Outpatient HIV/AIDS Treatment Package

Register Online and Be A PhilHealth Member

You may now register online using PhilHealth's Online Services - Electronic Registration System located at this link. Online registration was introduced in the release of PhilHealth Circular No. 05 s-2012.

Requirements (Things you need to prepare)

Scanned copy of your supporting documents (jpeg/jpg, bmp, png, gif or pdf). Size for each file should not be greater than 2MB.
- for employed members, you would need the scanned ER2 with signature from your employer.
- you and your dependents' birth certificates
- marriage contract for married individuals

You may also choose to mail the necessary supporting documents, however, your application can only be processed once they are received.

Process:

1. Click on this link-> Register Online to directly take you to PhilHealth's registration facility.
2. Click the Proceed button.
3. Click the "I agree to the conditions stated above and will comply to submit the required information and supporting documents to complete the registration." 
4. Click the Accept button.
5. Enter all the required information denoted by the asterisk (*) sign. Guardian information is required for principal members whose age is less than 18 yrs old. For employers registering their employees, you can specify the email address of the employees. You can simply ask the employees to forward the email of Philhealth for their issued PhilHealth number. If you used only one email address, employees would need to update their email addresses directly with PhilHealth for future correspondences. Tip: Use your current personal email address and encode your name as appearing in your birth certificate.
6. Click the Submit Registration button. An email will be sent to the email address you specified during registration.
7. PhilHealth will be processing the online applications and when the finished, an email indicating the PhilHealth number assigned to you will be sent.

You can claim your PhilHealth ID in any PhilHealth office near you. For individually paying members, upon receipt of your issued PhilHealth number, you can immediately start paying your monthly premium contributions.

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.

How to Request for a New PhilHealth ID Card

PhilHealth has recently introduced the new design layout of the PhilHealth Number Card that is currently being released to the employed and individually paying members per PhilHealth Circular No. 11 s-2010. The major difference is that the new design is now being recognized as a valid PhilHealth ID thus the name has been changed from PhilHealth Number Card (PNC) to PhilHealth ID Card (PIC).

Steps/Tips in Requesting for a new PhilHealth ID Card (PIC):

• Prepare a letter of request (cite your complete name, PIN and reason for replacement);
• For lost ID, prepare an Affidavit of Loss as attachment to the letter request (use this as reference);
• For damaged ID, be sure to bring your damaged ID. PhilHealth might require you to present or surrender it;
• Bring one (1) recent 1x1 ID Photo to be used for your replacement ID;
• A Letter of Authorization will be required if you will be designating a representative to receive the re-issued/replacement PIC on your behalf. Attach a photocopy of your ID and the ID of your representative to the Letter of Authorization. PhilHealth may also require you to present the actual IDs used for verification.

Submit your request to the respective PhilHealth Regional Offices (PhROs), Service Offices (SOs) or PhilHealth Member Assistance Center (PMAC). Bring a valid ID.

Normally you can just wait for the ID to be issued to you when you submit your request. However, your waiting time would depend on the number of persons that are transacting with PhilHealth at the time you submit your request.

Addendum: If you are looking for information on the new I-PhilHealthy Card with privileges and discounts, read this post.

What is Sufficient Regularity of Premium Payment?

Sufficient Regularity is defined as "payment of premium contribution of at least nine (9) months within the twelve (12) month period immediately prior to the month of availment" as cited in Section 3-iii of the Revised Implementing Rules and Regulations of PhilHealth. Now what does this mean for us NHIP members particularly since the release of PhilHealth Circular No. 25 s-2010?

• Who are covered by PhilHealth Circular No. 25 s-2010?
NHIP members under the Individually Paying Program and Employed members are covered in this circular. Availment of members belonging to the sponsored program and OFWs will still be based on their effectivity period defined by the date of coverage or payment. OFWs are covered for one year starting with the date of their payment while sponsored members have their corresponding one year NHIP coverage period. Lifetime members no longer have this eligibility criteria as they are no longer considered as paying members of the NHIP.

• What does this have to do with availment of benefits?
This now indicates that before the date of your or your dependent's admission, you should have nine (9) months contribution within a twelve (12) month period. Members covered in this Circular that do not meet this requirement will not be able to avail of PhilHealth benefits.
• How does this relate to our payment of premium contributions?

• Premium payment paid on or during the confinement period will be credited to the succeeding applicable period. Example, if the date of confinement/availment is on March 13, 2011 then payment for the first quarter (1st Qtr) should be made before March 13, 2011 so that the amount shall be credited to the first quarter. If payment was made on March 13 or during the confinement period, the payment will immediately apply to the 2nd Quarter. In short, pay your premium contribution before the date of your or your dependent's admission.

• For payments under the rules of sufficient regularity, payment should be made on the last day prior to confinement or availment of benefits in order to be considered or credited to the quarter being paid. This simply means no retroactive payments on the start, during or after the confinement/availment date will be allowed previously permitted under Section 7 of PhilHealth Circular No. 24 s-2003.

• All benefits shall be covered under this eligibility criteria including treatment or out-patient benefits.

The nine (9) over twelve (12) months contribution eligibility criteria shall take effect starting on July 2011 admission / treatment date. For additional information or clarification you may refer to the PhilHealth Circular No. 25 s-2010 or you may coordinate / inquire with PhilHealth's call center or the nearest PhilHealth office.

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.

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.

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.

Reference: PhilHealth Circular No. 27 s-2010

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).

Prepare and Submit the PhilHealth Employer Remittance Report (RF1) Online using the Electronic Premium Reporting System (EPRS)

A new reporting scheme has been launched on October 1, 2010 enabling the online preparation and submission of the Employer’s Remittance Report (RF1) by using the Electronic Premium Reporting System (EPRS). The availability of the online reporting scheme was announced under Circular No. 30, s-2010 published on October 28, 2010 in the PhilHealth website.

The EPRS is a web-based application which facilitates not only the posting of individual premium contributions but also the assignment of the PhilHealth Identification Number (PIN) for unregistered members.

There are three (3) major advantages in using this scheme:

1. Facilitates the assignment of PhilHealth Identification Numbers (PIN) to unregistered NHIP members.

2. Faster posting of employee contributions as the report directly prepared by the employer will be automatically posted in the PhilHealth database upon PhilHealth validation.

3. Ensures that the total contributions of the report would tally with the actual payment made as the report will be prepared prior payment of contributions.

Requirements in using the EPRS:

1. The reporting employer should have its own PhilHealth Employer Number (PEN). The PEN will be issued to the employer once the employer registers with PhilHealth.

2. The employer should be directly remitting or paying to any PhilHealth office.

3. The period and amount of the report being prepared and that reflected in the receipt should be the same.

The employer would need to be trained in using the web-based application. You will be required to fill-out a PhilHealth Online Access Form (POAF). The user account will be electronically sent in the email address you specified in the form so be sure to provide a valid and active email address. To request for the training schedule, contact any PhilHealth office near you.

I just hope that this will be the starting point of PhilHealth in providing an easier means to access their services and that the infrastructure of PhilHealth is capable in maintaining this facility.