Issuance of PhilHealth ID Cards and MDR to Employed Members

An official advisory has been released by PhilHealth informing the public that transactions for members belonging to the Private and Government Sectors should be facilitated by their respective Human Resource Departments (HRD).

Employees that are not yet registered with PhilHealth and those without PhilHealth Identification Numbers (PIN) should submit a fully accomplished PhilHealth Membership Registration Form (PMRF) with attached supporting documents:

• Clear copy of employee's birth certificate/baptismal certificate or one (1) valid ID;
• Clear copy of legal supporting documents of declared dependent/s such as birth certificate, marriage certificate and others as necessary.

Submit all the requirement to the HRD of the company you are in. They will in turn submit the documents together with the ER2 (Employer-Employee List) to PhilHealth. PhilHealth in turn will process your documents and forward your PhilHealth ID Card (PIC) and Member Data Record (MDR) to your office's HRD for distribution.

New employees whether newly employed or transferred who are existing PhilHealth members would just need to inform their current employer of their PhilHealth Identification Number (PIN) for the preparation of the Monthly Employer's Remittance Report (RF-1).

Source: PhilHealth Advisory No. 08-01-2011

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.

Who can Enroll or Register as a PhilHealth Member?

This post aims to discuss the different types of membership programs of the National Health Insurance Program. PhilHealth members are divided into five (5) main categories broken down as follows:

• Employed;
• Individually Paying Members (IPM);
• Sponsored Members;
• Lifetime Members;
• Overseas Filipino Workers.

The Employed category are basically those individuals that are employed either in a private or government institution and are therefore further classified into Private/Government. Individuals under this category are enrolled in PhilHealth through the employers in compliance with the law.

Individuals that are classified under the Individually Paying Member (IPM) are those that are directly paying their premium contributions to PhilHealth and belong to either of the cases below. Participation under this scheme is voluntary.

• Professional individuals are those whose professions are included in this list;
• Non-professional individuals which include individual farmers and fisherfolk;
• Individuals who are separated from work;
• Parents not qualified as legal dependents, sponsored members or lifetime members;
• Children not qualified as legal dependents;
• Unemployed individuals not qualified as a sponsored member;
• Citizens of the Philippines residing in other countries;
• Citizens of other countries (foreigners) residing/or working in the Philippines.

Sponsored members are those who are being paid for by local government units, government agencies or private institutions which fall under the implementation of the government subsidy program. Members under this category are usually covered on a yearly basis. Availment of PhilHealth benefits depends on the effectivity or coverage period as reflected in their membership.

Lifetime members generally covers retirees/pensioners who have reached the retiring age as defined by law and have met the required 120 monthly PhilHealth premium contributions. Individuals under this classification no longer need to be paying members in order for them or their dependents to avail of PhilHealth benefits.

Overseas Filipino Workers (Land-based) were previously under the IPM category. Due to the differences in the needs of the members under this category and the efforts with which these were addressed, PhilHealth decided to separate the monitoring and evaluation of those individuals who are working out of the country, hence a separate category was created. OFWs are required to enroll and pay a one-year premium contribution prior to leaving the country and to continue being an active member, OFWs would need to pay continuously to the program after the expiry of the one-year coverage.

Reference: Title III-Section 5 of the Implementing Rules and Regulations of the National Health Insurance Act of 1995

Do you get deducted for premium contributions if you are not a PhilHealth member?

You can't NOT be a PhilHealth member if you're employed.

Membership, coverage, and premium contributions are compulsory/mandatory for those with employment (formal sector).

Reference: Title III, Rule I, Implementing Rules and Regulations of the National Health Insurance Act.