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.
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:
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?
- Philhealth has over 100 service offices all over the country wherein members can pay for their premiums.
- 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
- 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.