Availability of Burial Assistance Benefits from PhilHealth (Philippine Context)

Last updated from general legal knowledge through 2024; verify any amounts or administrative procedures that may have changed since then. This is general information, not legal advice.

Bottom line, up front

PhilHealth does not provide a stand-alone “burial,” “funeral,” or “mortuary” cash benefit. PhilHealth is the National Health Insurance Program and pays for health services (e.g., inpatient, outpatient, and special packages). It does not pay for funeral expenses. If a member dies, PhilHealth coverage may still reduce or settle the last hospital bill through its case rates, but coffins, interment, cremation, embalming, and funeral home services are outside PhilHealth benefits.

Filipinos looking for burial assistance typically turn to SSS, GSIS, OWWA, ECC/Employees’ Compensation, DSWD (AICS), and LGUs, not PhilHealth. Details on those are summarized below for context.

Legal framework: why PhilHealth doesn’t pay burial benefits

Statutes
- Republic Act No. 7875 (National Health Insurance Act of 1995), as amended by RA 9241 and RA 10606, created and refined the National Health Insurance Program.
- Republic Act No. 11223 (Universal Health Care Act, 2019) expanded coverage and financing but continued the program’s health-service orientation.
Scope of benefits under the law The Acts and their IRRs authorize PhilHealth to finance health benefit packages—payments for medically necessary services, goods, and technologies delivered by accredited providers. Burial or funeral services are not classified as health services, and there is no statutory authority granting PhilHealth a mortuary/funeral cash assistance.
How PhilHealth pays PhilHealth generally pays case rates to the hospital and accredited professionals (or applies no-balance-billing for eligible patients). Payments are tied to clinical conditions or packages (e.g., maternity, dialysis, TB-DOTS, “Z” catastrophic cases, Konsulta primary care). None of these include funeral or interment costs.

What PhilHealth can still cover when a member dies

While there is no burial assistance, two death-related scenarios commonly arise where PhilHealth matters:

Final hospitalization before death
- If the member or qualified dependent was confined prior to death, PhilHealth benefits (case rates) may be used to settle or reduce the hospital and professional fees for that confinement.
- Accredited hospitals file electronic claims. Families should ensure:
  - The patient’s PhilHealth Identification Number (PIN) and eligibility were verified upon admission (via the PhilHealth Benefit Eligibility Form generated by the hospital).
  - Any required Member Data Record (MDR) updates (e.g., declaring dependents) were completed.
  - For employers: contributions and reporting were current at the time of illness. (Under UHC, coverage is broader, but contribution status may affect certain availments for non-indigent categories.)
- Excess/refund: If, unusually, the applicable case rate exceeds the actual charges, the balance should be released by the hospital to the patient’s representative/heirs. This is exceptional but recognized in case-rate mechanics. It is not a funeral benefit—it’s a by-product of hospital billing versus the fixed case rate.
Outpatient treatment prior to death
- If the deceased had ongoing PhilHealth-covered outpatient services (e.g., hemodialysis, TB-DOTS) before death, those prior sessions remain payable per rules and within limits. There is no retroactive “death payout.”

Key point: PhilHealth pays providers for health care actually rendered. It does not pay families for funeral costs.

Common misconceptions (and how to address them)

“The funeral home said they can process PhilHealth burial assistance.” This is incorrect. Funeral homes sometimes help families chase SSS/GSIS/OWWA/ECC/DSWD/LGU benefits, but there is no PhilHealth funeral grant to process.
“PhilHealth will pay something because the member died, right?” Only if there was a PhilHealth-covered hospitalization or package prior to death. Payment goes to the health-care provider (or exceptionally as a refund if case rate > actual charges). Funeral costs are not covered.
“Can we file a PhilHealth claim after the patient dies at home?” No, not for funeral costs. PhilHealth claims are tied to accredited services (e.g., hospitalization). A death at home without a PhilHealth-covered care episode does not create a claim.

Practical checklist for families when a member dies

Get the medical records and billing from the hospital if there was confinement. Confirm the PhilHealth portion has been applied to reduce the bill.
Ask the hospital billing/PhilHealth desk whether any excess from the case rate is due back. If yes, prepare:
- Valid ID of the claimant/representative
- Death certificate and proof of relationship/authority (e.g., SPA or authorization letter)
- Hospital official receipts/billing statements
Ignore offers that mention “PhilHealth burial cash.” Redirect your attention to the correct agencies below.
Keep all receipts for funeral expenses—most non-PhilHealth programs require them.

Where burial assistance actually comes from (non-PhilHealth)

These are separate from PhilHealth. Always confirm current amounts and requirements with the agency involved.

SSS (Private-sector workers and certain self-employed/voluntary members)
- Funeral benefit is payable to the person who paid for the funeral (not necessarily the legal heir).
- Amount depends on contributions and salary credit; historically capped (the cap has changed over time).
- Apply via My.SSS or SSS branches; typical requirements: death certificate, proof of funeral expenses (official receipt), valid IDs, and SSS forms.
GSIS (Government workers and pensioners)
- Funeral benefit for members/pensioners; amount fixed by GSIS policy (periodically updated).
- File with GSIS; present death certificate, IDs, and GSIS claim forms.
OWWA (OFWs)
- Death benefit (natural or accidental) plus a separate burial assistance for active OWWA members; amounts differ by cause of death under OWWA policy.
- Coordinate with OWWA Regional Welfare Offices; bring OWWA proof of membership, death certificate, IDs, and documents linking the deceased to OFW status.
ECC/Employees’ Compensation (work-related deaths)
- Funeral benefit and death benefits administered via SSS or GSIS, depending on sector, if the death is work-connected.
- Requires proof of compensability (e.g., employer’s report of accident/illness).
DSWD – AICS (Assistance to Individuals in Crisis Situation)
- Burial assistance for eligible indigent/low-income families; amounts vary by assessment and region.
- Coordinate with DSWD Field Office or LGU’s social welfare office; bring social case assessment, indigency proof, death certificate, funeral contract/receipt, and IDs.
Local Government Units (LGUs)
- Many cities/municipalities have own burial aid or tie-ups with funeral homes or memorial parks.
- Check the Mayor’s Office/CSWDO/MSWDO for programs, required documents, and timelines.

Tip: You can avail multiple programs if you qualify (e.g., SSS + DSWD + LGU), subject to each agency’s rules against duplication or double-payment for the same expense item.

Practical guidance for lawyers and advocates

Client intake
- Clarify early that PhilHealth has no burial/funeral benefit; set expectations and direct clients to SSS/GSIS/OWWA/ECC/DSWD/LGU as appropriate.
- For estates: track any PhilHealth hospital bill reductions and potential excess/refunds as part of the decedent’s receivables.
Documentation strategy
- Preserve the PhilHealth eligibility printout and hospital billing showing application of case rates.
- For refunds, prepare SPA/authorization if the legal heir is not the person named on hospital records.
Consumer protection
- Watch for misleading advertisements by non-government entities that suggest “PhilHealth burial assistance.” Consider Article 19/20/21 of the Civil Code and consumer protection laws if families are misled or charged “processing fees” for non-existent benefits.

Frequently asked questions

Does PhilHealth pay anything because the member died? Only indirectly—if there was a PhilHealth-covered confinement, the case rate can reduce the last hospital bill. No funeral cash is paid by PhilHealth.

Can the family claim PhilHealth money after discharge? Claims are generally provider-filed. Families may only receive an excess/refund where the case rate exceeded actual charges (rare), and that refund comes from the hospital, not as a PhilHealth “burial” payout.

Is cremation covered? No. Funeral, cremation, and interment costs are outside PhilHealth benefits.

What if the member died at home? There is no PhilHealth benefit for funeral costs. Explore SSS/GSIS/OWWA/ECC/DSWD/LGU programs instead.

Quick action plan (non-PhilHealth)

Identify the deceased’s coverage(s): SSS/GSIS? OWWA? Employed at time of death (ECC)? Senior citizen/indigent (for DSWD/LGU)?
Assemble documents: government ID(s), death certificate, funeral contract/receipts, proof of contributions/membership.
File promptly with relevant agencies; many allow online initiation (SSS) or walk-in with queueing (DSWD/LGU).

Sample authorization (for hospital “excess/refund,” if any)

AUTHORIZATION

I, ________________________, of legal age, [relationship], and
[ID number], hereby authorize ________________________ to claim on my behalf
any refund/excess derived from the application of PhilHealth case rate(s)
for the confinement of the late ________________________ at
________________________ Hospital, discharged on _____________.

This authorization includes signing receipts and acknowledging the release
of funds, but does not waive any other rights of the estate or heirs.

Signed this ____ day of __________, 20____ at ____________________.

Signature over printed name:

Takeaways

No PhilHealth burial assistance exists.
Use PhilHealth to ensure the last hospital bill is properly reduced/settled if there was confinement.
Seek burial aid from SSS, GSIS, OWWA, ECC, DSWD, and LGUs, depending on eligibility.

If you want, tell me the deceased’s affiliations (e.g., SSS/GSIS/OFW/employment status and where you live), and I can map the exact agencies and documents you’ll need next.