What is the Meaning of PhilHealth – Philippine Health Insurance Corporation

What is the meaning of PhilHealth?

PhilHealth is a short version of the Philippine Health Insurance Corporation.

Purpose of PhilHealth

The government established PhilHealth to serve as a health insurance program, ensuring that even financially disadvantaged Filipinos can receive medical treatment in hospitals. It provides financial assistance and facilitates affordable services for individuals of all age groups, including children, adults, and senior citizens.

PhilHealth plays a crucial role in helping individuals settle their hospital expenses. In cases where a patient is admitted or receives medical care in a private hospital, PhilHealth will cover a certain percentage of the total bill, including the doctor’s fees.

For PhilHealth members who are hospitalized or treated in a public hospital, there is typically no out-of-pocket payment required. However, it is important to note that patients may need to purchase the prescribed medications upon discharge.

About this Agency

The information you provided about the Philippine Health Insurance Corporation (PhilHealth) and the Universal Health Care Act is mostly correct. Here’s a summary:

The Philippine Health Insurance Corporation (PhilHealth) was indeed created in 1995. It is a government-owned and controlled corporation in the Philippines. PhilHealth’s primary objective is to provide health insurance coverage to Filipino citizens, ensuring they have access to affordable healthcare services.

PhilHealth operates under the supervision of the Department of Health (DOH), which is the government agency responsible for the country’s overall health policies and programs.

In February 2019, President Rodrigo Duterte signed the Universal Health Care Act (UHC Act) into law. The UHC Act aims to guarantee that all Filipinos, including overseas Filipino workers, have access to a comprehensive range of high-quality and affordable health services. The act emphasizes preventive, curative, palliative, and rehabilitative care, with a focus on ensuring financial protection for individuals who cannot afford necessary healthcare services. The UHC Act envisions a healthcare system that prioritizes the well-being of its citizens and aims to eliminate disparities in healthcare access across the country.

Functions and Responsibility

PhilHealth, as a government corporation attached to the Department of Health (DOH), plays a crucial role in providing healthcare coverage and services to the Filipino people. Here is a paraphrased version of the provided text:

As a government corporation under the DOH, PhilHealth is actively involved in responding to the COVID-19 pandemic by providing coverage to its members who are diagnosed with COVID-19. They ensure that a significant portion of the patient’s medical bills is covered by the agency.

PhilHealth’s mandates include providing assistance through the National Health Insurance Program and formulating new policies related to health programs. They establish standard health benefits for all Filipino individuals, aiming to ensure the quality of care, member satisfaction, and the overall financial capability of the population.

The agency also formulates and implements guidelines for the processing of contributions and benefits. They facilitate arrangements between healthcare providers and patients, including assessing payments and methods. PhilHealth is responsible for managing donations, grants, and other forms of financial assistance.

Furthermore, PhilHealth collects, deposits, administers, and disburses the funds of the National Health Insurance according to the provisions of the healthcare act. They negotiate with healthcare institutions and professionals regarding pricing, payment modes, procedures, and the delivery of healthcare services to their members. PhilHealth conducts inspections of healthcare facilities during office hours and compiles medical and financial records related to claims, contributions, accreditations, and members.

The agency also organizes and determines compensation while appointing specific personnel to assess recommendations from the corporation’s CEO. PhilHealth maintains an electronic database that stores all member data, ensuring the security and efficiency of services. They recognize the importance of investing in information technology systems to enhance their operations and accelerate progress.

How to Apply for a PhilHealth Membership?

For Newly Hired Employees Without Membership Yet

To comply with the given steps:

1. Obtain the PhilHealth Member Registration Form (PMRF): You can obtain the PMRF either from your company’s HR department or download it from the official PhilHealth website. Make sure you have the latest version of the form.
2. Fill out the PMRF: Provide accurate and complete information in the PMRF. This includes personal details such as your full name, date of birth, address, contact information, and employment details.
3. Submit the PMRF to your company’s HR department: Once you have filled out the form, submit it to your company’s HR department. They are usually responsible for processing employee benefits, including PhilHealth membership.
4. Wait for your employer’s announcement: After submitting the PMRF, you need to wait for your employer to announce the release of your Member Data Record (MDR) and PhilHealth ID. Your HR department or the designated person in charge will inform you when these documents are ready for collection.

Note: The processing time for the MDR and PhilHealth ID may vary depending on your company’s internal processes and the workload of the PhilHealth office. It can take a few days to a few weeks before you receive these documents.

5. Collect your MDR and PhilHealth ID: Once your employer announces that the MDR and PhilHealth ID are ready for release, follow their instructions to collect these documents. They may provide you with a specific location or schedule for pick-up.

Remember to keep your MDR and PhilHealth ID in a safe place as they are essential for availing PhilHealth benefits and services. If you encounter any issues or have further questions, it’s best to reach out to your HR department or PhilHealth directly for assistance.

For Self-Employed and Voluntary

To follow the steps you provided for PhilHealth registration, here is a paraphrased version:

1. Locate the closest PhilHealth branch to your current location.
2. Obtain and complete two copies of the PhilHealth Member Registration Form.
3. Bring your original Birth Certificate or a valid ID for verification purposes.
4. Submit the filled-out registration forms and present your identification documents to the PhilHealth personnel.
5. Wait for the processing of your Member Data Records (MDR) and PhilHealth ID Card. The time frame may vary depending on the branch and workload.
6. Once your MDR and PhilHealth ID cards are ready, you will be notified and can pick them up from the branch.
7. After receiving your PhilHealth ID number, you can proceed to pay your contributions using the provided ID number.

It’s important to note that the specific requirements and procedures for PhilHealth registration may vary, and it’s always recommended to consult the official PhilHealth website or contact their customer service for the most accurate and up-to-date information.

PhilHealth Registration Process

which outlines the registration process on how you can become a member of PhilHealth

Comprehensive Report about PhilHealth by GMA News

“GMA News has recently released a special report on the Philippine Health Insurance Corporation (PhilHealth). This report provides valuable information on the benefits, limitations, and coverage that you, as a PhilHealth member, can expect. I highly recommend watching the video below to gain a better understanding of the various aspects related to PhilHealth membership:

By watching this report, you will be able to familiarize yourself with the benefits that PhilHealth offers, such as hospitalization coverage, outpatient services, and preventive healthcare. Additionally, the limitations and restrictions associated with PhilHealth coverage will be discussed, enabling you to make informed decisions regarding your healthcare needs.

It is essential to stay informed about the services and coverage provided by PhilHealth to fully utilize the benefits you are entitled to as a member. Please take the time to watch the special report, as it will provide you with a comprehensive overview of PhilHealth and its offerings.

Frequently Asked Questions

Here are some common questions and answers about the PhilHealth membership:

1. Who is qualified to be a member of PhilHealth?

Every Filipino is qualified for this health care insurance. If you are. If you are below 21 years old, you can still be covered by your parent’s membership. For 21 and up, you can apply for a membership and become an active member to get your benefits.

2. Can I avail my PhilHealth benefits even if I already stopped contributing for a year?

Due to the new PhilHealth regulation signed by the present president of the Philippines, you should have paid at least 3 months of contribution before hospitalization to use your membership.

3. I’m a college student, and my school requires a PhilHealth Membership before I participate in face-to-face classes, am I qualified?

Due to the COVID-19 pandemic, a lot of changes have been established by schools, and requiring a PhilHealth membership is one. This is mandated by the government to ensure that all students will be covered by a specific amount of funds if ever they get infected.

If you are a student that is 21 years old or above, you are no longer qualified to be your parents’ dependent. Therefore, you need to register and apply for a PhilHealth membership. You can choose Voluntary/Informal Economy Member since you are still a student and you are not currently employed.

4. How much will the PhilHealth cover if the student is hospitalized due to Covid-19?

A student hospitalized due to Covid will get P43,000 for mild cases, and P786,000 for severe cases.

5. I want to be a member of PhilHealth, but I’m not employed.

You can still be a member of PhilHealth even if you’re not currently employed. There are two types of membership you can choose from. For the employed, there is a Formal Economy, for the unemployed you will be under an Informal Economy.

6. How much are the monthly contributions for PhilHealth? Can I afford it?

The monthly contribution to PhilHealth depends on your monthly salary or monthly earnings. For formal members, the monthly contribution will be 2.75% of your total basic salary.

For voluntary or informal members, the monthly contribution will be 3.5% of your monthly income stated in the application. So if you are earning P10,000 a month as a sari-sari store owner or a vendor, the total contribution per month will be P350.00.

Note: Fifty percent of the monthly contribution of formal members will be covered by the employer. 

7. Can I change my PhilHealth status from employed to voluntary?

Yes, you can change your PhilHealth membership status. For OFWs, you can change the status of your membership online. For self-employed in the Philippines, just visit the nearest branch in your place and have the necessary documents with you.

7. How to change your PhilHealth membership status online?

1. Get your PRMF online, you can download it @ https://www.philhealth.gov.ph/downloads/membership/pmrf_012020.pdf
2. Fill up the form and don’t forget to check the box at the upper right corner of the form and choose “For Updating”
3. Submit your accomplished PRMF (for self-employed go to the nearest PhilHealth branch) For OFWs, you can email it @ ofp@philhealth.gov.ph
4. After doing the said steps, you just need to wait for a printed copy or email of your updated PhilHealth Member Data Record (MDR)

Summary

Let’s acknowledge the fact that not all Filipinos have savings or lead wealthy lives, and not all people prioritize health insurance. What is the Meaning of PhilHealth – Philippine Health Insurance Corporation However, it is important to recognize that even though this topic may be less talked about and less prioritized by Filipino families, it remains one of the most crucial memberships we need.

If you cannot afford premium health insurance plans or do not have readily available emergency funds, it is advisable to obtain a PhilHealth membership. The government has made it possible for less fortunate individuals to access essential care even without a significant amount of money.

Remember, it is normal to fall ill because we are only human, and we cannot completely avoid it. What we can do is provide some level of security for ourselves and our families.

Consider this scenario: What if you get sick and you are the primary breadwinner of your family? How would you pay for your medications and hospitalization if you solely depend on your active income job?

PhilHealth is a significant asset for Filipinos as it provides coverage for both private and public hospitalizations, including certain surgical procedures. Additionally, specific check-ups for certain illnesses are covered by PhilHealth.

Whether you are a student or an adult, it is never too late to secure some health benefits. If you are already a parent, you can register your children as dependents to ensure they are covered as well. You may not realize how your small monthly contributions can save you a considerable amount of money in the future.