Home philhealth Important Details About the PhilHealth No Balance Billing Policy

Important Details About the PhilHealth No Balance Billing Policy

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The No Balance Billing policy is one of the privileges that PhilHealth provides to its qualified members. The corporation cited that no other expenses or fees shall be paid by the qualified member patient during the confinement period.Important-Details-About-the-PhilHealth-No-Balance-Billing-Policy

It is also stated in the guidelines of the NBB that the qualified members should receive complete quality care and all the necessary services they need.

Who are qualified for the PhilHealth No Balance Billing policy?

To qualify and enjoy the benefits of NBB policy, the member or dependents must be under the following categories:

  1. Senior citizen – This refers to anyone who is sixty years old or above and is a bonafide resident of the Philippines. Likewise, those who have dual citizenship whose age is 60 years and above, but should provide a proof of citizenship such as residing in the Philippines for at least 6 months.
  2. Lifetime – A PhilHealth member who has reached the retirement age and has completed the 120 monthly premium contributions.
  3. Indigent – This pertains to a person who has insufficient income to provide the needs of the family or has no apparent means of income. But, they should be identified by the DSWD based on the criteria specified for this purpose and according to the guiding principles set by PhilHealth.
  4. Kasambahay or domestic worker – Any individual who works as kasambahay within an employment relationship, except for those who works occasionally and not as an occupation.
  5. Sponsored – A PhilHealth member who was enrolled by DSWD or those in which the monthly contribution is being paid by a private entity or by another individual or government agency.

The NBB policy covers all case rates, primary care benefits, Z benefit packages, Ebola Virus Disease benefit package, and Middle East Respiratory Syndrome Coronavirus or MERS-CoV benefit.

The NBB policy has been implemented in all government and private health care institutions accredited by PhilHealth.

In order to avail the NBB policy, it is essential to verify the membership records before hospital admission or availing the outpatient services. Members should present an updated member data record or MDR. If the member is a beneficiary of 4Ps, he or she should present the ID card.

The No Balance Bill policy indeed provides benefits to patients including quality care, access to basic comforts, supplies/medications, availability of drugs, availability of diagnostic procedures and laboratory tests, pre-admission services, professional services, referral systems, and hospital NBB packages.

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