PhilHealth Maternity Care: The Unbundled 2026 Rates
Health · benefits
Quick answer
PhilHealth Circular 2026-0006 unbundled the Maternity Care Package into antenatal, intrapartum, postpartum and emergency referral benefits for non-hospital and outpatient facilities. Antenatal clinical and diagnostic rates total ₱12,050.00, a birthing facility delivery pays ₱14,000.00, and postpartum pays ₱1,350.00.
Every figure on this page is from PhilHealth Circular No. 2026-0006, Expansion of Maternity Care Benefits for Non-Hospital and Outpatient Facilities's own published documents.
Last verified 1 source, listed below
PhilHealth Circular No. 2026-0006, Expansion of Maternity Care Benefits for Non-Hospital and Outpatient Facilities1. PHGuides is independent and not affiliated with any agency.
Asking what the PhilHealth maternity benefit is worth used to have one answer. Since PhilHealth Circular No. 2026-0006, approved under Board Resolution No. 3089, s. 2026 and published on 12 May 2026, it has several, because the package was taken apart.
The Expanded Maternity Care Package (MCP) has been unbundled into: antenatal care, intrapartum care, postpartum care, and emergency stabilization and step-up referral.
That matters practically. Each piece is claimed by whoever provided it, at its own rate, at its own moment.
Antenatal: the clinic side
At least 8 antenatal visits, and the money follows the trimester rather than the visit.
| Code | Visit | Age of gestation | Frequency | Benefit rate |
|---|---|---|---|---|
| ANV01 | First trimester | 1 to 13 weeks | 1 | ₱1,100.00 |
| ANV02 | Second trimester | 14 to 27 weeks | 2 | ₱1,500.00 |
| ANV03 | Third trimester | 28 to 40 weeks | 5 | ₱3,750.00 |
| TDAP1 | Tetanus vaccine, 1st dose | 20 to 36 weeks | 1 | ₱150.00 |
| TDAP2 | Tetanus vaccine, 2nd dose | 27 to 36 weeks | 1 | ₱150.00 |
The rate is for the set, not the visit. Each set is claimable at the end of its trimester. Dividing gives ₱750.00 per visit in the second and third trimesters, against ₱1,100.00 for the single first-trimester visit. That division is arithmetic on the table, not a figure the circular prints.
A third-trimester claim showing fewer than 5 visit dates needs a justification letter, for reasons such as premature rupture of membrane, preterm labour, another obstetrical emergency, or a fortuitous event.
Antenatal: the laboratory side
Diagnostics are a separate claim, filed by the laboratory.
| Code | Service | Frequency | Benefit rate |
|---|---|---|---|
| AND1 | First routine diagnostics | 1 | ₱2,000.00 |
| AND2 | Second routine diagnostics | 1 | ₱900.00 |
| AND3 | Third routine diagnostics | 1 | ₱500.00 |
| ANS1 | Transvaginal ultrasound, first trimester | 1 | ₱1,000.00 |
| ANS2 | Pelvic ultrasound, second or third trimester | 1 | ₱1,000.00 |
AND1 is one set of 7 tests: pregnancy test, blood typing, complete blood count, urinalysis, hepatitis B screening, HIV screening and syphilis screening. AND2 is the oral glucose tolerance test. AND3 is a complete blood count and urinalysis.
Two rules bite here. The set is bundled, and failure to perform at least 1 test renders the whole claim non-reimbursable. And only 2 ultrasounds are reimbursable, with the pelvic one claimable once, at either the second or the third trimester, never both.
Clinical plus diagnostic antenatal comes to ₱12,050.00.
Delivery and referral
| Code | What it covers | Benefit rate |
|---|---|---|
| NSDBF | Normal spontaneous delivery in a non-hospital birthing facility, plus immediate post-partum care before discharge | ₱14,000.00 |
| NSD1L | Referral for complication during the 1st stage of labour | ₱1,600.00 |
| NSD2L | Referral for complication during the 2nd stage of labour | ₱8,500.00 |
| NSD3L | Referral for complication during the 3rd stage and immediate postpartum | ₱14,700.00 |
Only low-risk normal delivery is reimbursable in a birthing facility, and the partograph is a requirement for filing. The referral benefits are strictly for emergencies detected during labour and delivery. The circular is explicit that in no instance may they be claimed for a medical condition arising before labour begins.
Postpartum, and the six-week mark
| Code | Service | Frequency | Benefit rate |
|---|---|---|---|
| PPC01 | Postpartum visits after discharge | 3 | ₱1,350.00 |
Reimbursable at the end of the 6th week after delivery, and only after four mandatory services are provided at every visit: supplements, family planning, lactation and nutrition management, and mental health screening and support.
Postpartum IUD insertion is claimable as a second case rate at ₱3,900.00 in full under either the delivery or the postpartum schedule. Interval IUD insertion is a first case rate at the same ₱3,900.00.
The rule to remember at the counter
The health facility shall not charge the patient for essential services listed in this policy.
The No Co-Payment policy covers essential health services and basic accommodation at every participating facility. Three exceptions exist, and they are narrow: additional room amenities the patient requests, antenatal or postpartum consultations beyond the covered number, and diagnostics from the second repeat onwards. Extra antenatal visits in a private provider are capped at ₱900.00 of co-payment for the whole pregnancy, no matter how many extra visits there are.
Facilities must also remind you that the routine antenatal diagnostics are bundled and should be at no cost to you.
Who can claim it, and where
Eligibility is immediate. Every pregnant person enrolled in the National Health Insurance Program can avail under the Universal Health Care Act, and pregnant persons below 21 and their infants are covered under existing membership rules. The PhilHealth registration guide covers enrolling, and the membership categories guide covers which category you fall into.
Newborns are covered automatically and issued a PhilHealth Identification Number on registration or claims processing. Benefits for newborn care itself are deferred to a separate circular, so no newborn rate appears in this one. The PhilHealth dependents guide covers adding the baby to your record.
Every provider must designate at least 1 Care Coordinator, and tell PhilHealth within 30 calendar days of any change. Antenatal and postpartum benefits sit outside the YAKAP capitation and are reimbursed separately. The YAKAP guide covers that programme.
What this page does not cover
Circular 2026-0006 is for non-hospital and outpatient facilities only: birthing homes, lying-in clinics, primary care facilities and hospital outpatient departments. A hospital delivery, and caesarean section, sit under a different issuance, Circular 2026-0005 on maternal and gynecologic case rates, and none of its rates is stated here.
It also publishes no newborn care rate, since that is promised in a separate circular, and it does not list which specific facilities near you are accredited. Accreditation fees in it, from ₱1,000.00 to ₱3,000.00, are charged to facilities, not to patients.
Related
The first 1000 days guide covers the statutory entitlement these benefits pay for, the newborn screening guide covers the test required in the first days of life, and the mandatory immunization guide covers the vaccines the law requires PhilHealth to include in its package.
Frequently asked questions
- How much is the PhilHealth maternity benefit in 2026?
- There is no longer one number. Circular 2026-0006 unbundled the package. Antenatal clinical visits pay ₱6,350.00, tetanus doses ₱300.00, antenatal diagnostics ₱5,400.00, a normal delivery in a non-hospital birthing facility ₱14,000.00, and postpartum ₱1,350.00. Adding those is ₱27,400.00, which is arithmetic on the circular rather than a figure it prints.
- How many antenatal visits are covered?
- At least 8, distributed as at least 1 in the first trimester, at least 2 in the second, and at least 5 in the third. Each set is claimable at the end of its trimester, not per visit.
- Can the clinic still charge me?
- Not for essential services. The circular enforces a No Co-Payment policy in all participating facilities for essential health services and basic accommodation, and states the facility shall not charge the patient for essential services listed in the policy. Extra antenatal visits beyond the 8 are capped at ₱900.00 of co-payment per pregnancy in private providers.
- What if I need a repeat laboratory test?
- The first repeat is covered. The circular allows the facility to charge the patient from the second repeat onwards, and requires it to be documented in the Antenatal Care Record or Postpartum Care Record.
- Am I eligible if I have not paid contributions?
- All pregnant persons enrolled in the National Health Insurance Program are immediately eligible under the Universal Health Care Act. Pregnant persons below 21 years old and their infants are eligible under existing PhilHealth membership rules.
- Is my newborn covered?
- Automatically. Newborns are covered under the National Health Insurance Program and issued a unique PhilHealth Identification Number upon registration or claims processing. Benefits for newborn care itself are promised in a separate circular, so they are not in this one.
- What happens if there is a complication during labour?
- There are three separate referral rates: ₱1,600.00 for a complication in the first stage of labour, ₱8,500.00 in the second, and ₱14,700.00 in the third stage and immediate postpartum. They can only be claimed for emergencies detected during labour and delivery, never before labour begins.
- Does this cover a hospital delivery?
- No. This circular is for non-hospital and outpatient facilities: birthing homes, lying-in clinics, primary care facilities and outpatient departments. Hospital-based maternal and gynecologic case rates are handled by a separate circular, 2026-0005.