Ectopic Pregnancy is a kind of pregnancy in which the fetus develops outside the womb, usually in the Fallopian tube.
Hydatidiform Mole is an abnormal growth of mass in the womb at the start of pregnancy. The mass can either be an abnormal placenta and some fetal growth, or abnormal placenta and no fetus.
Ectopic Pregnancy or Hydatidiform Mole (H-Mole)
Present original copies and photocopies.
1. Maternity Reimbursement Application (MAT-2 form)
2. Maternity Notification (MAT-1 form)
It should be stamped received by SSS prior to delivery
3. SSS ID Card (Original and Photocopy)
If you have no SSS ID, present your SSS ID application acknowledgment stub and
2 valid IDs both with signature and at least one with photo and authenticated by the authorized signatory
4. Ultrasound Result
5. Medical Certificate
6. Obstetrical History
. It should indicate the number of pregnancies including H-mole.
. It should be certified by attending physician with his/her PRC number,
printed name and signature.
7. D&C report and Histopathology result
. It should be certified by the authorized hospital representative
8. Operating Room Record, if operation for ectopic pregnancy was performed
9. Other documents that may be required by the SSS Medical Specialist
For Separated Employees
If your date of D&C or operation is within 6 months of your date of separation, submit also this certificate:
Certificate of Separation from Employment and Non-advancement of SSS Maternity Benefit
from your former employer
It should certify the effective date of separation and that no advance payment was granted
For Employees who went AWOL, or who filed a DOLE complaint against their former employer, or whose former employer denied their request for certification:
you can use this Affidavit of Undertaking.