PhilHealth and SSS Maternity Benefits Every Parent Needs to Know

Venus Zoleta
·10 min read
Maternity Benefits in the Philippines | Moneymax
Maternity Benefits in the Philippines | Moneymax

Is a baby on the way? As a soon-to-be parent, you couldn’t be more excited. But you also couldn’t help being worried about the costs of pregnancy and childbirth. Do you have enough money to cover all of them?

Whether you’re financially ready for a baby or not, you should know all the government-mandated benefits you’re entitled to and factor them into your budget. Employed and stay-at-home or work-from-home mothers—married or not and regardless of employment status—can avail of maternity benefits of PhilHealth and SSS.

Maternity benefits in the Philippines may not be worth that much, but they can certainly help ease the financial burden that comes with preparing for a newborn and supporting yourself before returning to work.

SSS Maternity Benefits Guide

What is SSS Maternity Benefit?

The maternity benefit granted by the SSS[1] is a daily cash allowance for covered female members who are unable to work due to childbirth, miscarriage, or emergency termination of pregnancy (including stillbirth).

Who Can Receive SSS Maternity Benefits in the Philippines?

sss benefits for maternity - eligibility
sss benefits for maternity - eligibility

Female private employees, government employees, self-employed individuals, and national athletes covered by the SSS can avail of maternity benefits upon meeting the following requirements:

  • For private employees and self-employed women: At least three posted monthly SSS contributions within 12 months immediately before the semester of delivery, miscarriage, or abortion (For example, if you expect to give birth in June 2021, you should have paid at least three monthly contributions from January 2019 to December 2019.)

  • Notification and proof of pregnancy (ultrasound report, medical certificate, or pregnancy test stick) sent to the employer (for private workers), head of the agency (for government workers), or directly to the SSS through the My.SSS portal or SSS Mobile App (for OFW, self-employed, and unemployed members)

Related article: 10 Helpful SSS Benefits You Might Not Know Of

SSS Benefits Under the Expanded Maternity Leave Law

1. Paid Maternity Leave

Under the Expanded Maternity Leave Law (Republic Act 11210)[2], the SSS pays qualified SSS members a cash benefit equivalent to 100% of their average daily salary credit (See the SSS maternity benefit computation in the next section).

The paid leave lasts for up to a certain number of days as specified by the law:

  • 105 days for live childbirth, regardless if it’s a normal or caesarian delivery

  • 120 days for single mothers who are giving birth (105 days plus additional 15 days)

  • 60 days for women who had a miscarriage or emergency termination of pregnancy

Prior to the Expanded Maternity Leave Law, the SSS granted only 60 days of paid leave for normal delivery and 78 days of paid leave for caesarian delivery. The extended maternity leave duration gives mothers a longer time to prepare for childbirth, recover after giving birth, and take care of their newborns.

Your employer may provide longer maternity leaves beyond what the law mandates. Check your employment contract and collective bargaining agreement (CBA) or ask your HR department about it.

Another change imposed by the new maternity leave law is that there’s no limit to the number of covered pregnancies. Regardless of how many times you get pregnant, you’ll receive maternity benefits from the SSS each time you give birth or have a miscarriage/stillbirth. Previously, the granting of SSS maternity benefits is limited to the first four child deliveries or miscarriages.

2. Optional Maternity Leave Extension

On top of the mandatory 105 days of paid leave, SSS members who gave birth may choose to extend their maternity leave for 30 additional days without pay. You may avail of the maternity leave extension as long as you notify your employer in writing at least 45 days before the end of your maternity leave.

3. Optional Allocation of Maternity Leave to the Child’s Father

You also have the option to transfer seven days of your paid maternity leave to the baby’s father, whether you’re married to him or not. This applies only to cases of live childbirth.

If the child’s father is deceased, missing, or incapable of childcare, you may allocate the seven-day leave credits to a relative or your current partner you’re living with, regardless of gender identity.

If you’re availing of the optional maternity leave allocation, you should notify your employer about it. The father or alternate caregiver who will receive the allocated leave credits must notify his/her employer as well.

Read more: Paternity Benefits in the Philippines: What Expectant Fathers Must Know

How Much is the Maternity Benefit in SSS for 2020?

sss maternity benefits - sss computation for maternity
sss maternity benefits - sss computation for maternity

Eligible SSS members may receive maternity benefits of up to PHP 80,000. The maximum benefit applies to members with a monthly salary credit (MSC) of PHP 20,000 (those earning PHP 19,750 and above per month).

If you want to know how much you’ll receive, here’s the formula for SSS maternity benefit computation:

SSS Maternity Benefit Computation

Total amount of SSS maternity benefit = (Average monthly salary credit ÷ 180) x Number of paid leave days

How to Compute Maternity Benefits in SSS

Using the formula above, here are the steps to compute your SSS maternity benefits:

1. Exclude the semester of delivery or miscarriage from the computation. For example, if your expected delivery date is June 2021, exclude the period from January to June 2021.

2. Count 12 months backward starting from the month right before the semester of delivery or miscarriage. Based on the example above, the 12-month period is from January to December 2020.

3. Get the sum of the six highest MSCs within the 12-month period. To find your MSC, refer to the SSS contribution table[3]. For example, if your monthly salary for January to December 2020 is PHP 30,000, your MSC is PHP 20,000. The sum of your six highest MSCs would be PHP 120,000 (PHP 20,000 x 6).

4. Divide your average MSC by 180 days to compute your average daily salary credit (ADSC), which is equivalent to your daily maternity allowance. If your average MSC is PHP 120,000, your ADSC is PHP 666.67.

5. Multiply your ADSC by the number of days you’re taking maternity leave to get the total amount of your SSS maternity benefit. That’s 105 days for normal or caesarian delivery, 120 days for solo parents, or 60 days for miscarriage, abortion, or stillbirth. Deduct seven days if you’ll transfer your leave credits to the child’s father or an alternate caregiver.

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Sample SSS Maternity Benefit Computation

Based on the details above, here’s an example of how to compute your SSS maternity benefit.

  • For normal/caesarian delivery: (PHP 120,000 ÷ 180) x 105 days = PHP 70,000

  • For solo parents: (PHP 120,000 ÷ 180) x 120 days = PHP 80,000

  • For miscarriage/abortion/stillbirth: (PHP 120,000 ÷ 180) x 60 days = PHP 40,000

That’s the amount you’ll receive from the SSS if your salary is in the maximum MSC of PHP 20,000.

Note that you should still receive your full pay for the entire duration of your maternity leave. The Expanded Maternity Leave Law requires employers to pay for the salary differential, which is the difference between their covered employees’ full salary and the actual cash benefit from the SSS.

When Can I Get My SSS Maternity Benefit?

Your employer is required by law to pay your full maternity benefit within 30 days since you filed your maternity leave. The SSS will then reimburse the full amount that your employer paid to you. For self-employed or voluntary members, the SSS will pay the benefit directly to them.

PhilHealth Maternity Benefits Guide

philhealth maternity benefits
philhealth maternity benefits

What is PhilHealth Maternity Benefit?

PhilHealth maternity benefits refer to social health insurance coverage that provides women who are about to give birth with financial access to healthcare before, during, and after child delivery. It consists of complete essential health care services for qualified PhilHealth members throughout their pregnancy and childbirth.

Who Can Receive PhilHealth Maternity Benefits?

For PhilHealth members, here are the conditions to qualify for maternity benefits:

  • Active membership with qualifying PhilHealth contributions

    • Employed members: At least three posted monthly PhilHealth contributions within six months before availing of maternity benefits

    • Self-employed or unemployed voluntary members: At least nine posted monthly contributions before availing the maternity benefits

    • OFW and sponsored members: PhilHealth membership is within the validity period.

  • Have not used up the 45-day regular benefit limit

  • Admitted to a PhilHealth-accredited facility for not less than 24 hours

  • Attended by a PhilHealth-accredited doctor

Note: Under the Universal Healthcare Law, PhilHealth members may still avail of maternity benefits even if they don’t consistently pay their monthly premiums as long as they meet the required minimum number of paid contributions.

Related article: PhilHealth Benefits Guide for Regular and Voluntary Members

What are the PhilHealth Benefits for Maternity?

philhealth benefits for maternity
philhealth benefits for maternity

Under the Expanded Maternity Leave Law, PhilHealth is mandated to cover the health care needs of its active pregnant members and their newborns through different maternity benefit packages[4].

1. Antenatal Care Package

  • Prenatal consultation

  • Essential health care services

2. Maternity Care Package

  • Essential health care services during the entire pregnancy until the mother gives birth

  • Follow-up visits from three to seven days after childbirth

3. Normal Spontaneous Delivery Package

  • Essential health care services for normal, low-risk childbirth and post-delivery period

  • Follow-up visits from three to seven days after childbirth

4. Maternity Benefits for Other Types of Childbirth

PhilHealth also covers health care services for caesarian delivery and other types of delivery in any accredited hospital such as breech extraction.

5. Newborn Care Package

Newborns within their first hours of life, whether normal or caesarian delivery, can receive the following PhilHealth benefits:

  • Newborn screening test

  • Newborn hearing screening test

  • Essential newborn care (eye prophylaxis, weighing, first dosage of hepatitis B and BCG vaccines, etc.)

6. Z Benefits for Premature and Small Newborns

These are benefit packages for expectant moms (24 to 36 and 6/7 weeks pregnant) who are at risk of premature delivery, as well as premature newborns (fetal age of 24 weeks to less than 37 weeks) and small babies (500g to 2,499g fetal weight).

How Much is the Maternity Benefit in PhilHealth?

PhilHealth shoulders the following child delivery costs for qualified members:

PhilHealth Maternity Benefit

Coverage

Antenatal Care Package

PHP 1,500 in PhilHealth-accredited non-hospital facilities

Maternity Care Package

PHP 6,500 (PhilHealth-accredited hospitals) / PHP 8,000 (Maternity clinics, infirmaries, birthing homes, and other accredited non-hospital facilities)

Normal Spontaneous Delivery Package

PHP 5,000 (accredited hospitals) / PHP 6,500 (accredited non-hospital facilities)

Maternity Benefits for Other Types of Childbirth

PHP 19,000 (caesarian delivery) / PHP 12,120 (vaginal delivery after C-section/breech extraction) / PHP 9,700 (complicated vaginal delivery)

Newborn Care Package

PHP 1,750

Z Benefits for Premature and Small Newborns

PHP 600 to PHP 4,000 (prevention of premature delivery) / PHP 35,000 to PHP 135,000 (premature newborns with a fetal age of 24 weeks to less than 32 weeks) / PHP 24,000 to PHP 71,000 (premature newborns with a fetal age of 32 weeks to less than 37 weeks)

Read more related articles:

Final Thoughts

To make sure that you’ll get the maternity benefits of SSS and PhilHealth, check or update your membership status with these agencies. Ask for a Member Data Record (MDR) from PhilHealth and a Static Information Sheet from the SSS. You also need to check your SSS and PhilHealth contributions to confirm if your employer is remitting them.

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Sources:

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