Are you a Philhealth member? Do you regularly check if your contributions are posted on your account? What could be the reasons why a paying member may not be able to use his Philhealth benefits?
Regular remittance of premium contributions must be maintained in order for a Philhealth member to avail of the benefits seamlessly. Philhealth does not accept retroactive payments such that, if the member missed paying a certain period, he may not be able to use his Philhealth benefits.
Below is a summary of Philhealth’s Eligibility Requirements, based on the paying member’s type of membership:
| Sponsored Membership | Date of hospitalization / availment must be within the effectivity period indicated in the member’s ID and MDR. |
| Individually Paying Members (IPM) |
|
| Lifetime Member | The member just has to show their Lifetime ID card; no need to pay premium anymore. |
| Employed Members | Three months worth of premium within the last six months (3/6) prior to hospitalization. |
| Overseas Workers (OWP) |
Date of hospitalization / availment must be within the coverage period specified in themember’s MDR. |
How to maintain member’s eligibility?
The secret is simple: pay your premiums on time. Any discrepancies or gaps in your premium contributions will definitely affect your eligibility to claim benefits. Here are some tips to help you secure your Philhealth benefits:
a. Sponsored Members:
- Member’s card must be kept updated all the time. If card is about to or has expired already, Sponsored Member must proactively ask his Sponsor if his membership will still be renewed.
- If Sponsor will no longer renew the Sponsored Member’s membership, the latter has the option to register as an Individually Paying Member.
b. Individually Paying Member (IPM)
- He must make sure that each quarter of the year has been paid (and all payments are posted in his account).
- You have the option to pay your premiums yearly (advance payments) for security and convenience.
c. Overseas Workers Program Member (OWP)
- All premiums must be remitted and posted on member’s account before membership expires.
- In cases when contract abroad has been terminated, inform Philhealth to process shifting of membership category from OWP to IPM (or other applicable categories). Pay the corresponding premiums right away to avoid gaps in your contributions.
d. Employed Members
- If you are an employed member and you will be taking a Leave Without Pay, you may pay your monthly contributions at any nearest Philhealth office under the IPM category.
- Remember to bring a copy of your RF-1 issued by your employer (to attest to the fact that you are indeed on Leave without Pay status).
- In case you resign or get separated from work, you have to shift your membership category to IPM.
Remember that Philhealth does not have a “grace period” for missing your monthly contributions. Once a month is left unpaid, the member can no longer make a retroactive payment. These gaps will impact your and your dependents’ benefit claims, so make sure your payments are properly posted and your account is consistently updated.
Source: https://www.scribd.com/doc/115987403/Phil-Health-FAQs
MasterCitizen's Blog 
hai po, due ko po this month, since December-March nahuhulugan ko po yung philhealth ko through employer ko then nag resign na po ako so di ko nabayaran ang April-June pero nag self employed ako July-September nabayaran ko. pwede ko na bang hindi bayaran ang October-December na contribution? magagamit ko po ba yung philhealth ko this month if manganganak na ako?
Tawag ka sa 02 441 74 42 hotline.
Magagamit ko po ba ang philhealth benefit ko? 6 months pregnant po ako then duedate ko is on January. Pero first time ko pa lang nahulugan ang philhealth ko coverage is from Oct 2017- Dec 2017.
Tawag ka sa 441 7442 hotline nila yan.
Hi.. tanong ko lang wat if nitong araw palang nabayaran yung 3rd quarter tapos ngayong araw din naadmit yung patient makaka avail po ba?
Basta updated yung mga hulog pwedeng magamit yan. Tawag ka sa 02 4417442
Last contribution ko po since 2013… unfortunately i had to undergo surgery last May… pwede pa ba ako mag claim?
Thanks for your attention.
Hindi na. dapat updated ng last six months ang contribution mo at tuloy tuloy ang hulog bago mo ito magamit.
kung mula po ng naghulog ako since 2014 up to now updated po pero hindi pa po nagagamit khit minsan,pano na po mga nai contribute ko hulog,ano na po ang value nya pag hindi pa nagagamit,naiipon po ba un?
Hi Dolor,
The Philippine Health Insurance Corporation, or Philhealth, was created in 1995 to employ affordable health insurance coverage for all Filipinos. It is a government owned and controlled corporation, attached to the Department of Health, and serves as a means for the healthy to help pay for the care of the sick and subsidize medical assistance for those who cannot afford medical help.
Nagcocontribute ka sa Philhealth para masigurong covered ka ng benefits kahit na anong oras ka mangailangan dahil sapagkaka sakit. Ang perang ibinabayad mo, kasama ang budget ng gobyerno ay siya ring ginagamit sa pagpapahospital ng mga miyembrong mahihirap at walang pambayad. Ganun ang prinsipyo ng Philhealth.
MC
Kailangan ko pa ba magbayad pag 60 years old na ako next month at ito pa rin philhealth no. ko gagamitin ko pag senior citizen na ako ?
Kapag senior citizen na at may I.D ka na automatic member ka na. Coordinate kayo sa barangay nyo para dito.
gud day po..tnung ko lng po knuha ko po ang nanay ko ng philhealth kc po sinior nxa last 2 yirs na po ata.,ngaun dkuna po nabalikan yun id po nia.any time po ba pwd kong kunin.anu po ba ibig svhin ng NDR? Salamat po
Wala namang I.D for senior philhealth membership eh. Yung OSCA I.D nya at copy ng MDR from philhealth ok na yun.
Employed member po ako. Manganganak po ako this august 1, 2017. yung latest na 3 buwang hulog ko is feb, march, april 2017. Di ba po nakalagay sa philhealth na para makaavail ng benefit at least 3 months na hulog within 6 months prior to the date of confinement mabayaran. Does it mean po ba eligible ako or need pa rin update yung sa may, june and july 2017?
Mas maganda na updated ang contribution mo.
Member po ako ng philhealth for a year palang. Kakatapos lang din ng contract ko sa second job ko. I am 5months pregnant at due date ko po is 3rd week of August. Required po ang philhealth sa paanakan, paano ko po magagamit ang philhealth ko gayong wala na po akong trabaho ngayon. Ano po ba dapat kong gawin ? Salamat po.
Pwede mo hulugan yan ng voluntary.
Chineck ko ung Contribution ko online, nakita ko na wala sa record ung July Aug Sept 2016 pero merong April, May june 2016 tapos October Nov Dec 2016. Magkakaroon ba ng conflict kung gagamitin ko Philhealth ko sa May kasi maooperahan ako? Babayaran ko na ngaun ang January to June 2017
Pwede naman magamit kasi updated yung latest 6 months.
Hinulugan ko ang philhealth ko nuon feb..ito po ba pdi na magamit ng aking asawa sa sept .pag sya ay nanganak..isa po akong ofw
Kpag OFW ang hulog nyo ay para sa isang buong taon na diba. Magagamit na yun ng asawa mo lalo na kung nakalagay naman siya as beneficiary.
Helo po,OFW po ako dati.nag umpisa po ako nung 2011 till 2013 paid po lhat yun.2014 d po ko nkabayad.then abroad uli ako 2014 month of Nov.till Nov.2017.d ko pa po pina follow up till now.tanong ko po wat if d na ako babalik sa abroad pwede kb ichange yung OFW ko sa voluntary nalang?if incasa ok how much contfibution per month?
Ang alam ko kapag voluntary php 100 lang eh. pero sa opisina ng Philhealth mo pa fin ito aayusin.
hello po pwede pa po ba bayaran yung last quarter po noong 2016? di ko po kc nabayaran
Pag nag update ka ng membership mo para sa present month na yun.
so pwede pa po mahabol kung babayaran ko po ba?
Hello po, MasterCitizen! Tanong ko lang po, ofw po ako at ang nabayaran ko lang po sa philhealth ay from Dec. 28, 2015 to December 27, 2016 po. tapos naconfine ung family member ko po na beneficiary ko this month at d pa ako nakapagbayad for the Month of January 2017. cover po ba ako at beneficiary ko sa Philhealth benefits o hindi na po? Salamat!
I pa try mo ng ipagamit kasi paranmg lumalabas 1 month delay lang diba. Pakuhanin mo ng MDR at copy ng OEC mo kung meron.
cover po ba ako ng philhealth sa scheduled cs ko this coming feb 16 kahit na ngkaroon ng gap ang payments ko from sept- oct 2016 tapos nong nov na ulit ako nagbayad ng 12 months pagdating namin kac ofw po ako.
Try na lang gamitin pakuha ka ng copy ng MDR then yung copy ng OEC mo kung meron or proof ng Philhealth payment mo.
hello po pwede pa po ba bayaran ang 2016 4th quarter po. di pa po kasi ako nakabayad po
Nasa abroad ka ba?
Hello po. Due po ng sister ko this january 28, pero hindi po sya nakapagbayad ng contri since june 2016. Makaka avail po ba sya ng maternity benefits? Thanks
Dapat kasi early stage pa lang ng pregnancy nag re repot na sa SSS. Try nyo na lang mag file.
Un nga po eh d dn namin kse alam 😦 okey na po ung sss tinanggap nmn po ung MAT1, ung s phil health po kase d ako sure kung mkkaavail ba sya since wala sya hulog 6mos prior ng expected confinement date.. 😦
Dati naka member ako sa philhealth sponsored ng mayor namin but since napalitan na sya 6 yrs ago nawala na din,ask ko lang kung pwede ko ipagpatuloy now or apply na lang ako ng bago..un employed pala ako and 47 years old…
Pwede ka naman mag voluntary member basta lagi lang dapat updated ang membership mo.
saan po makikita kung naipasok ba sa account mu ung mga binabayad mu buwan buwan?
Hingi ka sa opi8s nyo.
Hi..is the membership still active even if i wasn’t able to pay from the moment i applied?..i only paid 3 months contribution then so i could be a member..and how will i know my membership #..i lost my record of my application..
Hi claiming of benefits for Philhealth depends on your on time payments of contribution. Just go to any Philhealth office to get your details.
tanung ko poh isa aq o.f.w dito sa doah qatar may philheath aq paano ko malalaman kung hinulugan ng agency ko yung akin
Pwede mo naman ipa check kung updated. By the way kinakaltasan ka ba para sa Philhealth?
San po pwde e check f nbayran ng employer ang Phil health..
Sa Philhealth mismo.
Ofw ako,,22 years ako nagtrabaho sa ibang bansa,in every vacation ko,,kuha ako ng balik mangagawa kasama rin philhealth,,kasalukoyan dito na ako sa pinas 2 years na ako dito,,tanong ko apply ba ako ulit sa philhealth 53 years old na ako.
Ituloy mo na lang ang paghulog nung Philhealth mo.
I have been a Philhealth member. I turned 61 years old last month. Am I still suppose to pay my monthly membership fee? I am already a senior citizen and I want to know if it’s true that all senior citizen are automatically members of Philhealth and no need for monthly payments? thanks
Yes automatically member ka na. No need na magbayad ka ng membership. By the currently employed ka ba?
Meron akong six months contributions sa philhealth, nag start ako maghulog since april-june and then yung pnka latest july- sept. 30 2016. Eight months pregnant ako at ang due date ko is first week of sept. magagamit ko pa rin ba yung mga benefits ng philhealth or need ko talaga makpag contribute ng 9 months? Pwede ko ba iadvance kung saka sakali? Tnx 🙂
Aang Philhealth dine de deduct yan sa total billing mo at kailangan updated ang pag babayad. Wala namang na a advance sa Philhealth eh.
Hi! I been paying my philhealth, once in two yrs.buy i dont have any ID.from them. I only have a SSS NUMBER.
Get an MDR from any Philhealth office it will shor Philhealth number. If you want and I.D inquire at any Philhealth office.
can i apply my philhealth even birthday will be augost23 this year 2016?
What do you mean? As far as i know there is no question regarding the birth date of who wants to be a member.