Why Having PhilHealth Isn’t Enough — You Still Need Critical Illness Insurance
Marami sa atin ang kampante kasi “May PhilHealth naman ako.” Pero alam mo ba na hindi lahat ng gastos sa ospital, sakop ni PhilHealth?
Let me share a real story.
Totoong Kwento: “Akala namin covered na lahat…”
Last May 2024, isang asawa ang naoperahan dahil sa ovarian cyst. Routine procedure daw — ovarian cystectomy — pero hindi biro ang bill.
- Total hospital bill: ₱170,613.20
- PhilHealth coverage: ₱30,290.00 lang
- ✅️ ₱13,910 para sa room at gamot
- ✅️ ₱16,380 para sa doctor’s fee
- ❌️ The rest? Kailangan nilang bayaran mula sa sariling bulsa.
Imagine the stress - hindi lang dahilan sa operation, kundi pati sa bayarin
The Truth: PhilHealth is helpful, pero hindi enough
PhilHealth uses a Case Rate System.
Ibig sabihin, bawat sakit o procedure may fixed na halaga lang na sakop.
For example:
| Illness / Procedure | PhilHealth Coverage |
|---|---|
| Pneumonia (moderate) | ₱29,250 |
| Dengue | ₱10,000 |
| Cesarean Section | ₱37,050 |
| Gallbladder Operation (Cholecystectomy) | ₱60,450 |
*above mentioned are just examples (It depends on the case rate)
You can check here for the actual case rate: https://www.philhealth.gov.ph/services/acr/
So kung ang hospital bill mo ay ₱100,000, pero ₱15,000 lang ang case rate — ₱85,000 pa rin ang lalabas sa’yo.
PhilHealth isn’t a “swipe card” na automatic fully covered. It’s only a partial aid. Kapag hindi mo alam paano siya gumagana, madali kang ma-shock sa hospital bill.
Hindi rin automatic ang coverage
Maraming akala, basta may PhilHealth number, covered na agad.
Pero may mga requirements:
- Dapat may at least 9 months of contributions in the last 12 months.
- Kung senior citizen, kailangan pa ring magparehistro at mag-submit ng documents.
- Kung self-employed o OFW, dapat tuloy-tuloy ang hulog.
Kung hindi updated ang contributions — sorry, hindi ka eligible.
Kaya mo kailangan ng Critical Illness Insurance
Ang Critical Illness Insurance ay nagbibigay ng lump sum cash kapag ikaw ay na-diagnose ng major illness tulad ng cancer, stroke, o heart attack.
- ✅️ Pambili ng gamot, treatment, o maintenance care
- ✅️ Pangbayad ng hospital bills na hindi sakop ng PhilHealth
- ✅️ Pang-support sa family mo habang di ka makapagtrabaho
Real Talk
PhilHealth is a blessing — pero hindi siya magic. Hindi siya pangbuo, kundi pampuno.
Ang totoong peace of mind ay kapag alam mong kahit anong mangyari, may backup plan ka.
That’s where Critical Illness Insurance comes in.
Protect Your Future Today
Kung may PhilHealth ka na, good!
Pero kung gusto mong secured talaga,
add Critical Illness Insurance sa financial protection mo.
Because at the end of the day,
it’s not just about saving money —
it’s about protecting your life and your family’s peace of mind.
📩 Sign-up for a free consultation today and let’s secure your health before life catches you off guard.
About the Author
Jonathan Ventula Mendoza
💼 Licensed FWD Financial Wealth Planner
Helping Filipinos build a secure and confident financial future — one plan at a time.
