PhilHealth Benefit Estimator (2026)
PhilHealth pays a fixed case rate per condition — for example ₱29,000 for a normal delivery, ₱58,000–₱62,000 for a C-section, ₱29,250 for moderate pneumonia, ₱19,500 for dengue, and ₱6,350 per hemodialysis session (up to 156/year). The case rate is deducted from your bill at an accredited facility; the rest is out of pocket or covered by an HMO.
Maternity & newborn
Facility and professional fees for a normal spontaneous delivery. Increased in 2026.
Fixed PhilHealth case rate deducted from your bill at an accredited facility — the actual amount depends on the facility and your case. Your remaining balance is out of pocket (or covered by an HMO). Last verified 2026-07.
2026 PhilHealth case rates at a glance
Maternity & newborn
Facility and professional fees for a normal spontaneous delivery. Increased in 2026.
Facility and professional fees for a cesarean delivery. Increased in 2026.
Common illnesses (confinement)
Fixed case rate for low- to moderate-risk community-acquired pneumonia.
Fixed case rate for high-risk pneumonia requiring more intensive care.
Fixed case rate for dengue fever without severe complications.
Fixed case rate for severe dengue / dengue hemorrhagic fever.
Surgery & procedures
Fixed case rate for surgical removal of the appendix (open or laparoscopic).
Dialysis & kidney
Per-session case rate for chronic hemodialysis, deducted from your bill at accredited centers.
Annual package for Continuous Ambulatory Peritoneal Dialysis, incl. catheter insertion and PD-related care.
Outpatient & primary care
Free check-ups, selected lab tests, and maintenance medicines at your registered primary-care provider.
This is a curated list of the most-searched benefits. For every PhilHealth case rate, use the official PhilHealth Case Rate Search.
Frequently Asked Questions
How much does PhilHealth cover for a hospital stay?
PhilHealth pays a fixed "case rate" per condition or procedure — for example, ₱29,250 for moderate pneumonia, ₱19,500 for dengue, or ₱29,000 for a normal delivery. The case rate is deducted from your bill at an accredited facility; any remaining balance is out of pocket (or covered by an HMO).
Does PhilHealth pay the full bill?
No. The case rate is a fixed amount, not the full bill. In a private hospital your total bill is usually higher than the case rate, so you still pay the difference. In many government hospitals the case rate can cover most or all of the bill.
How many dialysis sessions does PhilHealth cover?
PhilHealth covers up to 156 hemodialysis sessions per year at ₱6,350 per session (about ₱990,600 a year), deducted from your bill at accredited dialysis centers.
Where can I see every PhilHealth case rate?
This tool lists the most commonly searched benefits. For the full, official list you can search PhilHealth's Case Rate Search by condition, ICD-10, or RVS code.
Case rates are fixed PhilHealth benefit amounts and can change by circular. Figures are for planning only — confirm current rates and your eligibility with PhilHealth or the facility. Sources per benefit; maternity per Circular 2026-0005, dialysis per 2025 PhilHealth Board.