Widow Says Husband Paid PhilHealth for 25 Years Only to Be Denied Benefits After Death

(SPOT.ph) Twenty-five years of contributions to the Philippine Health Insurance Corporation (PhilHealth) were not enough to spare one family from a painful answer at the hospital billing section.

In a June 12 Facebook post that has since gone viral, Maria Lourdes Sulit said her husband, Marvin, died from a brain hematoma on June 4 after their family was unable to raise the amount needed for a life-saving operation.

In just a day, the charges had reached around P200,000. Sulit said she then went to PhilHealth, hoping the agency could help reduce the burden of the bill. Instead, she said she was told that Marvin was not eligible for benefits because he had been hospitalized for less than 24 hours.

“My husband had just died. How could he not be eligible?” Sulit said. “I was only asking for the benefits that my husband spent more than 25 years contributing to. He was a lifelong member. He paid faithfully throughout his working years.”

Like many working Filipinos, Sulit said her husband had been paying into PhilHealth for years. For 2026, members pay 5% of their income, or P500 to P5,000 a month, depending on how much they earn. Employees split this with their employers, while those who work on their own like self-employed workers, professionals, kasambahays, and OFWs are also covered by PhilHealth’s contribution rules.

To put that in perspective, even at PhilHealth’s current minimum premium of P500 a month, 25 years of payments would amount to P150,000 in contributions.

“What is the purpose of #PhilHealth if the people who have contributed for decades cannot access the benefits when they need them most?” Sulit said.

Also read: PhilHealth Expands Benefits to Include Outpatient Emergency Care

PhilHealth issued a statement on June 14 acknowledging the viral post, though it did not name the Sulits.

“We are aware of the circulating post regarding a PhilHealth member who passed away while in the process of being transferred to and assessed at a receiving hospital. We empathize deeply with the family who lost a loved one,” PhilHealth said. “PhilHealth immediately mobilized, upon learning of the incident, to understand and address the situation. We have since reached out to the member’s wife and have agreed on the next steps as we explore all avenues of support.”

At the center of the case is PhilHealth’s 24-hour confinement rule. In general, patients must be admitted and stay in the hospital for at least 24 hours to claim inpatient benefits, but PhilHealth’s own rules also recognize exceptions. Circular No. 31, s. 2010 states that a patient who stayed less than 24 hours is generally not covered, except when the patient is transferred to another facility, the case is considered an emergency, or the patient dies.

PhilHealth said it is now coordinating with the hospitals involved.

“My heart is broken, but I share our story in the hope that no other family will have to endure the same pain,” Sulit wrote in her Facebook post.

Also read: GUIDE: How to Apply for PhilHealth YAKAP to Get Free Check-Ups, Lab Tests + P20K in Meds