We have been receiving a lot of questions about Philhealth contributions and membership renewals so we decided to run a research on these topics. Below are just some of the questions we researched on; all answers were lifted from the Philhealth website and memorandum circulars available online:
- If I don’t get hospitalized in a year, can I refund my unused Philhealth contributions?
- Does Philhealth accept retroactive contribution payments?
- Do I need to pay more than one Philhealth contribution if I have multiple jobs?
- Are my Philhealth privileges transferable to my dependents after I pass away?
- Are employed Senior Citizens still mandated to make Philhealth contributions?
- Can a member who has not used his Philhealth benefits for an entire year refund his Philhealth contributions?
The answer is no. Philhealth members’ premiums are pooled to become a single fund which is then used to pay for the benefits of sick members. It being a social health insurance program, whatever funds are not “used” by a member, are kept in the premiums pool.
2. Can a member, who has ceased making regular Philhealth contributions, still use his benefits? If not, can he pay his missed contributions in lump sum and immediately become eligible for Philhealth benefits once again?
A member should have paid at least three months premium contributions within the immediate six-month period before his medical confinement and Philhealth benefits claim. If the member is an Individually Paying member, he must have paid at least nine months’ contributions within the last 12 months in order to enjoy the following Philhealth benefits:
- Pregnancy-related cases
- Dialysis (except those undergoing emergency dialysis service during confinement)
- Cataract Extension
- Selected surgical procedures
Only active members (updated contributions payments) will be afforded Philhealth benefits.
Retroactive payments are only allowed if the member can show proof of sufficient regularity of premium contributions or payment of nine consecutive months or three consecutive quarters within the last 12 months prior to the missed quarter. Should the member be able to execute the said proofs, he shall be given a grace period of one month immediately after the missed quarter to pay retroactively including the current calendar quarter.
Newly enrolled members (with less than 12 months totaled 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.
3. If an employed member who was separated from service last October 2011 wants to continue his membership as an Individually Paying Member in March 2012, can he retroactively pay the premiums for November to December 2011 and first quarter 2012, in March 2012?
Yes; the said member shall be given a grace period of one calendar quarter immediately after the unpaid quarterly period to retroactively settle his obligation.
4. Do I need to pay more than one Philhealth contribution if I have multiple jobs?
According to RA 7875 (Section 18-20 of IRR), employers are mandated to enroll their employees, deduct from their salaries the required premium contribution, and remit the same, together with the corresponding employer share, to Philhealth. This means that Philhealth members who have more than one employment should consequently be deducted of their corresponding employee share by each and every employer with which they are currently employed.
5. Are my Philhealth privileges transferable to my dependents after I pass away?
No; a deceased member’s privileges are automatically terminated as well. Only the dependents of a Sponsored Member are allowed to use the unexpired portion of the member’s contributions.
6. I already have a lifetime member card, but my current employer still continues to pay for my premiums. Can these premium contributions be credited to my son/daughter’s membership when I retire?
As mentioned in item number 4, employers are mandated to pay the Philhealth contributions of their employees, including those within the Senior Citizen bracket. The payments made are non-transferable and cannot be credited to the Senior Citizen’s dependents after the member retires.
Sources: www.philhealth.gov.ph (Philhealth FAQs)