Tag Archive: PSA Death Certificate


10 - 17

As part of Taiwan’s goodwill to the Filipinos and in observance of their “New Southbound Policy”, Pinoys may now visit and tour Taiwan for 14 days, without a visa!

In October of 2016, we released an article on the conditions that Pinoy tourists must meet in order to enjoy a visa-free entry to Taiwan.  Back then, you must have a valid visa to Australia, Canada, Japan, Korea, New Zealand or any of the Schengen countries before you are granted free entry to Taiwan.  With this new policy, Pinoys can do away without the above requirements and enjoy hassle-free vacations to the country.

Below are the details of the good news released just yesterday by the Taipei Economic and Cultural Office (TECO) in the Philippines.

  1. Pinoys who intend to visit Taiwan for purposes of tourism, business, or visiting relatives can enjoy visa-free entry for 14 days, beginning November 1, 2017.
  2. This initiative will undergo a nine-month trial period that will last until July 31, 2018.
  3. Pinoy visitors must have at least six months remaining validity in their passports, while diplomatic and official passport holders are not eligible for visa-free treatment.
  4. A return ticket or a ticket with visa if needed for the next destination must be presented upon entry.
  5. Tourist must have no criminal records in Taiwan.
  6. Tourist must be able to show proof of accommodation while in the country.

Exemptions:

Those who intend to stay for more than 14 days to study, work, or are part of missionary activities are required to obtain the necessary visas before entering Taiwan.

Now is your chance to explore the sights and sounds of Taiwan!  Remember that the policy takes effect on November 1, so plan your trip accordingly.

Enjoy your vacation!

 

References:

www.philstar.com

www.roc-taiwan.org

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10 - 16

What is the No Balance Billing?

No Balance Billing or NBB is a privilege given to qualified PhilHealth members.  If you are covered by the NBB policy, you no longer need to pay for your hospitalization at any government hospital and selected private medical centers nationwide.  It is the government that pays for the member’s hospital expenses without prejudice to the quality of service and attention given to the patient.

Who are covered by the NBB Policy?

  • Indigent members
  • Sponsored members
  • Kasambahay members
  • Lifetime members
  • Senior Citizens

What services and benefits are covered by the NBB Policy?

All services and benefits afforded to other PhilHealth members are likewise extended to those under the NBB policy, such as:

  • All case rates
  • Case Type Z benefits
  • TB-DOTS package
  • Outpatient Malaria Package
  • Animal Bite Treatment Package
  • Voluntary Surgical Contraception Package
  • Outpatient HIV/AIDS Treatment (OHAT) Package

Which packages can be availed through NBB at both private and public hospitals?

NBB is currently offered at the following medical facilities:

Type of Facility Government

Hospital

Private

Hospital

Benefits Covered by NBB
Hospital Yes No All applicable benefits covered by NBB for hospitals.
Malaria – outpatient case Yes No Outpatient Malaria Package
Animal Bite Treatment Centers Yes No Animal Bite Treatment Package
Treatment Hubs Yes No Outpatient HIV/AIDS Treatment Package
Hospitals that offer Z Benefits Package Yes Yes Z Benefits Packages
Ambulatory Surgical Clinics Yes Yes All applicable benefits covered by the NBB, such as:

·         Cataract extraction

·         Bilateral Tubal Ligation

·         Vasectomy

Freestanding Dialysis Clinics Yes Yes Dialysis Package
Peritoneal Dialysis Center Yes Yes Peritoneal Dialysis
TB-DOTS Centers Yes Yes TB-DOTS Package
Lying-in Clinics (Maternity Cases) Yes Yes ·         Maternity Care Package

·         Antenatal Care

·         Normal Spontaneous Delivery

·         Newborn Care Package

·         Family Planning Procedures

Facilities for Primary Care Benefits Yes Yes ·         Primary Care Benefits

·         Family Planning

·         Procedures

Infirmaries / Dispensaries Yes Yes Public Infirmaries:

All applicable benefits covered by the NBB, including vasectomy.

 

Private Infirmaries:

·         Maternity Care Package

·         Antenatal Care

·         Normal Spontaneous Delivery

·         Newborn Care Package.

Will NBB be applied to a patient who is admitted on a private bed?

NBB is applicable only to service beds or PhilHealth beds?  If no service bed is available the time of admission, NBB can still be applied as long as the hospital guarantees that there are no service beds available.

Does the NBB Policy cover doctors’ professional fees?

Yes, that’s why doctors are not supposed to bill patients under the NBB policy; however, if the patient is admitted to a private room, doctor’s fees will still apply.

What if the hospital could not provide the needed medicines, laboratory, and diagnostic tests and the patient is compelled to transfer to a different facility?

It is the government hospital’s obligation to ensure that they have ample stocks of medicines, especially for NBB patients.

In case they are not able to provide the needed laboratory or diagnostic tests, they shall be held responsible and will have to make sure that the NBB patient is given the needed medicines and tests at their expense.

For more information on the No Balance Billing Policy, you may call the PhilHealth hotline at 02-441-7442.  They are able to take your calls, 24×7.

Source: www.philhealth.gov.ph

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10 - 11

Tuberculosis (TB) is a disease caused by bacterial infection, usually affecting the lungs.  The bacteria is highly contagious and can be passed on to others through coughing and sneezing, even through the accidental spread of saliva when laughing, singing, and spitting.  In 2012, it was reported to be the 6th leading cause of death with about 200,000 to 600,000 Filipinos having the bacteria in its active state in their system.

In spite of these seemingly bad news about the said disease, TB can be cured through effective anti-tuberculosis drugs, made available through national and local government health centers.  These are likewise made more affordable even when bought from private hospitals and pharmacies through the Generic Law.

The Philippine Health Insurance Corporation or Philhealth offers the Tuberculosis – Directly Observed Treatment Short Course (TB-DOTS) Benefit Package, worth P4,000, for members diagnosed with the disease.

Below is a summary of the package’s inclusions and how a Philhealth member can avail of the program.

Package Inclusions:

  • Consultation
  • Diagnostic Exams
  • Information and advice on the patient’s health and treatment progress
  • Medicines

The TB-DOTS package is available to all PhilHealth members and their qualified dependents who are likewise suffering from TB and requiring medical attention.  All they need to do is visit the nearest PhilHealth accredited TB-DOTS center in their area; you may ask for information on center locations in your barangay hall.

TB, although highly communicable, can now be easily cured with the right kind of medications.  Regular visits to your doctor will also help you determine how your system is responding to treatment.  To ensure that you get the proper treatment, visit the nearest Philhealth-accredited medical center in your area.

Source: www.philhealth.gov.ph

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10 - 09

What are the benefits that OFWs can enjoy as bona fide PhilHealth members?  Are their dependents entitled to the same benefits as well?

Below are the latest case rates applicable to OFW members.  The amount stated in this summary is PhilHealth’s participation in the member’s hospital and medical expenses.  Any amount over the stated coverage will be shouldered by the member or by his Health Maintenance Organization (HMO).

1. Examples of Case Rates

ILLNESS AMOUNT OF BENEFIT
Pneumonia Moderate Risk (Pulmonya) P15,000
Pneumonia High Risk P32,000
Stroke – Infarction P28,000
Stroke – Hemorrhagic or Stroke with Bleeding P38,000
Hypertensive Emergency/Urgency P9,000
Dengue (Severe) P16,000
Acute Gastroenteritis (AGE) or Diarrhea with Dehydration P6,000
Asthma in Acute Exacerbation (Hika) P9,000
Newborn Care Package or Services for Newborn Babies P1,750
SURGERIES AMOUNT OF BENEFIT
Hemodialysis P4,000
Maternity Care Package (Normal delivery in lying-in clinics) P8,000
Normal Spontaneous Delivery Package (Normal delivery in a hospital) P6,500
Cesarean Section P19,000
Radiotherapy Linear Accelerator (Linac) P3,000
Cataract Package P16,000
Dilatation and Curettage (Raspa) P11,000
Cholecystectomy P31,000
Appendectomy P24,000

1.1 Z Benefits

These types of packages are for those stricken by diseases that need long and continuous medication.  These normally entail costs beyond one’s usual hospitalization budget.  Z Benefit packages have pre-conditions and selection criteria that need to be met in order to qualify for the benefits at selected government hospitals.

ILLNESS / SURGERY AMOUNT OF BENEFIT
Acute Lymphocytic Leukemia or ALL P210,000
Breast Cancer (Stage 0 to 3) P100,000
Prostate Cancer (Low to Intermediate Risk) P100,000
Kidney Transplant (Low Risk) P600,000
Coronary Artery Bypass Graft Surgery P550,000
Surgery of Tetralogy of Fallot in Children P320,000
Surgery for Ventricular Septal Defect in Children P250,000
Cervical Cancer Chemoradiation with Cobalt and Brachytherapy (Low Dose)

Linear Accelerator and Brachytherapy (High Dose)

P120,000

P175,000

External Lower Limb Prostheses P15,000

1.2 Outpatient Benefits under All Case Rates

SERVICES AMOUNT OF BENEFIT
Tuberculosis – Directly Observed Treatment Short-course administered at accredited TB-DOTS centers P4,000
Malaria treatment administered at accredited rural health units. P600
Outpatient HIV/AIDS Treatment P30,000
Treatment package for animal bites administered at accredited government animal bite centers. P3,000
Vasectomy and Tubal Ligation P4,000

Important Reminder: A member is allotted 45 days of hospitalization in one year and another 45 days to be divided among his qualified dependents.

What are the conditions before an OFW member or dependent may avail of PhilHealth benefits?

  1. Updated contributions as shown in the member’s MDR.
  2. Make sure you are seeking consultation or treatment at a PhilHealth-accredited hospital and by a PhilHealth-accredited doctor.
  3. You have not yet used up the 45-day hospitalization period (OFW or dependents).

How does an OFW member and his dependents avail of PhilHealth benefits?

  1. Before checking out of the hospital, submit the following documents at the Billing Section of the hospital:
  • Duly accomplished PhilHealth Claim Form 1. You may request for a form at the hospital, PhilHealth offices and branches, or download from the PhilHealth website at philhealth.gov.ph
  • Health Insurance ID Card and or Updated Member Data Record (photocopies).
  • Proof of contributions (photocopies).
  1. Medicines purchased outside of the hospital while member is confined may be reimbursed at the hospital if the patient has not yet used up the allocated benefit amount. Make sure that PhilHealth benefits have been deducted from the total hospital bill and professional fees before signing the Claim Form 2.

What if the OFW member is confined in a hospital abroad?  Can he still use his PhilHealth benefits?

 A member confined abroad may file for benefits claim in the Philippines by submitting the following documents to any PhilHealth office, within 180 days after he has been discharged from the hospital abroad:

  1. Copy of Medical Certificate where the following are clearly stated:
    • Final diagnosis
    • Confinement period
    • Services rendered
  2. Duly accomplished PhilHealth Claim Form 1
  3. Copy of Official Receipt or detailed Statement of Account
  4. Updated Member Data Record or proof of payment.

For further information on OFW’s PhilHealth membership, claims, and benefits, you may call the PhilHealth call center at 02-441-7442.  They are available to take your calls, 24/7.

Source: www.philhealth.gov.ph

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10 - 06

Even while employed in a foreign country, Filipinos must be registered under the Philippine Health Insurance Corporation or PhilHealth and pay their contributions regularly.  Medical emergencies can happen anytime, anywhere: to the OFW member or his dependents.  The only way you can fight against the added stress of going through these emergency cases is the security of a medical insurance.

In this 2-part series, we are going to share all the important details that OFWs need to know about becoming a Phillhealth member and the how they can keep their account updated even while they are out of the country.  From membership registration to availing benefits, we got all the information right here.

Share this with your OFW friends and relatives.

GET YOURSELF REGISTERED

  1. Fill out a PhilHealth Member Registration Form (PMRF) with your information. You may ask for a copy of the form from any Local Health Insurance Office (LHIO) or download it at www.philhealth.gov.ph. Submit the accomplished form to any PhilHealth office or at the Philippine Overseas Employment Administration (POEA)

Seafarers may submit their PMRF to their HR Department or to their manning agency.

OFWs may declare the following as their dependents:

  • Legal spouse who is not a PhilHealth member;
  • Children below 21 years old, unemployed, and not married;
  • Children who are 21 years old and above and are physically or mentally handicapped;
  • Foster children based on the Foster Child Care Act of 2012;
  • Parents who are 60 years old or older and are not PhilHealth members;
  • Parents who are permanently incapacitated/disabled.

A completely filled-out PMRF is all you need to register as a PhilHealth member.  No need for other documents unless PhilHealth requires further verification of your personal information.

  1. Pay your contributions regularly.
  2. The OFW member will be provided with a Health Insurance ID Card with his permanent PhilHealth Identification Number (PIN), and Member Data Record (MDR).

Online Registration Option

Since OFWs cannot physically visit PhilHealth offices in the Philippines, they have the option to submit their membership applications online or by sending an email to PhilHealth.  Here’s how:

For Membership Registration:

  1. Send your duly accomplished PhilHealth Member Registration Form (PMRF) to ofp@philhealth.gov.ph.
  2. PhilHealth will send your Member Data Record (MDR) with your PhilHealth identification number through email. You may also request for a Health Insurance ID Card from any Local Health Insurance Office (LHIO) of PhilHealth.

To Update your MDR:

  1. Send your duly accomplished PMRF with the corresponding updates on your information. Do not forget to tick the check box beside “FOR UPDATING” that is found at the upper part of the PMRF.
  2. You will receive a copy of your updated MDR through email.

PAY YOUR CONTRIBUTIONS!

How much should your contributions be?

1.For Migrant Workers (OFWs) (documented and undocumented):

Beginning January 2014, the premium contribution is Php 2,400.00 for a year.  You have the option to pay two years in advance or base it on the number of years stated in your employment contract, but must not exceed 5 years.

2. For Migrant Workers / OFWs (seafarers) who are under manning agencies in the Philippines:

Monthly Salary Range Total Monthly Premium Rate Employee Share Employer Share
Php8,999.99 and below Php200 Php100 Php100
Php9,000 up to Php34,999.00 2.5% 1.25% 1.25%
Php35,000.00 and up Php875.00 Php437.50 Php437.50

You also have the option to check the complete contribution schedule at www.philhealth.gov.ph

Where can you pay your contributions?

  • PhilHealth Local Health Insurance Offices (LHIOs)
  • POEA One-Stop-Shop
  • At the following PhilHealth Accredited Collecting Agents who have tie-ups abroad:
    • Development Bank of the Philippines (DBP)
    • Philippine Veterans Bank (PVB)
    • Land Bank of the Philippines (LBP)
    • I-Remit, Inc.
    • Ventaja International Corporation
    • Bank of Commerce
    • Asia United Bank
  • You may also request your family and relatives to  visit any PhilHealth office to pay for your contributions.

The second part of our feature article will focus on the benefits and services that every OFW PhilHealth member and their dependents are entitled to.

If you have further questions about PhilHealth membership, you may call their hotline at 02-441-7442.

Source: www.philhealth.gov.ph

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10 - 03

If you want to get updates on a loan or claim you filed at the SSS but do not have the means or time to call their hotline, you can text them instead!

The Text-SSS facility is now made available for SSS members on-the-go, allowing them to inquire about their contributions and claims status without having to call the SSS hotline.  We summarized the how-to’s and other interesting updates from this facility for everyone’s information.  If you have not tried this new service from the SSS yet, you can start today by registering your SS number using your mobile phone!

What is Text SSS?

Text-SSS facility is a text-based information service that allows a member to inquire about the number of his/her contributions, loan application status, loan balance, status of benefit claim, document requirements in filing benefit claim and membership registration, change in member record, SSS branch location and feedback on SSS concern through short messaging service (SMS)s.

How can a member register?

A member can register by creating a message using the format below and sending it to 2600.

Type: SSS REG <SSNumber> <BDAYmm/dd/yyyy> send to 2600

Upon successful registration, the system will send a text message informing the member of his/her unique system-generated Personal Identification Number (PIN), which will be required in inquiries sent to the Text-SSS facility (2600).

Service fee is P2.50 for Globe and Smart subscribers, P2.00 for SUN subscribers.

How can one inquire about his/her contributions, loan status, and loan balance?

To inquire:

On Contributions, type: SSS CONTRIB<SSNUMBER><PIN> send to 2600

On Loan Status, type: SSS LOANSTAT<SSNUMBER><PIN> send to 2600

On Loan Balance, type: SSS LOANBAL<SSNUMBER><PIN> send to 2600

To retrieve PIN, type: SSS RESET<SSNUMBER><BDAYmm/dd/yyyy> send to 2600

Other services:

To know the different commands, key in: SSS HELP send to 2600

To send feedback: <SSnumber><concerns/inquiries/complaints> send to 2600

To know the nearest SSS branch: SSS BRANCH<city> or <postal code> send to 2600

To get requirements on SSS ID: SSS ID send to 2600

To get requirements for OFWs: SSS OFW send to 2600

To get requirements for voluntary member: SSS VOL send to 2600

To get requirements for self-employed: SSS SELF send to 2600

To get requirements for change in membership data: SSS CHANGE send to 2600

To check status of claim:

SSS STATUS Sickness <SSNUMBER><PIN> send to 2600

SSS STATUS Maternity <SSNUMBER><PIN> send to 2600

SSS STATUS Disability <SSNUMBER><PIN> send to 2600

SSS STATUS ECMed <SSNumber><PIN> send to 2600

SSS STATUS Retirement <SSNUMBER><PIN> send to 2600

SSS STATUS Death <SSNUMBER><PIN> send to 2600

SSS STATUS Funeral <SSNUMBER><PIN> send to 2600

To inquire about documents required in filing benefit claims, key in:

SSS DOC Sickness send to 2600

SSS DOC Maternity send to 2600

SSS DOC ECMed send to 2600

SSS DOC Disability send to 2600

SSS DOC Death send to 2600

SSS DOC Funeral send to 2600

For retirement less than 65 years old, key in:

SSS DOC Retirement send to 2600

For retirement with minor dependent, key in:

SSS DOC Retirement Minor send to 2600

Sources:

www.sss.gov.ph

www.facebook.com/SSSPh

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09 - 21

Good news to minimum wage earners in the private sectors in Metro Manila!  Yesterday, the government announced that minimum wage earners are set to receive an additional Php 21.00 per day in their basic wage beginning October 5, 2017.  In the same manner, workers in the agriculture, retail/service establishments employing 15 workers or less, and manufacturing establishments regularly employing less than 10 workers are also set to receive a minimum wage rate of Php 475.00, from the previous basic wage rate of Php 444.00.

Below are detailed information on the new wage rates, who are covered of the adjustments, and exemptions from the wage order:

  1. RATES
  NEW BASIC WAGE COLA NEW MINIMUM WAGE RATES
NON-AGRICULTURE Php 502.00 Php 10.00 Php 512.00
AGRICULTURE (Plantation and Non-plantation) Php 465.00 Php 10.00 Php 475.00
RETAIL/SERVICE ESTABLISHMENTS EMPLOYING 15 WORKERS OR LESS Php 465.00 Php 10.00 Php 475.00
MANUFACTURING ESTABLISHMENTS REGULARLY EMPLOYING LESS THAN 10 WORKERS Php 465.00 Php 10.00 Php 475.00

2. COVERAGE

The following workers are covered by the rate adjustment:

All minimum wage earners in the private sector in the National Capital Region, regardless of their position, designation, or status of employment and irrespective of the method by which they are paid.

The following workers are NOT covered by the rate adjustment:

  • Kasambahay/Domestic Workers
  • Persons in the personal service of another
  • Workers of duly registered Barangay Micro Business Enterprises (BMBEs) with Certificates of Authority pursuant to Republic Act No. 10644.

3. EXEMPTIONS

The following are exempted from the applicability of the wage order:

  • Distressed Establishments
  • Retail/Service establishments regularly employing not more than 10 workers
  • Establishments adversely affected by calamities such as natural and human-induced disasters.

4. COMPLAINTS FOR NON-COMPLIANCE

If you are covered by the rate adjustment and your employer refuses to comply, you may file a complaint at the Regional Office of the Department of Labor and Employment in your area.

5. EFFECTIVE DATE

Take note that the New Wage Order NCR-21 is effective on October 5, 2017. You may download the order at www.nwpc.dole.gov.ph

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09 - 19

For three years now, the government has been hosting earthquake drills all over the country to spread awareness and encourage defensive responses in the event of an earthquake.  The drill is headed by the National Disaster Risk Reduction and Management Center (NDRRMC) and this year, it will be held at the Strike Gymnasium in Bacoor City, Cavite.  Although the activities are focused in Metro Manila and nearby areas, the entire country is encouraged to participate whether they are in their offices, homes, and even while on the road.

For most of us, our response during the earthquake drill (and during an earthquake!) should be to “duck, cover, and hold”.  But how about if you are driving a vehicle when an earthquake strikes?  How do you protect yourself from the damaging effects of this anticipated disaster while inside a moving car?

We are sharing the following article below to help drivers and commuters be aware of the safest, most defensive response when caught on the road by an earthquake.  Share this to all your friends and families whose jobs require them to be behind the wheel most of the time.

Step 1: Be aware of the intensity of the earthquake.

Drivers will not feel tremors as fast as people in buildings would.  A good indicator that an earthquake is happening is when you feel your vehicle wobble like it has a flat tire.  Pay attention to hanging streetlights and road signs too; any unusual swinging and shaking could mean a strong quake is happening.

Step 2: Pull to the side of the road.

Do not just stop in the middle of the street to avoid getting in other drivers’ way.  Do your best to pull to the side of the road, avoiding tall structures, poles, and lamp posts.  This means that even in the middle of the emergency, you have to remain calm and composed to make sure you and your car are secured and safe.

Step 3: Switch off your engine and put your handbrake on.

This gives you a bit of time to collect your belongings in case you’d need to flee from your car (which is most likely if the quake is at intensity 5 or higher).  Be prepared to exit and leave your vehicle.

Step 4: Proceed to the nearest open area you can find.

When it is safe to leave your car, head to an open area.  Avoid seeking refuge under flyovers, footbridges, and near lamp posts or hanging streetlights as these structures could give way anytime.

Step 5: Check for internet access to get the latest news on situations on the road, your destination, and nearby areas. 

After a strong quake, people are most likely to conjure up the worst scenarios through hearsays and well, superstitious beliefs.  These are the last things you need to hear as it will waste your time and may cause you to panic.  If you have your mobile phone with you, check for internet access and get the latest news from reliable sources.  Call your family at home, locate your children, and ensure everyone’s safety while you still have batteries on your phone.  Plan a meeting place that is accessible to your family and start moving.

We hope the NDRRMC and the MMDA would also conduct earthquake drills that are designed for motorists, private, and public vehicle drivers.  This will help save a lot of commuters’ lives when an earthquake strikes while they are in major thoroughfares such as EDSA, Commonwealth Avenue, NLEX, SLEX, and the like.

Most people take earthquake drills for granted; this is sad news.  We all know that earthquakes are unpredictable disasters, unlike typhoons and volcanic eruptions, and the only way you can get a fighting chance to survive is to be aware of what must be done while the ground is shaking and causing damages and panic all around you.  If your company is participating in the drill, take it as a chance to be familiar with your building’s entry and exit points, safe hiding places, and escape routes.  If you are at home during the drill, encourage all family members to join in as well.

If you are joining the earthquake drill on Thursday (and we hope you will!), you can share your stories with us right here at the Master Citizen blog page!

References:

www.ndrrmc.gov.ph

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09 - 12

Here is the continuation of yesterday’s feature article on Philhealth contributions and membership renewals.  In today’s blog, we will cover the answers to common questions from Philhealth members such as refunds for unused contributions, how to “reactivate” membership after failing to pay several months, and how to continue paying for your Philhealth membership after you have resigned from your employment.

Read on!

How do I maintain my eligibility?

The key to maintaining eligibility is paying your premiums on-time.  If there are gaps in premium contribution, eligibility will also be affected.  Here are several tips for each member category to ensure that you’ll always be able to use your benefits:

  1. Sponsored Members
  • If the member’s card is about to expire, the member must proactively inquire, whether the Sponsor will renew his/her membership.
  • If not, the member may opt to register as an Individually Paying Member.
  1. Individually Paying Member
  • Ensure that each calendar quarter has been paid.
  • If possible, pay your premiums yearly for your own convenience.
  1. Overseas Workers Program Member
  • Premiums must be remitted prior to your membership’s expiration.
  • If your contract abroad is already terminated, make sure that you shift member category from OWP to IPM (or other applicable categories) to be able to pay premiums again.
  1. Employed Members
  • For seasonal employment or if you’re going to take a leave without pay, just head to the nearest Philhealth Service Office to pay your contributions for the months that you will not be compensated. You may continue paying your premiums as an Individually Paying Member (IPM).
  • To pay your premiums as an IPM, visit any Philhealth office and present a copy of the RF-1 from your employer indicating that you are on leave without pay or a Certification from your employer indicating the same.
  • Once you get separated from employment, make sure you shift category to IPM.

If I missed paying the past quarters, can I still pay for this now to become eligible again?

This is an example of a retroactive payment.  Unfortunately, Philhealth does not accept retroactive payments to avoid abuse of benefits.  This policy has to be in place to avoid those instances when members only choose to pay when they get sick or need to avail of benefits (and conversely stop paying when they don’t need it), which will be unfair for those who pay their premium contributions regularly.

What is the tolerable delay for paying premiums for a member to still be able to use his/her benefits?

None.  Philhealth strictly follows its policies on premium payment and benefit availment.

 Can contributions be refunded by the member who was not able to use it?

No. Philhealth is a social insurance program, wherein members’ premiums are pooled into a single fund used to pay for the benefits of sick members.  Even if a member is not able to use benefits or does not get sick within a particular enrolment year, funds are kept in the pool.

If I stopped paying my premium for considerable amount of time, can I still use my benefits?  Do I need to pay the missed contributions to be able to avail of the benefits again?

No.  Only active members are eligible to avail of Philhealth benefits.  Member should have paid at least three months premium contributions within the immediate six month period prior to medical confinement.  However, payment of at least nine months within the last 12 months shall be asked of Individually Paying Members availing of the following procedures/packages:

  • Pregnancy-related cases
  • Dialysis (except those undergoing emergency dialysis service during confinement)
  • Chemotherapy
  • Cataract Extraction
  • Radiotherapy
  • Selected surgical procedures

Individually Paying Members and Employed Members will now be required to have at least nine (9) months contributions within twelve (12) months prior to the month of availment for all confinements including availment of outpatient benefits.

What if the member passes away?  Can the dependents still use their benefits?

In case the member dies, his/her membership privileges are also terminated.  However, dependents of Sponsored Members may still avail of the Philhealth benefits for the unexpired portion of the member’s contribution.

I used to be employed, but am now self-employed.  Can I still continue paying for my premiums?  How do I go about this?

In case you get separated from employment, you may continue your Philhealth membership by becoming an Individually Paying Member and paying the applicable premium.  Simply accomplish the Philhealth Member Registration Form (PMRF) and tick the box “For Updating” and the appropriate box of the membership category to which you are shifting.  Make sure you continuously and religiously pay your premiums so as to avoid suspension of benefits.

If you have further questions regarding your Philhealth membership, claims, and other benefits, you may call their hotline at 02-441-7442.  They are available to take your call 24/7!

If this blog helped you, share it with others so it would help them too.

Source: www.philhealth.gov.ph

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09 - 07

There are two types of Philhealth members, those whose contributions are regularly remitted by their employers, part of which is deducted from their salaries, and those who pay for their contributions voluntarily.  Of the two types, the latter often fall into the trap of foregoing monthly remittances to Philhealth and as a result, their claims for benefits and assistance are adversely affected.

We ran a research on how Pinoys can keep their contributions regular and consistent, and why we all need to make an effort to ensure that our Philhealth memberships are updated.

Read on!

Why must a member pay his contributions regularly?

Regularly contributing to Philhealth assures the member of hassle-free availment of hospitalization benefits when medical needs arise.  This will also ensure the member’s qualification/eligibility to register under the Lifetime Member Program upon reaching the age of 60 years old, provided he has paid at least 120 monthly premium contributions.

How much is the premium contribution rate?

The premium contribution that each member has to pay is detailed in the following table:

09 - 07 TABLE (2)

Are overtime pay, commissions, and allowances included in the computation of premium contributions of employees?

No they are not included.  The amount of monthly premium contribution of members shall be based on the employee’s salary or wage, which is the basic monthly compensation received for services rendered.

Where can the members remit their contributions?

  1. Philhealth has over 100 service offices all over the country wherein members can pay for their premiums.
  2. Philhealth has also accredited the following collecting agents:
  • More than 1,000 CIS Bayad Centers
  • Collecting Banks
  • MLhuillier Philippines Pawnshops
  • LBC Express outlets
  • Offices of the Philippine Postal Corporation
  • Selected Local Government Units
  1. For Overseas Workers Program Members, i-Remit branches, other partner agents, and foreign offices of Philippine Veterans Bank (UK, Abu Dhabi, and Qatar) also accept premium payments.

When is the deadline for paying my premium contributions?

The following table summarizes when premiums have to be in for each member category:

Membership Category Deadline for Paying Premium
Overseas Worker Before leaving the country or before the last contribution expires.
Employed Tenth day of the following month.
Sponsored Based on the agreement between the Sponsor and Philhealth
Individually Paying 1. Semi-annually/Annually – last day of the third month of the first quarter.

2. Quarterly – last day of the third month of a quarter.

3. Monthly – last day of the month.

What is the effectivity date of Philhealth coverage?

Philhealth benefit coverage starts upon payment of premium (no waiting period) and is valid for one year from the date of payment.

 What are the requirements for eligibility?  When is a member eligible to claim?

In order to become eligible to claim benefits, a member must pay premium contributions regularly.  If the member missed paying for a certain period, he/she and his/her dependents may not be able to use the benefits.  The table below summarizes the eligibility requirements:

Sponsored Members Date of hospitalization/availment must be within the effectivity period indicated in the member’s ID and MDR.
Individually Paying Members 1. There are certain confinement cases wherein three months’ worth of premium within the last six months (3/6) prior to confinement is acceptable.

2. For pregnancy-related cases, dialysis, chemotherapy, radiotherapy, and other selected surgical procedures, the member must have paid nine months worth of premium within the last 12 months (9/12) prior to confinement in order to become eligible.

Lifetime Members and Senior Citizens The member just has to show their Lifetime ID Card or Senior Citizen ID; no need to pay premiums anymore.
Employed Members Three months worth of premium within the last six months (3/6) prior to hospitalization.
Overseas Workers Date of hospitalization/availment must be within the coverage period specified in the member’s MDR.

Just remember the 3/6, 9/12, and effectivity period requirements and you’re good to go!

We will continue with more information on eligibility, contributions, and benefits availment tomorrow.  Meantime, if you have questions about Philhealth membership, send us a message and we will answer your questions to the best of our abilities (and as far as our research will take us!).  You are most welcome to share your knowledge on related topics as well.

Source: www.philhealth.gov.ph

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