Overseas Filipino workers (OFWs) are entitled to medical reimbursement from the Philippine Health Insurance Corporation (PhilHealth) even if they were hospitalized abroad. The OFW’s qualified dependents are also covered.
Who are Entitled to PhilHealth Benefits?
All OFWs, whether land-based, seafarers, or dual-citizen Filipinos are entitled to full PhilHealth benefits, as long as the member’s contributions are up to date. OFWs are also entitled full benefits under PhilHealth, whether they were confined abroad or in the Philippines.
Even if the principal or paying member is working overseas, qualified dependents are also entitled to the full benefits given to PhilHealth members.
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Advantages of Getting PhilHealth
Aside from the OFW and his/her qualified dependents being entitled to the benefits of PhilHealth, the following are also added advantages of becoming a member:
- Confinements for over 4,600 medical and surgical procedures are covered by PhilHealth.
- Principal members (OFWs) are given up to 180 days to submit their claims.
- Qualified dependents are entitled to the same set of benefits as the OFW, depending on the case rates for the particular medical condition or procedure he undergoes.
- OFWs are entitled to Lifetime membership as long as they had paid up at least 120 monthly contributions.
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How to Make a PhilHealth Claim While Abroad?
Check if the confinement, either of the OFW or the dependent, meet the following requirements:
- The 45-day annual benefit limit for hospital room has not been fully consumed.
- The availment period falls within the coverage of the OFW’s membership.
- For confinements in the Philippines, the hospital or health care facility and all health care professionals should be accredited.
Submit all of these documents:
- Properly filled out PhilHealth Claim Form 1.
- Medical certificate, medical abstract, or medical record written in English stating the confinement period, final diagnosis, and medical services rendered.
- If an operation was performed, copy of the operative record written in English.
- Hospital bill or detailed statement of account.
- Official Receipt issued by the hospital and doctor.
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All claims must be filed at a PhilHealth office in the Philippines. If the OFW was confined abroad, all documents must be sent viral via courier to the PhilHealth Regional Office or Local Health Insurance Office nearest the OFW’s registered address within 180 calendar days from the date of confinement.
If the OFW or his dependent had been confined at a hospital in the Philippines, then PhilHealth Claim Form 1 needs to be submitted to the Billing Section of the accredited hospital.