Life is unexpected and you never know when illnesses might hit you. Medical fees are not cheap and can bring one to financial ruins. Hence, it is always better to be insured and well-prepared financially.
PhilHealth is the Philippine Health Insurance Corporation. Set up in the year 1995, this body has been mandated with implementing health coverage for all Filipinos living in the Philippines. The body is linked to the Health Department and is owned and controlled by the government. It is social insurance, which means that those who are healthy and working will pay or subsidize costs for those who are ill and impoverished. Local and national government pitch in to ensure that funds are available for healthcare.
Medical treatments are not cheap. When one falls sick and does not have the required amount for healthcare, things can go downhill fast. Luckily, PhilHealth is available to provide a subsidy for all its members. They receive healthcare benefits that includes both outpatient and inpatient care.
Formal economy members are government employees, private employees, workers rendering services, owners of micro enterprises and SMEs (Small Medium Enterprises), household helpers and family drivers. As long as the employees have offices based in the Philippines, they are members of the formal economy.
This type consists of migrant workers, Filipins working in the informal sector (street hawkers, market vendors, tricycle drivers, home-based industries and small construction workers), self-earning individuals, Filipinos with dual citizenship, naturalized Filipino citizenship and citizens of other countries residing or working in the Philippines.
Any OFWs who passed through POEA (Philippine Overseas Employment Administration) and paid their OEC (Overseas Employment Certificate) fees.
Workers whose contributions are being paid for by another individual, government or private entity. This consists of all members who are working for non-profit organizations.
Members are individuals who have no visible source of income, or members whose income is not enough for the household or those without a stable income.
Individuals who are 60 years old and above and have paid at least 120 monthly contributions with PhilHealth. Membership becomes free if one qualifies for both.
Filipinos who are 60 years old and above but are not members of PhilHealth. This also includes senior citizens who have not been able to make 120 monthly contributions for their PhilHealth membership.
The first step to getting the healthcare that you need is to become a member of PhilHealth. Registering for membership is quite easy. One can register at a PhilHealth Office close to their home or through PhilHealth’s online portal.
Generally, all applicants can submit their membership forms at Regional Offices, Local Health Insurance Offices, Business Centres and PhilHealth Express Branches. You can view the branches at different regions here.
PhilHealth has created an online application system to increase the convenience for their members and interested applicants. You can find the application form here. They will require interested applicants to fill up forms and upload necessary documents.
If you are already a member but have forgotten your PhilHealth Number, not to worry, there are three ways to access it.
1. Drop a text to 0917-5129149 or send an email to PhilHealth ofp@philhealth.gov.ph. Do remember to include your full name (first name, middle name and last name) and your birthday.
2. Visit the PhilHealth branches near you. The list of branches can be found here (https://www.philhealth.gov.ph/about_us/map/regional.htm) and the head office is located at Citystate Centre, 709 Shaw Blvd. 1603 Pasig City. Do drop a call before visiting the place to make sure that they are available.
3. Check with your employer or previous employer if they still have your PhilHealth records.
For 3 consecutive years, the contributions remitted to PhilHealth have remained the same. However, in 2018, those who are employed found that their contributions had been raised from 2.5% to 2.75% of basic salary.
This increase was found necessary in order to meet the increased costs incurred by the NHIP (National Health Insurance Program). NHIP covers partial and sometimes the full costs of medical treatment for the underprivileged, elderly, women and children, indigents and people living with disability.
The health agency also went ahead to phase out the previous bracketing system that had 28 tiers. Monthly premiums have now been simplified as follows:
The increase applies to all employed people including those in formal economy, Kasambahays, sea-based OFWs, government employees, private sector employees and employers, and even family drivers. Every house helper is required to pay their contributions as well but their contribution will be solely paid by the employer unless they are earning P5,000 and over at which point the contribution will be split 50-50 with the employer.
If one is given a pay rise and now earns P20,000, he or she will need to know how much they will be paying towards PhilHealth. Here is how to work that calculations:
Formula
PhilHealth contribution = (Monthly income * 0.0275)/2
Self-employed people are encouraged to keep their PhilHealth account updated at all times. Payments can be made quarterly, twice a year or even once a year.
These contributions have not been adjusted. They remain as per the 2014 contribution adjustments. Land-based migrants pay P2,400 every year in contributions. This amount can be paid yearly or after every 6 months. The contributions can be remitted at PhilHealth offices, POEA shop centers, or even at any oversees PhilHealth Collecting Agency. Sea-based migrants pay the same rate as employed people at 2.75% of the employee’s monthly income. The employee contributes half of it, while the employer contributes the other half.
These are impoverished families that have been selected via the National Household Targeting System for Poverty Reduction. Their contribution is P2,400 every month.
These are senior citizens who have attained the age of 60 and retired from work. They must have contributed for a minimum of 120 months to Philhealth before they can now be considered for lifetime coverage without having to contribute any longer.
Every Filipino above the age of 60 is already covered. This is according to RA 10645 Expanded Senior Citizen Act. They are not required to make any further contributions towards PhilHealth and they get free lifetime coverage.
This group not only includes self-earning individuals and OFWs; it also cover foreigners who are living and working in Philippines as well as naturalized Filipinos. They contribute P2,400 every year if they are earning P25,000 and under. If they earn over P25,000, then they will be expected to pay P3,600 each year towards PhilHealth.
PhilHealth covers outpatient services that include day surgeries, radiation therapy, blood transfusions, and even hemodialysis sessions. Sponsored and indigents as well as others who fall within this category also get TSEKAP. This package covers consultations, counseling, digital rectal exams, blood pressure checks, and breast exams from time to time. They also get diagnostic exams covered. These include chest x-rays and lab test. In addition, they are covered for medications for particular illnesses that include urinary tract infections, respiratory infections, gastric problems and asthma.
Other benefits include mother and child care. It covers maternity care in clinics and birthing homes too. This means that prenatal care and delivery is covered. The amount paid out will depend on the facility and type of delivery and usually covers the doctors’ fees, facility fees and care. The child’s newborn care package is also covered.
Z Benefits are also part of the package. This covers diseases that are considered medically and economically devastating. These include various cancers, heart surgery, kidney transplants, some orthopedic implants and interventions to prevent preterm delivery.
MDG benefits are available to those suffering from conditions that are part of the Millennium Development Goals of PhilHealth. They include animal bites, Malaria, Tuberculosis, and HIV-AIDS. They also cover voluntary vasectomy and tubal ligation.
