Showing posts with label lapse. Show all posts
Showing posts with label lapse. Show all posts

Monday, July 18, 2011

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:

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.

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.

Saturday, May 21, 2011

If I lapsed with my 1st quarter PhilHealth payment can i still pay it?

Normally, no.

There are exceptions though.

As per PhilHealth Circular No. 06, series of 2001, retroactive payments are not allowed except when a member can show proof of sufficient regularity of premium contributions or payment of nine (9) consecutive months or three consecutive quarters within the last 12 months prior to the missed quarter. If you meet this condition, you shall be given a grace period of one month immediately after the missed quarter to pay retroactively including the current calendar quarter.

For newly enrolled members (with less than 12 months reckoned from date of enrollment), retroactive payment for the missed quarter including the current calendar quarter shall also be allowed within the month immediately following the missed period.

This privilege is granted only once every 12 months.

Reference: PhilHealth IPM FAQs.

However, even if you miss a quarterly payment, you may still be eligible to avail of PhilHealth benefits if there is sufficient regularity.

Save yourself the worry and just pay your premiums on time.

If I lapse one month PhilHealth payment within a year can I still avail of PhilHealth benefits?

Yes.

The keyword is sufficient regularity.