Friday, April 29, 2011

NCR: Directory of PhilHealth Offices

PhilHealth NCR - South Branch
Citystate Center 709 Shaw Blvd., Brgy Oranbo, Pasig City
Tel no. 637-8239; 637-1284

  • Pasig Service Office
  • DAP Building Ground Flr., One San Miguel Avenue, Pasig City
    Tel no. 683-0206, 447-6806
  • Las Pinas Service Office
  • 471 Editha Bldg., Alabang, Zapote Road, Almanza I, Las Pinas City
    Tel no. 556-5687
    Covered Areas: Las Piñas, Muntinlupa, Parañaque
  • Makati Service Office
  • 337 ITC Building, Gil Puyat Avenue Makati City
    Tel no. 897-6389 and 897-3337
    Covered Areas: Makati, Pasay
PhilHealth NCR - North Branch
MARC I Building, 1971 Taft Avenue, Manila
Tel no. 523-9481, 523-9842, 524-9839

  • Caloocan Service Office
  • G/F REMCOR Building, Lot 5, Blk. 172 Rizal Avenue, Ext. (Bet. 10th & 11th Ave) Caloocan City
    Tel no. 365-2012 and 365-2014
  • Mandaluyong Service Office
  • Liberty Boni Bldg., #94 Boni Ave. cor. P. Cruz St., Brgy. San Jose, Mandaluyong City
    Tel no. 532-1905 and 532-0095

PhilHealth NCR - Central Branch
#880 F.R. Estuar Building, Quezon Avenue, Quezon City
Tel no. 332-1550, 332-1551

  • Rizal Service Office
  • The Brick Road, Sta Lucia East Grand Mall, Marcos Hi-way cor. Felix Ave., Cainta Rizal
    Tel no. 681-5499, 681-5111

Thursday, April 28, 2011

How to Update Your Membership Record with PhilHealth

In our previous post, we discussed about the instances on when to update our membership record with PhilHealth and its importance. Here we will discuss the procedure and required documents to update your membership record.

Steps in updating your member record:
  1. Fill-out the PhilHealth Membership Registration Form (PMRF);
  2. Submit the PMRF with attached supporting documents to any PhilHealth Office near you;
  3. Validate that the changes requested have been correctly reflected in your newly released Member Data Record (MDR);
  4. For correction/change in your name, ensure that you are issued a new PhilHealth ID Card (PIC) reflecting the corrected/updated name.

Accomplishing the PMRF:
  • Accurately write your PhilHealth Identification Number (PIN) in the form;
  • Put a check mark in the "For Updating" under the PURPOSE;
  • Write your name and date of birth. This will be used by PhilHealth to verify the member record retrieved using the PIN. If purpose is for correction of your name, write your correct name;
  • Write the necessary information that you would need to update or correct, there is no need to provide all the information in the form. If you are going to update your address, just write in the address portion, to register new dependents, just write your dependent's information and so on;
  • Affix your signature and write the date the form was accomplished.

Documents that are normally being required:
  • ID card/s issued by a government official authority;
  • Birth Certificate for correction on member's/dependent's name or date of birth and/or for declaring of new dependents;
  • Marriage Certificate or Contract / Affidavit of Marriage issued by Office of Muslim Affairs to update your civil status, change your last name (for females) and/or to declare your spouse as a dependent.

Other documentary requirements can be found in the second page of the PMRF.

Wednesday, April 27, 2011

Cases for Amending or Updating Your PhilHealth Records

As PhilHealth Members, it is your responsibility to ensure that your information recorded in PhilHealth's database is up-to-date and accurate. If you want to know how to go about updating your information then read on.

When should you update your information?

  • Correction in member profile
  • If you are issued a Member Data Record (MDR), immediately validate the accuracy of the reflected information. If you find that there is a discrepancy in your name, date of birth or any other information, you should amend or update your record immediately;

  • Correction in dependent's profile
  • This can also be checked in the MDR. Check whether the name and date of birth of your declared dependents have been accurately recorded by PhilHealth as this might become a problem in availment of benefits;

  • Change in address
  • If you relocated to another residence or address, immediately amend your PhilHealth record. It is important for PhilHealth to have your current address as notices/letters are being mailed based on your location registered in PhilHealth;

  • Change in civil or marital status
  • PhilHealth will require a copy of your marriage certificate, or Affidavit of Marriage issued by the Office of the Muslim Affairs, or annulment papers in order to effect the change in your last name. You should also request for a new PhilHealth ID Card and MDR.
    Males should likewise update their membership record to reflect the change in civil status and to include their spouse as a dependent;

  • Change in membership category
  • For separated employees wishing to continue their coverage with PhilHealth, they should amend their record to be under the Individually Paying Member category (refer to this post for distinction between Professional and Non-Professional). The premium amount that you will be required to pay would depend on your membership category, so it is important for you to update it;

  • Adding new dependents
  • If you wish to include your parents, spouse or child/ren under your PhilHealth coverage, they should be registered with PhilHealth as your dependents. For guidance on the declaration of dependents you may refer to this post. Siblings however cannot be declared as a dependent.

There are instances when you will no longer be required to go to PhilHealth in order to update your PhilHealth MDR. Among them are:

  • If your member profile reflected in Claim Form 1 (CF1) is different from your membership record, PhilHealth will use the information contained in the CF1 to update your membership record. (Pursuant to PhilHealth Circular No. 08 s-2007);

  • For the employed sector, if you are reported as a newly hired employee, then your membership category will automatically be updated to Private/Government depending on your company type. For separated employees, your membership record will reflect that you are already separated from the company. Those who transferred from another company, your record will display the new company. These information shall be captured using the Employer Remittance Report (RF-1). (Pursuant to PhilHealth Circular No. 13 s-2010);

  • Retiring employees in the private/government institutions will be covered as Lifetime Members provided that the member is at least 60 years of age, has met the 120 monthly contributions and that their employer facilitated their enrolment at least three months prior to the date of retirement. (Pursuant to PhilHealth Circular No. 28, s-2010.

However, it is still recommended that you to check your current MDR so that any further discrepancies can be immediately amended. To know how to amend / update your membership information click here.

Sunday, April 24, 2011

Tips in Availing PhilHealth Benefits

These are simple tips to guide and help you in availing PhilHealth benefits:

  • Know your PhilHealth Identification Number (PIN) or always have your PhilHealth ID Card (PIC). Most hospitals will ask you to present your PhilHealth ID Card in order for them to acknowledge that you are a PhilHealth member. Those under the sponsored program will be required to present their ID card for the hospital to validate your PhilHealth coverage. If you do not have a PhilHealth Identification Number (PIN) yet, then go to this post;

  • Make sure that your registration details with PhilHealth is up-to-date. An updated record is usually the cause of problems in availing PhilHealth benefits. Be sure to update PhilHealth about your change in address, civil status and new dependents. If you find that there is a discrepancy in your record, have it corrected immediately. If you are unable to do so, make sure that you attach the required supporting document in the availment/claim document;

  • Always have your PhilHealth Official Receipt (POR), PhilHealth Agent Receipt (PAR) or other receipt acknowledged by PhilHealth as proof of payment. Hospitals may require you to present proof of your latest payments especially if you are under the Individually Paying Member category. You should have the receipt/s of your latest nine (9) months payment prior confinement.

  • For employed members, request your employer to certify the Claim Form 1 (CF1). This will be required by the hospital for automatic deduction of PhilHealth benefits. Ensure that your contributions are being reported and remitted by your employer. As of now PhilHealth does not have an online facility accessible by its members to inquire about their contributions. You may however contact PhilHealth's call center or the Collection Section of PhilHealth Offices to verify your contributions.

    For OFWs, your Member Data Record (MDR) will show your recent payments with PhilHealth. Sponsored members' coverage will be visible in their Phil Hea lth ID Card;

  • Your or your dependent's confinement should be in a PhilHealth accredited hospital or facility. If you or any of your dependents are confined in an unaccredited hospital or facility then you might not be able to avail of PhilHealth benefits for bills paid to the institution. Accredited hospitals/facilities have a PhilHealth signage at their entrance. You should also know that hospitals and facilities should ha ve a n active accreditation period with PhilHealth in order to avail PhilHealth benefits.

  • The doctor, anesthesiologist and other professionals should also be PhilHealth accredited. If your doctor is not accredited, then you will not be able to reimburse the professional fees paid to them. You should also be aware that like the accredited health institutions, there are instances when you may not be paid depending on their accreditation period with PhilHealth;

  • Inquire how much is the regular professional fee and how much would be the PhilHealth deduction from your doctor. Some doctors have different rates for a non-PhilHealth and a PhilHealth member. This question should be asked as soon as possible as you might find it a pain if you fully pay the professional fee and then later want to reimburse it directly with PhilHealth only to find out that the doctor will not sign or provide you a disclaimer for full payment. This is usually the cause of conflict between the member and the doctor;

  • Inquire whether the hospital allows the senior citizen or government employee discount combined with PhilHealth benefits. Aside from PhilHealth benefits, your hospital bill may still be lessened if the patient is a senior citizen or the member is a government employee. Ask if the hospital/facility is implementing this scheme and if the senior citizen or government employee discount can be combined with the deduction from PhilHealth. As per experience, we have previously availed the senior citizen discount plus the PhilHealth benefit;

  • Retain a copy of the hospital and professional receipts, statement of accounts and other documents that will be attached to the PhilHealth claim. This can be used in requesting for adjustments, you may use these as evidence in cases of conflicts and may further be used in ensuring that you have received the right amount of benefits due to you.

  • Evaluate the Benefit Payment Notice (BPN) sent by PhilHealth. The Benefit Payment Notice (BPN) is basically a document informing you of how much the hospital, doctor or you as the member received from PhilHealth for your confinement. You may use this document to validate if the amount deducted by the hospital and doctor tallies with the amount they received from PhilHealth. If the amount they received from PhilHealth is greater than the amount they have deducted, then you may request for a refund from the hospital and the doctor. If the balance was returned to PhilHealth you may contact the PhilHealth Office near you. So save your receipts and make sure that the address you have in the PhilHealth record is updated.

Hope this helps you improve your experience in availing benefits under the National Health Insurance Program (NHIP).

Wednesday, April 20, 2011

Members with Multiple Employment Can Avail Refund or Adjustment for Overpayment of Personal Share

Overpayment of Premium Contribution due to multiple employment is a situation where a person is employed in more than one employer and both employers are remitting PhilHealth contributions as mandated by Section 18-20 of the Implementing Rules and Regulations of R.A. 7875.

To resolve this situation, PhilHealth has released PhilHealth Circular No. 05 s-2009. In this circular PhilHealth members are given the option to apply the overpayment to succeeding months or to request for a refund of the personal share. The personal share is the amount being deducted to the employee. Discussed below are the two options.

Overpayment of Personal Share Applied to Succeeding Months
  • Adjustment can be done only once.
  • The following qualifications/conditions must be met by the requesting member:
    • Member is currently unemployed;
    • Aggregate monthly premium contribution is greater than the maximum premium rate in the prescribed premium contribution schedule (this may be based on the current rate at the time of the contribution);
    • Overpayment occurred due to multiple employment;
    • Overpayment incurred from January 2009 onwards (based on effectivity of the Circular);
    • The period covered for adjustment is posted in PhilHealth's contribution database and Treasury database. (This means that you should be included in the monthly report prepared by your employer and the employer is paying the contribution as evidenced by the record in the Treasury database.)
  • The overpayment of the personal share shall be reflected or adjusted as an advance payment of the premium contribution for the Individually Paying Member.
This alternative may be used by those shifting to the Individually Paying Member (IPM) category. It is advised however, that prior to paying the premium contribution as an IPM, you may request for the adjustment so that you will only be paying the remaining balance of your premium contribution dues for the current year.

Request for Refund of Personal Share
  • This alternative is only available to members under the Lifetime membership program or eligible members of the said program.
  • Qualifications are as follows:
    • Overpayment was due to multiple employment;
    • Overpayment was incurred only upon effectivity of the Circular;
    • The period covered for adjustment is posted in PhilHealth's contribution and treasury database (This means that you should be included in the monthly report prepared by your employer and the employer is paying the contribution as evidenced by the record in the Treasury database.);
    • Member is no longer employed;
    • Member is 60 years old and above and has paid the 120 monthly premium contributions.
  • Only the personal share shall be refunded to the member.
Documentary Requirements to avail of the Two (2) Options:
  • Filled-out request form/letter requesting of adjustment or refund of overpayment in personal share (specify the period where you are being deducted more than once, include the names of your employers for the corresponding period);
  • Copy of any 2 valid IDs with photo;
  • Copy of Employment Contract reflecting monthly income and status of employment from each of your employers;
  • Certificate of Employment with monthly income and status of of employment signed by the employers;
  • Other documents required by the Collection Section of PhilHealth.
Before going to the PhilHealth Office, call the Collection Section first so that you will be sure what other documents they will be requiring you to bring.

Tuesday, April 19, 2011

Discussion board on the EPRS on FB

If you have a Facebook account, please feel free to post any of your queries regarding the Electronic Premium Reporting System on our Facebook account discussion board. If you don't have a Facebook account, just enter your comments or questions here or email us at

Six top reasons to enroll in PhilHealth

For those thinking of deactivating, cancelling, or otherwise not participating in the National Health Insurance Program as administered by PhilHealth, here are six reasons why you should continue:
  1. PhilHealth is pro-Filipino;
  2. PhilHealth is affordable;
  3. PhilHealth covers your whole family;
  4. PhilHealth is pro-poor;
  5. PhilHealth assures quality;
  6. PhilHealth is supported by experience from other countries.
 Read the full Philippine Star article here.

Deactivate or Cancel My PhilHealth Membership - Is this possible?

Some of you might be wondering if it is possible to deactivate or cancel your PhilHealth membership and how this can be done. Your reason might be because you have not availed of any PhilHealth benefits yet or you may have had a bad experience with the corporation.

Employed individuals whether in a private or government company/agency will not be able to discontinue paying the PhilHealth premium contribution until such time that they are no longer employed. This is because the employers are mandated or required by law to enroll and deduct the said premium from their employees as they will be penalized for non-compliance. Household help also belong under this category.

For individually paying members or those individuals directly paying PhilHealth premium contributions, you would only need to discontinue payment. You will still be considered registered under the program but your membership will now be set to inactive. If you discontinue payment however, you may no longer be able to avail of PhilHealth benefits if you or any of your registered dependents are hospitalized. You may reactivate your membership upon payment of the required premium contribution for a given quarter, semester or year. Your eligibility to avail of PhilHealth services will be determined by the number of consecutive payments you contribute to the program.

For those under the sponsored sector, membership is automatically set to be inactive once the coverage period reflected in the PhilHealth ID Card (PIC) has expired. Prior to expiry of the coverage however, it is common for the local government units and/or sponsor to enroll or renew the membership to ensure eligibility of PhilHealth benefits.

For the Overseas Filipino Workers, it is mandatory to pay the premium contribution for a one year coverage before departure from the Philippines either directly through the POEA or PhilHealth. Upon expiry of the one year, you may continue paying the premium to ensure that you and your dependents are eligible to avail of PhilHealth benefits.

It is however recommended that before you give up on the program, you should get feedback from other individuals who have availed of PhilHealth benefits. We are sure that although there are some who finds the program below their expectations, there are also those that have a high regard for its existence. We hope that you would be able to choose the right option to secure both you and your family's health. You may check out the reasons why others stay with PhilHealth by clicking here.

Do you have an inactive account with PhilHealth? Know how you can reactivate it by clicking here.

Sunday, April 17, 2011

Is PhilHealth violating our privacy?

We have received word from some of our sources that PhilHealth intends to provide a copy of their membership database to other government agencies. A memo was recently issued by the President of PhilHealth directing all their regional offices to extract the membership information and distribute it to other institutions.

Just what constitutes the membership database anyway? Basically all the information that you wrote down in your membership form is included in the membership database. This includes your address, telephone number, gender, date of birth, your dependents, civil status and your employer. We as members do not appreciate our personal information being given away to just anyone without our knowledge or permission as it violates our privacy and it is no different from giving away our identities to a strangers.

As a registering agency, PhilHealth should ensure the safety and appropriate use of the information they capture. If sharing this information is indeed necessary, wouldn't it be wise to have a non-disclosure agreement with the other party to ensure that only the right information will be provided to external parties and that the information will only be used for the purposes intended, nothing more and nothing less? In other companies, information is treated securely which is why information is protected from being leaked outside. Why then would PhilHealth be giving out their database, more so, our personal information without the necessary precautions?

We are not saying that data sharing is a bad thing. Given that it's supposed to be a straight government to government agreement, there is nothing irregular with sharing the membership data as long as there are reassurances that the data will not be copied by parties outside the government where it can be abused. Due diligence to protect our data should be ensured.

Just to be clear, we are just saying that PhilHealth should only provide information that is necessary to accomplish the goals it sets with other entities and that such information should be guarded via non-disclosure agreements to prevent unscrupulous parties misusing our personal information. They should, specify in writing, what information is to be shared, the parameters of how the information is to be used, and an assurance that the data will not be shared with outsiders.

In this day and age, knowledge is power. PhilHealth ought to be careful whom they trust our personal information with.

We just hope that PhilHealth takes the proper precautions before agreeing to distribute the data.

Thursday, April 14, 2011

PhilPost as a PhilHealth Accredited Collecting Agent

As of January 2011, there are additional PhilPost Offices that are collecting PhilHealth premiums. Among them are:
  • Manila Central Post Office
  • Makati Central Post Office
  • Quezon Central City Post Office
  • Kalookan Central Post Office
  • Pasay Central Post Office
  • Muntinlupa Central Post Office
  • Marikina Post Office
  • Parañaque Post Office
  • Araneta Post Office
  • Novaliches Post Office
Payments from employers and individual members are accepted in PhilPost.

If you will be paying at a PhilPost Office, you should provide them the following information:
  • PhilHealth Employer Number (PEN) / PhilHealth Identification Number (PIN)
  • Name of employer / member
  • Applicable month or period to be paid
  • Amount to be paid
As a safety precaution, always double check the receipt given to you to ensure that the above information has been correctly captured by the collecting agent and PhilHealth as well. Any discrepancies require that the  agent correct the information and you should have the corrected copy of the receipt or payment return form.

Wednesday, April 13, 2011

PhilHealth's New Vision and Mission Statement

mPhilHealth has just changed its Vision and Mission statement which was announced in the PhilHealth Circular No. 04, s-2011.

Vision Statement

Adequate and Affordable Social Health Insurance Coverage for ALL Filipinos

Mission Statement

To ensure adequate financial access of every Filipino to quality health care services through the effective and efficient administration of the National Health Insurance Program (NHIP).

With the changes in the vision and mission statement of the Corporation, we hope to see great improvements in the services and the manner in which these services are delivered.

Tuesday, April 12, 2011

Download the PhilHealth Premium Payment Slip (PPPS)

For employers and PhilHealth members who are paying their premium contributions or remitting their payments through accredited collecting agents of PhilHealth, the PhilHealth Premium Payment Slip is now downloadable.

The PhilHealth Premium Payment Slip is currently being used by accredited collecting agents. The employer/member would need to fill-out the slip, present the slip and the payment to the agent. You should ensure that the slip is properly filled-out as the details you have reflected will be recorded in PhilHealth's database.

To avoid the long lines and ensure availability of the form, PhilHealth is now allowing access to the form in softcopy format. You may download the PhilHealth Premium Payment Slip here.

Monday, April 11, 2011

Schedules of PhilHealth Premium Payments

This is a reminder on when to pay your premiums.

For OFWs:
  • OFWs are required to pay their premiums prior to departure covering a one year period.
  • The date of payment will be the starting date of your coverage to PhilHealth so for regularity of payment, you would need to pay after the expiry of your coverage which is a year starting from the date of your payment. Payment on January 13, 2010 will expire on January 12, 2011, hence you would need to immediately pay the premium on January 13, 2011.
For Individually Paying Members
  • For quarterly payments, deadline is the last working day of the applicable quarter. Payment of the 1st Quarter should be made on or before the last working day of March.
  • For semi-annual/semestral payment, deadline shall be the last working day of the first quarter of the applicable semester. Deadline of payment for Jan-June shall be on or before the last working day of March, while payment for July-December may be made on or before the last working day of September.
  • For annual payment, deadline shall be on or before the last working day of the 1st quarter of the applicable year.
  • It is recommended to pay your premiums prior the last day of payment to avoid long queues in PhilHealth Offices.
For Employers:
  • Payment is made every month, deadline of which is the 10th calendar day of the month following the applicable month. As an example, remittance of the contributions of January should be on or before February 10.
If the deadline of payment falls within a holiday, the member/employer should pay prior the said deadline.

Wednesday, April 6, 2011

Who are under the Individually Paying Members (Professional) Category of PhilHealth?

In PhilHealth Circular No. 24 s-2010, PhilHealth introduced the Individually Paying Member - Professional category. As you will notice, the premium contribution for this type of membership now has a higher rate currently at Php600.00 per quarter for the first year of implementation and will eventually be Php900.00 per quarter in the succeeding years.

Below are members that fall under this category:
  • Accountant;
  • Architect;
  • Criminologist;
  • Customs Broker;
  • Dentist;
  • Dietician;
  • Aeronautical Engineer;
  • Agricultural Engineer;
  • Chemical Engineer;
  • Civil Engineer;
  • Electrical Engineer;
  • Electrical Communications Engineer;
  • Geodetic Engineer;
  • Marine Engineer;
  • Mechanical Engineer;
  • Metallurgical Engineer;
  • Mining Engineer;
  • Sanitary Engineer;
  • Geologists;
  • Landscape Architect;
  • Law Practitioner;
  • Librarian;
  • Marine Deck Officer;
  • Marine Engineer Officer;
  • Master Plumber;
  • Medical Technologist;
  • Medical Doctor;
  • Midwife;
  • Naval Architect;
  • Nurse;
  • Nutritionist;
  • Optometrist;
  • Pharmacist;
  • Physical and Occupational Therapist;
  • Professional Teacher;
  • Radiologist and X-ray Technician;
  • Social Worker;
  • Sugar Technologist;
  • Veterinarian;
  • Agriculturist;
  • Artist;
  • Businessman/Business Owner;
  • Consultant;
  • Environmental Planner;
  • Fisheries Technologist;
  • Forester;
  • Guidance Counselor;
  • Interior Designer;
  • Industrial Engineer;
  • Media (Actor / Actresses);
  • Media (Director);
  • Media (Scriptwriter);
  • Media (News correspondent);
  • Professional Athlete, Coach, Trainor, Referee etc.
Those members not belonging or practicing any of these professions will be categorized as Individually Paying Members (Non-Professional).

Tuesday, April 5, 2011

PhilHealth Premium Contribution Payment Rates

As with most insurance and HMO companies, PhilHealth members are required to pay a premium contribution in order to be qualified to receive PhilHealth benefits. Regularity of the payment will ensure uninterrupted availability of benefits from PhilHealth.

For individual members of the program,
  • Overseas Filipino Workers (OFW) are required to pay the one year premium of Php900.00. However, members have the option to pay the corresponding amount as an advance payment dependent to the number of years reflected in the contract period. Payment should be made to the POEA or directly to any PhilHealth office prior to departure. You may continue to pay your premiums through the accredited remittance centers shown here.
  • Individually Paying Members (Non-Professional) are required to pay Php300.00 per quarter to remain an active member of PhilHealth. You may also opt to pay semi-annually or annually directly to PhilHealth offices or through Accredited Collecting Agents. Payment on a monthly basis equivalent to Php100.00 is available only through the Remittance-By-Air facility. If your occupation is not included in this list then you belong to the Non-Professional classification.
  • Individually Paying Members (Professional) are required to pay the amount of Php600.00 per quarter or Php2,400.00 per year on the first year of implementation starting October 1, 2010.
  • For the succeeding years, members shall pay Php900.00 per quarter or Php3,600 per year. For those whose family income in the last 12 months is Php25,000.00 and below premium rate of the Non-Professional will be used. Payments may be made directly with PhilHealth or through the Accredited Collecting Agents.
If you are in a government or private institution (employed member), the employers will be deducting your PhilHealth premium based on your basic salary with the corresponding employer share. Refer to the table of Premium Contribution here.

Friday, April 1, 2011

Members: Declaring PhilHealth Dependents - Qualifications for Valid Dependents

This blog post is for those:
  • Members who are wondering who to declare as PhilHealth dependents in the PhilHealth Membership Registration Form (PMRF), and;
  • Those whose Member Data Record (MDR) did not reflect the dependents previously declared.
Who to Declare as a Dependent:
  1. Biological Mother;
  2. Biological Father;
  3. Step Mother (if biological mother already deceased);
  4. Step Father (if biological father already deceased);
  5. Adopted Mother (with adoption papers or Court Decree/Resolution of Adoption);
  6. Adopted Father (with adoption papers or Court Decree/Resolution of Adoption);
  7. Biological Son/Daughter;
  8. Step Son/Daughter;
  9. Adopted Son/Daughter (with adoption papers or Court Decree/Resolution of Adoption);
  10. Legal spouse (non-member or membership is inactive).
Qualifications of a valid dependent:

1. For Parents (birth certificate)
  • Should be 60 years old and above;
  • Non-member or inactive member;
  • Unemployed.

2. For Spouse (with marriage certificate/contract)
  • Non-member or inactive member;
  • Unemployed;
  • A Muslim member can declare more than one wife (with attached Affidavit of Marriage issued by OMA).
3. For Children
  • Should be below 21 years old;
  • Unmarried;
  • Unemployed;
  • 21 years old and above with congenital disability either physical or mental;
Additional Guidelines:
  • A dependent is qualified if they are not registered as PhilHealth members or if their membership is no longer active;
  • Generally, PhilHealth requires the submission of supporting documents to establish the relationship of the declared dependents to the member. Dependents without supporting documents will not be visible in the Member Data Record (MDR);
  • A dependent cannot be declared more than once, as in the case of both parents declaring the same child as their dependent, or siblings both declaring their parent;
  • There is no limit as to the number of dependents that you can declare. However, you should take note of the 45 days allowable limit shared by your dependents.