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If the member has an existing Housing Loan, Multi-Purpose Loan (MPL) and/or
Calamity Loan, the account must not be in default as of the date of the loan application.
2. How much can one loan? An eligible member may borrow up to a maximum of 80% of
his Total Accumulated Value (TAV) subject to the terms and conditions of the program.
The current interest rate for the Calamity Loan is 5.95% per annum.
3. What is the payment period? The Calamity Loan is amortized over a period of 24
months with a grace period of 3 months. Said member shall start paying his loan on the
4th month following the date of his DV/Check date.
4. Can a member still avail of a Calamity Loan even if he has an outstanding
MPL/Calamity Loan? Yes, said member may still avail of a Calamity Loan subject to
certain conditions. In no case, however, will the aggregate short-term loan (MPL and
Calamity Loan) exceed 80% of the borrowers TAV.
If, in addition to an outstanding MPL, the member also has an outstanding calamity loan
in the amount of P2,000, in the example above, the member is still granted a new
calamity loan of P3,000 but will only receive P1,000 because the P2,000 will pay off the
existing calamity loan balance. This means that at any given time, a member can have
both MPL and calamity loan, but only one calamity loan.
5. Until when can an eligible member avail of the loan?Eligible borrowers must avail of
the Calamity Loan within a period of 90 days from the declaration of a state of calamity.
6. What are the documentary requirements for the loan application?
1. Completely filled-up Calamity Loan Application Form*
2. Photocopy of at least 2 valid IDs
3. Proof of Income
4. For formally employed members, duly accomplished Declaration of Being
Affected by Calamity*.
* Said documents can be downloaded from the Pag-IBIG Fund website at
www.pagibigfund.gov.ph or can be secured at any Pag-IBIG Fund office.
o Where can one apply for a loan? The borrower may submit his requirements to
any Pag-IBIG Office nationwide. For inquiries, Pag-IBIG Funds hotline is open
24/7 (02) 724-4244. E-mails can be sent to publicaffairs@pagibigfund.gov.ph.
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Housing Loan Programs


Housing Loan Availment
Two (2) modes of applying for a Pag-IBIG housing loan: (a) Developer-Assisted - the developer
assists the member in his/her housing loan application and (b) Retail - the member applies
directly to the Fund.
Housing Programs
Disposal of Pag-IBIG Fund Acquired Assets
ROPOA for Joint Venture

Employee Compensation Commission Benefits


A. Development and Review of Policies on the Employees Compensation Program (ECP).
This entails development and review of policies and procedures for the improvement of
the ECP such as increase of benefits and/or expands the coverage of the ECP.
B. Rehabilitation of the Persons with Work-Related Disability (PWRDs) Program
The main objective is to facilitate the integration of PWRDs into the economic
mainstream of society through the following programs and projects:
1. ECC-Quick Response to PWRDs
This project aims to provide immediate assistance to workers or their families in
the event of major work accidents or outbreak of occupational diseases at the
workplace. The ECC intervention includes psycho-social counseling services,
medical help and assistance in the filing of the necessary claims with the System.
2. KAGABAY Project
Katulong at Gabay sa Manggagawang May Kapansanan or KaGaBay is an
assistance project to PWRDs which provides vocational skills and entrepreneurial
training and other assistance that will allow PWRDs to find employment or selfemployment.
3. Physical Restoration of PWRDs
An assistance project to facilitate the provision of ECC-funded rehabilitation
services like physical therapy, occupational therapy and provision of rehabilitation
appliances.

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4. Job Placement Facilitation


This involves assistance to PWRDs and/or their children to find employment or
re-employment
5. Prevention Program in the Workplace
This project aims to promote health and protection of workers in the workplaces
by raising the employers and workers awareness on the value of adopting and
observing appropriate preventive measures.
C. ECP Information Dissemination Services
This program is designed to increase public awareness on the Employees Compensation
Program (ECP). The projects under this program are:
1. Development/Updating/Reproduction of IEC Materials
This project ensures that reader-friendly ECP materials are continually developed.
This involves three important activities, namely: (1) Development and printing of
information materials such as flyers, posters, ads, audio visual presentation
materials and other related information; (2) Publication of The ECC Reporter
designed to inform ECC publics of the latest on employees compensation
policies, case decisions, OSH research findings on work contingency prevention
and others; and (3) Re-printing and distribution of existing IEC materials.
2. Intensification of Information Dissemination on the ECP through Quad-Media
This project includes publication of press releases in broadsheets, tabloids and
regional papers, airing of infomercials on radio, television and the like as well as
linkages with radio and TV networks for participation in public affairs
programs/interviews, distribution of IEC materials to ECC clients (notably flyers
explaining the ECP, how to file EC claims at the SSS and GSIS, various projects
of the ECC such as the KaGaBay Program) and the publication of The ECC
Reporter.
3. Intensification of Information Dissemination on the ECP through Seminars,

Training and One-on-One Services


This involves the conduct of seminars/lectures on the ECP and OSH right at the
workplaces in coordination with the employers and the employees unions. Target
participants of ECP seminars/lectures are rank and file workers, labor union
representatives and human resource officers. Another important project is the
Public Assistance Center (PAC) which is designed to provide personalized
assistance/information to walk-in clients on how and where to file EC claim or the
follow-up of the status of their claims pending at the SSS or GSIS or at the ECC
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and other related matters. PAC is located at the ECC ground floor for this purpose
and was operationalized since 2005.

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