List of Sickness Covered by SSS and How to file a claim?

The Social Security System (SSS) is a government-mandated insurance program that provides financial support to Filipinos during life-changing events, such as illness, disability, maternity, or death. SSS coverage is vital in helping people cope with the financial burden that comes with these circumstances.

It is essential to understand the list of sicknesses covered by SSS and the process of claiming benefits to ensure you get the assistance you deserve. This article aims to provide an overview of SSS coverage, including the medical conditions and illnesses covered, how to claim benefits, and what exclusions to keep in mind.

By knowing the details of SSS coverage, Filipinos can plan and budget accordingly to ensure they receive the necessary financial support during difficult times. Whether you are a current SSS member or planning to become one, this article will help you navigate the system and get the benefits you deserve.

Sickness Coverage Overview

The coverage for sicknesses provided by SSS includes chronic illnesses, maternity benefits, disability benefits, and death benefits.

This can be obtained by fulfilling specific criteria, submitting the necessary forms and supporting documents, and undergoing a review process to determine eligibility for benefits.

SSS covers long-term illnesses such as hypertension, arthritis, diabetes, and cancer, all of which can incur significant medical expenses.

Maternity benefits are available for registered members who meet specific criteria, and the allowance can help ease the financial burden of expenses associated with pregnancy and childbirth.

Moreover, disability allowance is available for those who experience an illness or injury resulting in a disability, and rehabilitation programs can help individuals regain independence and transition back into the workforce.

Death benefits can provide a crucial lifeline for loved ones, and filing a claim promptly is important to receive necessary financial support during a difficult time.

The extent of medical conditions and illnesses covered by the SSS is critical, and it is essential to be aware of what the SSS Pension does and does not cover.

Pre-existing conditions are not covered by the SSS Pension, and cosmetic procedures are typically not included in SSS plans.

A clear understanding of the list of sicknesses covered by SSS and how to file a claim is crucial, and planning and budgeting accordingly is important.

It is recommended to reach out to a pension expert or SSS representative for assistance to ensure that you get the benefits you deserve.

Claiming SSS Sickness Benefits

Claiming SSS sickness benefits involves filling out necessary forms including SSS Sickness Notification Form 101 and submitting them with supporting documents, which can be done in person or through the SSS online portal, and then waiting for the SSS to review and determine eligibility for benefits.

The process can take up to 2 weeks, depending on the complexity of the claim and the completeness of the supporting documents. Once approved, benefits can be received through direct deposit or a mailed check.

To ensure a smooth and successful claims process, here are some tips to keep in mind:

  1. Familiarize yourself with the list of sicknesses covered by SSS and the specific criteria for each benefit.
  2. Keep all necessary documents, such as medical records and receipts, organized and readily accessible.
  3. Double-check all forms and supporting documents for completeness and accuracy before submitting.
  4. Follow up with the SSS regularly to check on the status of your claim and address any concerns or questions that may arise.

Important Exclusions to Note

It is important to be aware of the exclusions to SSS coverage, including pre-existing conditions and cosmetic procedures, in order to fully understand the extent of the benefits available.

Pre-existing conditions refer to medical conditions or illnesses that were present before the member availed of SSS coverage. These are not covered by the pension and may require additional health insurance coverage.

Cosmetic procedures, on the other hand, are typically not included in SSS plans as they are considered elective and not medically necessary.

Knowing these exclusions can help members plan and budget accordingly for their healthcare needs. It is also important to seek additional coverage for pre-existing conditions or cosmetic procedures that are not covered by the SSS pension.

Understanding the extent of SSS coverage, as well as its limitations, can make a significant difference in a member’s healthcare journey.

Review the Latest SSS Contribution Table.


The Social Security System (SSS) provides Filipinos with financial assistance during times of illness, disability, maternity, or death.

Understanding the list of sicknesses covered by SSS and how to file a claim is crucial for individuals to receive the benefits they deserve.

By having a clear understanding of SSS coverage, Filipinos can plan and budget accordingly to ensure they receive the necessary financial support during difficult times.

Overall, SSS sickness coverage offers a crucial safety net for Filipinos during times of need.

It is essential to be aware of the illnesses covered by SSS, the process of claiming benefits, and the important exclusions to avoid any misunderstandings or delays in receiving benefits.

By staying informed and taking advantage of the resources provided by SSS, Filipinos can ensure that they receive the financial support they need to overcome difficult circumstances and live a more secure life.

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