Friday, July 22, 2011

Using the Electronic Premium Reporting System (EPRS)

This is in reference to our previous post introducing the new online reporting scheme implemented by PhilHealth last September 2010. The said scheme is used by employers in submitting their monthly remittance report (RF-1) containing a list of their employees and corresponding premium contributions that have been deducted.

For those who are already registered under the new scheme, you may download the user guide or user manual (in PDF format) through this link. You may also post or share your experiences on our Facebook page so that we may get your feedback.

For those employers who haven't already registered under this scheme, we recommend you to implement the online reporting scheme as the report will be automatically processed and recorded in PhilHealth's database, hence a timely updating of your employee's premium contributions. Access to the status of your submitted online reports are also provided in this facility.

Monday, July 18, 2011

Continuing PhilHealth Coverage for Separated Employees

This post is intended to guide newly separated employees on how to continue being eligible to receive PhilHealth benefits. There are two ways by which you may continue your PhilHealth coverage, the first is by becoming a qualified dependent of an active PhilHealth member and the second is by continuing your coverage by being a contributing member under the Individually Paying Program of the Corporation.

Continuing Coverage as a Qualified Dependent

You will need a certification from your previous employer that you are no longer connected with them. This will be used by PhilHealth as basis to deactivate your member record and facilitate your coverage as a dependent.

For married individuals, if your spouse is an active PhilHealth member, you may enroll under your spouse as a valid dependent. Your spouse should fill-out the PhilHealth Membership Registration Form (PMRF) reflecting you as a dependent, attach a copy of your Marriage Certificate, your birth certificate and the certification from your previous employer.

For single individuals, if you are already 21 years old or above, you can no longer be covered as a dependent of any of your parent. If you are however below 21 yrs old and unmarried, any one of your parents (not both) may declare you as a dependent. They would need to fill-out the PhilHealth Registration Form (PMRF) reflecting you as a dependent and attach your birth certificate and the certification from your previous employer.

If you cannot be covered as a dependent, then you may choose to be a contributing PhilHealth member under the Individually Paying Program.

Continuing Coverage as an Individually Paying Member

To prevent creating a gap with your coverage, you should immediately begin paying the premium contribution as a voluntary member of PhilHealth. It is important for you to know your PhilHealth Identification Number (PIN) as this will be used when paying the contributions. To know more, please read these posts:

You should also ensure that you have an updated membership record with PhilHealth so that if you would be needing your Member Data Record (MDR), there will be no inconsistencies with your profile.

Additional Information

We strongly recommend that you immediately continue your coverage so as not to hamper your eligibility to avail of PhilHealth benefits by being a qualified dependent or continuing to be a contributing member.

Moreover, we would like to stress that for married individuals, you may be able to maximize your PhilHealth benefits by both becoming a contributing member. As a contributing member, you may both declare each of your parents (aged 60 years old and above), and if you have more than one child, for example four children, then you may each declare your two children to maximize the 45-days allowable limit shared by your dependents. This would mean a wider PhilHealth coverage for your family.

Friday, July 15, 2011

PhilHealth Maternity Benefits

Since Nov. 1, 2009, PhilHealth has been giving the following benefits for all normal spontaneous deliveries performed in accredited hospitals/lying-in clinics:

P2,500.00 - Hospital (room and board, drugs and medicines, laboratories, supplies, ancillary procedures, other medically necessary charges);
P2,500.00 - Physician (actual deliver, immediate postpartum care, counseling);
P1,500.00 - Prenatal care.

Total benefit amount is P6,500.00.

Note that this applies only the first four (4) low-risk normal spontaneous deliveries.

The basis for this revised maternity benefit package is Circular No. 39, s. 2009 pursuant to PhilHealth Board Res. No. 1282, s. 2009.

You can read PhilHealth's media release regarding this benefit package here.

Thursday, July 14, 2011

Disclaimer - A Reiteration

We would just like to reiterate that this blog and it's associated Facebook account, Facebook page, and Twitter account are NOT officially sanctioned by the Philippine Health Insurance Corporation.

This is a PRIVATE blog, plain and simple. We do not get paid to do this, we do not receive any support from PhilHealth, we do this on our own time, using our own resources, on our own internet connections...which tend to be flaky every now and then. We also have jobs and other responsibilities, so we get to do this only during breaks, or after the day's work has been completed.

It just turns out that we have some knowledge of the National Health Insurance Program and it's benefits and other activities, arising from experience, prior knowledge and from inputs from some of our friends who are directly connected with the program.

Unfortunately, PhilHealth is a bit old-fashioned, preferring to stick with traditional media such as newspapers, television and radio. Most of us are now aware that traditional media is no longer sufficient to address the needs of a significant number of Filipinos, especially those who now turn to the internet for most of the media they consume, particularly social networking sites like blogs, Facebook, and Twitter.

This is a niche that PhilHealth officially has not seen fit to exploit yet, despite the vast numbers of Filipinos it could potentially reach.

So we thought to ourselves, if PhilHealth is a bit slow in embracing the new social media...why don't we do it ourselves? Hence we came up with this blog, the Facebook and Twitter accounts. We find it rewarding to help people with their PhilHealth related concerns, especially since hardly anyone else is doing this in this manner.

We will continue to do this for as long as we find the experience rewarding, and there are people who need our help. Once PhilHealth officially makes it's presence on blogs, Facebook and Twitter known, maybe then we'll take a step back and let the professionals do their thing.

For now, we simply ask that our readers, friends and followers just put their expectations in check. WE ARE NOT PHILHEALTH. We are just doing our bit to help. If the help we provide is insufficient, you can always get directly in touch with PhilHealth via its official webpage, through its hotline at 441-7442, or though the closest PhilHealth office in your location.

We hope this clears up everything.

Sunday, July 3, 2011

Suspension of the 9-over-12 Premium Requirement

A PhilHealth Advisory and PhilHealth Circular No. 09 s-2011 were released to inform the public of the suspension of the Nine (9) over Twelve (12) months premium requirement for availment of benefits that is supposedly due for implementation this July 2011 under PhilHealth Circular No. 25 series 2010.

Hence, employed and voluntary members may still avail PhilHealth benefits with only three months contributions within a six month period prior to the date of confinement. Availment of other benefits such as maternity package are still requiring 9-over-12 premium requirement for voluntary members.