PhilHealth Claim Form 1 (CF-1)

What is PhilHealth CF-1 claim form?

Claim Form 1, or CF-1, is the PhilHealth form a member (or their representative) completes when PhilHealth benefits are used for a hospital confinement. It sits with the other claim forms the hospital files, and tells PhilHealth whose membership covers the patient.

The current edition is marked 'Revised September 2018'. Part I is the member's information, Part II the patient's when the patient is a dependent, Part III the member's certification, and Part IV the employer's certification for employed members. Part V is for PhilHealth. The form's reminders say claims should be filed within 60 days of discharge (180 days for benefits availed abroad), and that the hospital's representative helps the member complete it.

FileIt asks the questions in order, prints the PIN, PEN and dates one digit per box in capital letters, and fills PhilHealth's own CF-1 PDF. You print it, sign it and give it to the hospital.

Who needs to fill out PhilHealth CF-1 claim form?

• PhilHealth members who are confined in a hospital and using their benefits.
• Members whose declared dependent (child, parent or spouse) is the patient.
• Representatives signing for a member who is incapacitated or otherwise unable to sign.
• Employers certifying contributions for an employed member's claim.

When to use PhilHealth CF-1 claim form

• During or after a hospital confinement, when the hospital asks for the PhilHealth claim forms.
• When filing a claim for benefits availed abroad, within the longer period the form allows.
• Each time a new confinement is claimed — each claim has its own CF-1.

What you need before you start

• The member's 12-digit PhilHealth Identification Number (PIN).
• The member's full name, date of birth, sex, mailing address and contact numbers.
• If the patient is a dependent: their PIN (if any), name, date of birth, sex and relationship to the member.
• If a representative signs: their name, relationship to the member and the reason for signing.
• For employed members: the PhilHealth Employer Number (PEN), the employer's business name and contact number, and the name and position of the person who certifies.

What’s on PhilHealth CF-1 claim form

The 2018 edition has 1 page. FileIt asks for it in 4 parts:

1. Part I — Member informationMember
2. Part II — Patient informationMember
3. Part III — Member certificationMember
4. Part IV — Employer's certificationEmployer

How to fill out PhilHealth CF-1 claim form, step by step

1 Part I — Member information

Enter the member's PIN, name (last name, first name, extension, middle name), date of birth in month-day-year boxes, mailing address, sex and contact details. Question 7 asks whether the patient is the member: answer Yes to go straight to Part III, or No to fill in Part II.

2 Part II — Patient information

Only when the patient is a dependent. Give the dependent's PIN if PhilHealth issued one, their name, date of birth and sex, and tick whether they are the member's child, parent or spouse.

3 Part III — Member certification

The member, or a representative, attests that the information is true. Choose who signs: FileIt prints that person's name on their signature line and the date in their date boxes. A representative also ticks their relationship (spouse, child, parent, sibling or other) and the reason for signing (the member is incapacitated, or another reason). If the signer cannot write, they put a right thumbmark in the box, assisted by a hospital representative.

4 Part IV — Employer's certification

For employed members only. The employer enters its PEN, contact number and business name, and certifies that the required premium contributions were remitted. The authorised representative prints their name and position, signs and dates it.

Common mistakes to avoid

• Answering No to question 7 but leaving Part II empty, or filling Part II when the member is the patient.
• Writing the PIN with a digit missing — the PIN has 12 digits in 2-9-1 boxes.
• Filling in both signature lines in Part III; only the person who signs completes theirs.
• Forgetting the employer's certification for an employed member.
• Missing the filing period printed on the form (60 days from discharge, 180 days abroad).

After you fill it out

Print the CF-1 from your FileIt vault. The member or representative signs over their printed name (or thumbmarks), and the employer signs Part IV if needed.

Give it to the hospital with the other PhilHealth claim forms and documents it asks for. FileIt does not file the claim.

Keep the PDF in the patient's folder in your vault, alongside the hospital bills and discharge papers.

PhilHealth CF-1 claim form: frequently asked questions

Official sources

• Blank form (PDF), published by Philippine Health Insurance Corporation (PhilHealth): https://www.philhealth.gov.ph/downloads/claim/ClaimForm1_092018.pdf
• Official instructions and guidance: https://www.philhealth.gov.ph/downloads/claim/PhilHealth_ClaimForm1_Guidelines.pdf
• Edition shown on this page: Revised September 2018 (checked 2026-10-19).

FileIt is not affiliated with or endorsed by Philippine Health Insurance Corporation (PhilHealth) or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-19.

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