Dissecting PhilHealth: Know your Rights and Benefits Part 1

Dissecting-PhilHealth---myfinancemd-WordPressNow that PhilHealth is on the rocks.  Let’s know it’s what and how.  This will be the first part of a 3-part-series regarding PhilHealth.

 

“Health is not valued until sickness comes.” Thomas Fuller

 

Health is wealth, the saying goes.   But health insurance can be costly. One affordable option especially for any employee, is PhilHealth.   As a contributor, do you know your Philhealth Rights and Benefits?

With 81% coverage of the national population, do PhilHealth members really know what is available to them if they get sick?.

Today, we will take a look at the benefits of PhilHealth and how you can make the most of it.

 

Basics of PhilHealth

 

Who can be qualifies as PhilHealth Members?

21 years old and above that can be paying through their employees, as voluntary or as subsidized by the government.

How much is the Contribution?

 

PhilHealth Premium Contribution Table for Employees

PhilHealth Contribution table

Premium contributions for OFWs:

New premium contributions of P2,400/year applies to OFW or those under the OWP (Overseas Workers Program) applicable to Land based OFWs, either documented or undocumented.

 

 

PhilHealth Contribution for Self-employed, Individually Paying Member

 

With monthly income of P25,000 and below – P2,400/year

With monthly income above P25,000 P3,600/year

All members under this category can pay quarterly, semi-annually or annually.

 

PhilHealth Contribution Table 2015 for the Sponsored Program Members

To this category belong persons who have no visible means of income, or whose income is insufficient for family subsistence, as identified by the Department of Social Welfare and Development (DSWD), based on specific criteria. All indigents identified by the DSWD under the National Household Targeting System (NHTS) for Poverty Reduction and other such acceptable methods, shall automatically be enrolled and covered under the Program.

Annual premium of P2,400 is also applied to these type of members.

As a Paying PhilHealth Member, who can be your dependents:

  • Legitimate spouse who is not a member;
  • Child or children – legitimate, legitimated, acknowledged and illegitimate (as appearing in birth certificate) adopted or stepchild or stepchildren below 21 years of age, unmarried and unemployed.
  • Children who are twenty-one (21) years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support, as determined by the Corporation;
  • Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012;
  • Parents with permanent disability regardless of age as determined by PhilHealth, that renders them totally dependent on the member for subsistence.

 

Senior Citizen:

Starting November 25, 2014, all senior citizens without PhilHealth coverage can already avail all privileges and benefits of PhilHealth.

President Benigno Aquino III signed RA 10645 amending RA 9994 or the Expanded Senior Citizens’ Act of 2010. It removed the qualification that a senior citizen has to be an indigent before being covered by PhilHealth.

 

 

Are Senior Citizen automatically becomes a member of PhilHealth?

If a Senior Citizen is not a lifetime member, he is advised to register under Senior Citizen (RA 10945) the “Mandatory PhilHealth Coverage for all Senior Citizen” in the office of Senior Citizen Affairs (OSCA) in the municipality near your place. Just bring the following documents:

  1. PhilHealth Member Registration form (PMRF)
  2. Updated 1×1 picture (photo taken within the last 6 months); and
  3. Senior Citizen’s ID card from OSCA or any documents that can certify his age like Birth Certificate.

 

How many Sick Days are covered for members and dependents?

Principal Member shall be entitled to a separate coverage of up to 45 days per calendar year.

Another 45 days per calendar year shall be shared among the Qualified dependents.

 

Important:

Qualified dependents must be declared by the principal member. Their names must be listed under the principal member’s Member Data Record (MDR) to ensure hassle-free benefits availment.

 

What out for the Part 2:  I will be discussing the Benefits of PhilHealth!

 

 

Read More:

 

 

Do you want to compute your own SSS Retirement Pension? Click here to Download this FREE SSS Retirement Pension Calculator NOW.

SSS Retirement Pension Calculator myfinancemd-01

This is best used in laptop or desktop.

 

 

 

Sources: PhilHealth Website.

Disclaimer: I am not an employee of PhilHealth, any changes in the future may happen after writing this article.  If you have concerns, contact your nearest PhilHealth branch.

 

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Doc Pinky is a licensed Medical Physician, Internationally Registered Financial Consultant, Certified Investment Solicitor and Associate Wealth Planner and Estate Planner of the Philippines. She loves to educate and spread financial literacy. She is a Lactation Consultant. She loves to travel. She is a devoted wife and mother.

3 thoughts on “Dissecting PhilHealth: Know your Rights and Benefits Part 1

  1. salamat at nasagot dito lahat ng aking mga katanungan.

  2. Ramilo vergara

    Hello,

    My wife got a rare decease called GBS, a paralysis syndrome which is very expensive to treat. We spend almost 4 weeks in hospital that includes almost 2 weeks in ICU.

    Our hospital bill blown to 607,000pesos and what strucked me is we were only got 10k assistance from my philhealth out of 607k bills..

    Cant imagine how little philhealth is giving with such big amount we have payed.

    Is it really that small that philehealth can give?
    I mean half of my life ive been paying philhealth and at the most crucial moment i need it this is what it can offer.

    Hope to get positive feedback

    5nx
    Mr vergara

    • Now, it’s a case rate. Depends on the diagnosis and they will give you a fixed pre specified amount. That’s the real deal right now. That’s why it’s important to have to own a plan with critical illness benefit in case of a these kinds of events.

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