PhilHealth Case Rates for Common Children's Diseases 2026
| Condition | Case Rate | Hospital Share | Professional Fee |
|---|---|---|---|
| Dengue (mild) | ₱9,000 | ₱6,750 | ₱2,250 |
| Dengue (severe) | ₱16,000 | ₱12,000 | ₱4,000 |
| Pneumonia (mild) | ₱15,000 | ₱11,250 | ₱3,750 |
| Pneumonia (severe) | ₱32,000 | ₱24,000 | ₱8,000 |
| TB (Category I) | ₱4,000 | ₱3,000 | ₱1,000 |
| Typhoid fever | ₱11,000 | ₱8,250 | ₱2,750 |
| Acute gastroenteritis | ₱6,000 | ₱4,500 | ₱1,500 |
| Febrile seizure | ₱7,000 | ₱5,250 | ₱1,750 |
| Appendectomy | ₱19,000 | ₱14,250 | ₱4,750 |
Case rates are fixed PhilHealth payments. The patient pays the balance above the case rate. Government hospitals typically have lower bills.
What PhilHealth Does NOT Cover
Cosmetic procedures
Dental care (except oral surgery)
Eyeglasses and contact lenses
Hearing aids
Vitamins and supplements
Home medicines (outpatient)
Private room upgrades
Most private clinic consultations
Experimental treatments
Injuries from illegal activities
Frequently Asked Questions
Disclaimer
PhilHealth coverage and case rates are subject to change. Always verify current rates with PhilHealth directly at philhealth.gov.ph or hotline 1-800-10-441-7442.