Increase on PhilHealth Premium for Individually Paying Members to start on October 1, 2012

PhilHealth through the Advisory No. 07-01-2012 has announced that the increase in premiums for Individually Paying Members (IPM) from Php100.00 to Php200.00 per month shall take effect this coming October 1, 2012.

Hence, IPMs may still pay the quarterly premium of Php300.00 for the 3rd quarter. Payment for the 4th Quarter will still be Php300.00 if done before October 1. As a means to promote continuity of coverage, PhilHealth is granting its voluntary members the option to pay their annual premiums for Jan-Dec 2013 using the current rate of Php1,200 per year if paid before the effectivity of the premium increase.

The advisory is applicable to all Individually Paying Members except professional and those average monthly earnings is more than Php25,000.00

PhilHealth Cataract Package

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PhilHealth Hemodialysis Benefits

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Good Morning Kuya - 2011/04/18

Premium Payment and Benefits for Individually Paying Members, KaSAPI and Organized Group Enrollees

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:

• Knowing my PIN through contacting the Call Center
• How much should I pay?
• When is the deadline for payment?
• What do I need to pay my contributions?
• Where do I pay my contributions?

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.

• When should you update your PhilHealth records?
• How to update your membership record with PhilHealth?

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.

Preparing for PhilHealth Sabado 2 set on June 25, 2011

The Nationwide PhilHealth Registration Day (NPRD) or what is commonly known as "PhilHealth Sabado, Magseguro, Magparehistro" is a nationwide activity conducted by PhilHealth to fast-track the registration/enrollment under the National Health Insurance Program (NHIP). This is a continuing advocacy program which aims to provide an easier method for non-members of the NHIP to register and pay the one quarter premium contribution by putting up various registration sites aside from PhilHealth Offices that may be open to new registrants or existing members that will be updating their membership record.

With the success of the PhilHealth Sabado conducted last October 2, 2010, PhilHealth shall be conducting the same activity this coming June 25, 2011. If you are planning to join the event, we suggest you to:

1. Accomplish or fill-out the PhilHealth Membership Registration Form (PMRF) for new registrants and those updating their membership record. The PMRF can be downloaded here. Make sure that you entered your current and complete address including the name of your barangay;
2. Prepare the necessary supporting documents that you would need to attach to the PMRF such as birth certificates of you and your dependents, marriage certificate (if married), adoption papers of your parent/child (if applicable), annulment/separation papers (if applicable) and others. You may click here to know who you can declare as dependents;
3. Prepare the premium amount equivalent to a quarter payment for new registrants. You will only be given a PhilHealth ID Card once payment of at least a quarter is made. If you do not pay the premium, you will only be provided a copy of your PhilHealth Identification Number (PIN);
   
4. For requests on printing of PhilHealth ID Card / Member Data Record (MDR) please prepare the documentary requirements. For PhilHealth ID Card requests requirements are discussed in this post. For MDR requests, you might be asked to bring with you a request letter, photocopy of two (2) valid ID Cards;
5. Bring any valid ID Card to be presented during registration/updating.

Depending on the number of registrants and the connectivity of the registration site, there may be cases when your registration forms and attachments will only be received and your Member Data Record (MDR), Open Category Slips or PhilHealth ID Card will be mailed to the address you have provided after the backroom processing of your registration form. This will usually be done by PhilHealth to manage the number of transactions and to maintian a speedy process. Hence, you may take note of the date when the registration form is received and contact the Call Center to follow-up on your registration.

Can a sponsored member continue his or her membership after it expires?

Yes.

Sponsored members are those whose premiums are paid for by local government units, government agencies, or perhaps private institutions, and whose membership lasts for one (1) year. After the expiration of the membership, the member has three options:

1. If the membership is not renewed, he/she can reapply for the sponsored program again with the Department of Social Welfare and Development (DSWD) who will evaluate the application and endorse it to a sponsor;
2. Continue the membership as an Individually Paying Member(IPM). To avoid any gap in his or her coverage, it is recommended that the member pay the Individually Paying Program (IPP) dues before the expiration of his or her sponsored membership;
3. If the member manages to find employment, the employer will pay half of his or her premiums and the member will shoulder the other half via salary deduction.

It is not unusual for a PhilHealth member to move between the different classes of PhilHealth membership in a lifetime.

For more information read this post.

When is the best time to transact with PhilHealth?

This post is intended to answer inquiries of some members on the office hours of PhilHealth or when is the best time to transact with PhilHealth.

Generally, you may transact with PhilHealth from Monday to Friday from 8:00 AM to 5:00 PM at any PhilHealth Office nationwide. The same office hours are also being implemented in the operation of PhilHealth's Call Center that can address your concerns through phone. PhilHealth Offices also comply with the legal and special holidays as declared by the government.

You should also avoid the periods below if you don't want to wait for a long time as there will be more persons transacting with PhilHealth during these periods:

• 10th day of the month - deadline of premium payment of employers;
• last day of the quarter - deadline of premium payment for individual members;
• 15th day of the month - deadline of submission of the employer remittance report.

Hopefully, you won't have too difficult a time transacting with PhilHealth. Also be sure to share your experiences with us through Facebook and/or Twitter so that we may help PhilHealth improve its services through your feedback.

Is PhilHealth coverage mandatory for all Filipinos?

Yes. Put another way, PhilHealth membership is compulsory.

SEC. 6. Coverage. - All citizens of the Philippines shall be covered by the National Health Insurance Program. In accordance with the principles of universality and compulsory coverage enunciated in Section 2 (b) and 2 (1) hereof, implementation of the Program shall, furthermore, be gradual and phased in over a period of not more than fifteen (15) years: Provided, That the Program shall not be made compulsory in certain provinces and cities until the Corporation shall be able to ensure that members in such localities shall have reasonable access to adequate and acceptable health care services. (underlining supplied)

Reference: Art. III, Sec. 6, R.A. 7875 

SECTION 4. Objective – It is the main objective of the NHIP to provide all Filipinos with the mechanism to gain financial access to quality health care services within the first 15 years of its implementation. Coverage of the employed members in the government and private sectors, individually-paying, retirees, and indigent families shall be ensured. (underlining supplied)

Reference: Title III, Rule 1, Sec. 4, IRR of R.A. 7875

Please note though, that membership and eligibility to avail of benefits are two different things. You may be a member, but if you are not paying your PhilHealth contributions with the required frequency, you are not eligible to avail of your PhilHealth benefits.

This applies to everyone who is employed, regardless if it is with the government or the private sector, or Overseas Filipino Workers (OFWs).

Individually Paying Members (IPMs) may or may not choose to register or pay premiums under the IPM program. If they choose not to, they are not eligible for PhilHealth benefits. It is strongly recommended that those qualified as IPMs register and pay their contributions.

Lifetime members need not pay as they are already retired and have already made at least 120 monthly contributions.

The contributions for those belonging to sponsored program are paid for by government or private entities.

For further information on who can enroll or register as a PhilHealth member, read this post.