Good Morning Kuya - 2011/04/18

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.