PhilHealth and Some of its Benefits
Good evening everyone!
In line with educating other Filipino steemians and Filipino readers online, I would like to share some guidelines for PhilHealth member and aspiring PhilHealth members. These were all taken from the pamphlets which is the organization’s tool to educate its customers, us, the Filipino People.
It was written in Filipino and a little bit of English, thus I took time in translating it English so that non-Filipino readers would also have an idea about the Philippine Health Care.
A photo I took on one of the materials given to members at PhilHealth office.
By the way, PhilHealth is one of the state’s program crafted to ensure that every Filipino would be covered with medical access. A big thanks to the late Senator Ed Angara for championing PhilHealth.
PhilHealth aims that every Filipino would be its member. It also seeks that every member would be protected. Lastly, it seeks that everyone’s health is secured. Coming from its slogan, Bawat Pilipino ay miyembro. Bawat miyembro protektado, Kalusugan natin segurado.
A Guide for the Informal Economy Members of PhilHealth
The Informal Economy Members
People who are under this program are the following:
-Informal sector, or also known before as non-professional who are Individually Paying Members
Examples of this are street hawkers, vendors at the market, pedicab and tricycle drivers, small construction workers, and home-based industries:
Self-earning individuals or professionals, or also known before as professionals who are Individually Paying Members
-Examples of this are doctors, lawyers, artists, architects, athletes, coaches, and a lot more.
-Filipinos with dual citizenship o Filipinos who reside in another country
-Naturalized Filipino Citizen
-Foreigners working or residing in the Philippines
-Individuals who are below 21 years old but are not declared dependent on to anyone
-Individuals who are 60 years old and up and could not be declared as dependent by anyone and are not qualified to be Lifetime Member
-And other individuals that are not under any membership programs of PhilHealth
How to register?
Write the correct and complete PhilHealth Member Registration Form that can be asked to any Local Health Insurance Office (LHIO) of PhilHealth or you can download it from www.philhealth.gov.ph and submit it to PhilHealth.
The following can be declared as dependent:
-Spouse who is not member of PhilHealth
-Child who is under 21 years old, has no work, and has not been married
-Child who is 21 years old or up but is disabled
-Foster child in accordance with Foster Care Act of 2012
-Parents who are 60 years old and above and is not yet a -PhilHealth member
-Parents who are permanently disabled
There is no need to submit supporting documents unless it has been required by PhilHealth as proof.
To avoid complications with the law, it is advised to write the information correctly and truthfully
Image from pixabay.com
One can also register online!
Visit www.philhealth.gov.ph on your smartphones with internet connection, tablets, or personal computers
(1)Click Online Services at the homepage
(2)Click the Electronic Registration option and follow the steps for registration
(3)Submit online your applicable supporting documents as scanned copies
(4)Wait for the notification from your PhilHealth on your e-mail. PhilHealth will then send to you your PhilHealth Identification Number and MDR.
You can also request for Health Insurance ID Card at any Local Health Insurance Office of PhilHealth.
Now, how do we update our membership record?
You just need to submit to the nearest PhilHealth Office your PhilHealth Membership Registration Form with the corrected or new information. Do not forget to check (/) “For Updating” which can be found on the top of the PMRF. Prepare copies of the applicable supporting document/s in case it is being asked to as your proof.
It is often asked as well on how much to pay on your contribution as most people often forget about it. Well, since January 2014, the premium contribution has been changed:
To those who are earning until Php25,000.00 a month including those who are land-based migrant workers
Mode of Payment
Quarterly – Php 600.00
Semi-annually – Php1,2000
Annually – Php2,400.00
To those who are earning Php25,000.00 and up
Quarterly – Php900.00
Semi-annually – Php1,800.00
Annually – Php3,600.00
Where can we pay for the contribution?
You can pay at any of these institutions: PhilHealth Local Health Insurance Offices, chosen PhilHealth Express Offices, and PhilHealth Accredited Collecting Agents (local and abroad) like the CIS Bayad Center branches , SM Retail Inc., banks, and many more.
For complete list of accredited collecting agents or partners, you can check it out at www.philhealth.gov.ph.
Now here is the most awaited portion, how much do we earn on specific cases?
The member and his qualified dependents have benefits for the payments on illnesses and operations. It would be based on the Case Rates that would be answered by PhilHealth.
For other inquiries which are not mentioned below, you can inquire at PhilHealth CARES at the hospital or you can check it at www.philhealth.gov.ph.
Cases:
Pneumonia Moderate Risk – Php15,000.00
Pneumonia High Risk – Php32,000.00
Stroke (Infarction) – Php28,000.00
Stroke (Hemorrhagic) – Php38,000.00
Hypertensive Emergency – Php9,000.00
Severe Dengue – Php16,000.00
Acute Gastroenteritis – Php6,000.00
Asthmas in Acute Exacerbation – Php9,000.00
Newborn Care Package – Php1,750.00
For Operations:
Hemodialysis – Php4,000.00
Maternity Care Package – Php8,000.00
Normal Spontaneous Delivery Package – Php6,500.00
Caesarian Section – Php19,000.00
Radiotherapy Linear Accelerator – Php3,000.00
Cataract Package – Php16,000.00
Cholecystectomy – Php31,000.00
Appendectomy – Php24,000.00
Z benefits – These are the benefits given with Case Rates for illnesses that needed long and expensive medication. There are pre-conditions and selection criteria that are needed to be given emphasis on some chosen government hospitals.
Acute Lymphocytic Leukemia – Php210,000.00
Breast Cancer Stages 0 to 3a – Php100,000.00
Prostate Cancer with low to intermediate risk – Php100,000.00
Kidney Transplant with low risk – Php600,000.00
Coronary Artery Bypass Graft Surgery – Php550,000.00
Surgery Tetralogy of Fallout in Children – Php320,000.00
Surgery for Ventricular Septal Defect in Children – Php250,000.00
Cervical Cancer Chemoradiaton with Cobalt and Brachytherapy (Low Dose) – 120,000.00
Cervical Cancer Chemoradiaton with Linear Accelerator and Brachytherapy (High Dose) – Php175,000.00
External Lower Limb Prostheses – Php15,000.00
Outpatient Benefits under the All Case Rates
Tuberculosis – Directly Observed Treatment Short-course given by the accredited TB-DOTS centers– Php4,000.00
Malaria treatment given by accredited rural health units – Php600.00
Outpatient HIV/AIDS treatment – Php30,000.00
Treatment package for those who were bitten by dogs and other animals given by the accredited animal bite treatment centers of the government – Php3,000.00
Vasectomy and Tubal Ligation- Php4,000.00
What are the conditions to avail the following benefits?
(1)Has contributed a specific amount
(2)PhilHealth-accredited doctors and hospitals
(3)Not lower than 45 days of being admitted to the hospital in one year
How to use the benefits on the PhilHealth-accredited facilities?
(1)Before being discharged in the hospital, submit the following at the Billing Section at the hospital:
(2)Carefully filled in PhilHealth Claim Form I that can be asked at the hospital, PhilHealth offices, or you can download it at www.philhealth.gov.ph
(3)Health Insurance ID Card or Updated Member Date Record (photocopy)
(4)Proof of contribution
A Guide for Foreigners wanting to be part of PhilHealth
I was also asked one time whether or not foreigners could be part of PhilHealth. Of course, they can be a member of it under the Informal Economy Program. Foreigners can secure their family and themselves too.
Who may be covered?
Starting last July 1, 2017, all nationals registered to PhilHealth would be part of it, specifically:
These members are foreign retirees or former Filipino nationals and other qualified dependents who are holders of Special Resident Retiree’s Visa or also known as SRRV an granted with permanent residency status.
The second one is that the citizens of other countries working and/or residing in the Philippines holding of Alien Certificate of Registration Identity Card or ACR I-Card.
Now, the second important question is, who may be covered by it or considered as qualified dependent?
Filipino spouse and children below 21 years old who is not covered under the NHIP; or
Either the foreign spouse or one (1) of their children who is below 21 years old who is not a Filipino citizen.
How to enroll?
For those who are PRA or Philippine Retirement Authority Foreign Retirees, they are required to submit the following requirements at the nearest PRA office:
Properly accomplished PhilHealth Member Registration Form or PMRF for Foreign Nationals , which may be downloaded from www.philhealth.gov.ph, and
Presentation or photocopy of valid ACR I-Card issued by the Bureau of Immigration.
What Is the amount of premium?
Foreign retirees – Php15,000.00 annually
Other foreign citizens – P17,000.00 annually
This can either be paid in quarterly basis, semi-annually, or annually.
Initial payment shall be made to the nearest LHIO, while succeeding payments can be paid at any PRA, PhilHealth Office or satellite offices, or at the nearest PhilHealth Accredited Collecting Agent.
Image from pixabay com
What are the benefits?
- Hospitalization benefits for in-patient ( benefits under the Z Benefits Package, special privileges of Women About to Give Birth and reimbursements for confinements abroad, however, are not included)
- Ambulatory for out-patient Benefits such as Out-patient Aids/ HIV Treatment, Animal Bite Treatment, and Voluntary Surgical Contraception Procedures.
Source Material: PhilHealth Corporate Affairs Group May 2014 Pamphlet For Action Center Hotline, you can contact it on (02)441-7442. You can also visit its website at www.philhealth.gov.ph www.facebook.com/PhilHealth www.twitter.com/@teamphilhealth actioncenter@philhealth.gov.ph