PhilHealth’s

Maternity Care Package

and
Newborn Care Package
 Maternity Care Package
• Members and Qualified Dependents
Who can avail • Up to 4th delivery only

• Non-hospital facilities
Who provides • Engaged Maternity and Lying-in Clinics
• Engaged physicians and midwives

• Prenatal care
What services • Delivery
• Post natal care

Important • P 1,500 pre-natal care fee

• P 6,500 facility fee including professional fee
Features • No balance billing
 Maternity Care Package
 Applicable to Normal spontaneous vaginal deliveries
performed in a non-hospital facility (birthing homes, lying-in,
midwife managed clinics)
 Covers first 4 normal spontaneous deliveries
• Inclusion
– Normal (uncomplicated) vaginal deliveries
• Low risk at the start and throughout labor and delivery
• Infant in vertex position
• Infant in 37 to 42 weeks AOG
– 1st pre-natal check-up must not exceed 16 weeks AOG
 Maternity Care Package
• Exclusion
– 5th and subsequent deliveries  not covered
– Maternal conditions that are considered high risk
as enumerated in Circular 20, s 2008
 Maternity Care Package
Excluded Maternal Conditions
1. Age less than 19y/o
2. First pregnancy at the age of 35 or greater
3. Multiple pregnancy
4. Ovarian abnornality (ovarian cyst)
5. Uterine abnormality (myoma uteri)
6.Placental abnormality (placenta previa)
7. Abnormal fetal presentation (ie breech)
8. History of 3 or more abortions/miscarriage
9. History of 1 stillbirth
10. History of major obstetric/gynecologic surgical operations (ie CS, uterine
myomectomy)
11. History of medical conditions (hypertension, pre-eclampsia, thyroid disorder)
12. Other risk factors that warrant referral for further management (ie premature
contractions, vaginal bleeding)
 Maternity Care Package
• Eligibility
– Members and qualified dependents
– Contribution requirements
• Amount P 8,000 (as case rate)
– P 6,500 for the actual delivery including
professional fee
– P 1,500 for the prenatal care fee
• No Balance Billing Policy
– Applies to all
 Benefit Availment –
•
Maternity
Requirements:
Care Package
– Claim form 1
– Claim form 2
– Claim form 3 (Part II)
– Member Data Record
– Proof of eligibility
• Sponsored – ID
• OWP – ID
• IPP – proof of premium payments
• File within 60 days after the delivery
 Newborn Care Package
• Qualified dependents (newborn) of members
Who can avail • No limit as to number of births

• Non-hospital facilities
Who provides • Maternity and Lying-in Clinics
• Hospitals

• Newborn care
• Screening tests – newborn screening and hearing
What services • Vaccination – hepatitis B and BCG
• EINC protocol

Important • P 1,750
Features • No balance billing
Components of Newborn Care Package
• Immediate drying of the newborn
• early skin-to-skin contact
• cord clamping
• non-separation of mother/baby for early
breastfeeding initiation
• eye prophylaxis
• Vitamin K administration
• Weighing
• BCG Vaccination
• Hepatitis B Vaccination
• Newborn Hearing Test
• Newborn Screening Test
• Professional Fee
Components of Newborn Care Package

P 1750 500 500 550 200

Newborn Care

EINC and Professional Newborn Hearing

Test
vaccines Fee Screening
Test
 Benefit Availment –
Newborn Care Package
• Eligibility
– 3/6 contribution
– Even if 5th delivery and beyond
• Requirements
– Claim Form 1
– Claim Form 2  all services must be enumerated
– Member Data Record
– Certificate of live birth
– Proof of contribution
• File within 60 days after delivery