PhilHealth is a health insurance program run by the Philippine government. It offers coverage for hospitalization, surgery, and other medical expenses. It is available to all Filipino citizens, regardless of employment status.
Not everyone can afford a health insurance plan, especially those who are earning below minimum wage. Let’s admit it, getting sick nowadays is so expensive.
Getting sick without having enough funds to get hospitalized and be treated by professionals is a nightmare. When you get sick, your active income will definitely stop. What’s next? Get into debt to sustain the family’s needs and even pay hospital bills.
So if you’re a laborer and you are covered with PhilHealth, it is one of the best privileges you can have from the government. PhilHealth provides health insurance coverage to every Filipino of all ages.
In 1960s, the Philippine Medical Association launched the MARIA Project. This project aimed to provide medical help to communities that were in need. It was former President Ferdinand Marcos’s time when he passed the law called Philippine Medical Care Act.
As the years went on and administrations changed, this medical care program has improved.
In late 1995, PhilHealth was finally put into action as universal health coverage for the Filipino people. This is a government-owned and controlled corporation that is attached to the Department of Health.
What is the meaning of PhilHealth?
PhilHealth is a short version for Philippine Health Insurance Corporation.
Purpose of PhilHealth
The government formed PhilHealth to stand as health insurance to ensure that every sick Filipino will be treated in hospitals even if they don’t have a handful of money. It gives financial assistance and quick access to affordable services, regardless if the person is a child, adult, or senior citizen.
This government agency helps people pay their hospital bills. If a patient is confined or treated medically in a private hospital, PhilHealth will still cover a percentage of your total bill, and this includes the doctor’s fee.
If you are a PhilHealth member and you get hospitalized of treated in a public hospital, you don’t have to pay anything. You will just need buy the medicines you are prescribed to take after being discharged.
About this Agency
The Philippine Health Insurance Corporation or commonly known as PhilHealth was created in 1995. This agency was fully-owned by the government of the Philippines and was considered as tax-exempt.
PhilHealth is associated with the Department of Health. The said agency aims to provide health insurance for Filipino people without payment for expensive monthly health plans.
President Rodrigo Duterte has signed the Universal Health Care Act (UHC Act) on February 20, 2019, to ensure that every Filipino, including overseas Filipino workers, has access to a comprehensive set of high-quality, cost-effective, preventive, curative, palliative, and rehabilitative health care without causing financial hardship, with those who cannot afford such services receiving priority.
Functions and Responsibility
Since PhilHealth is a government corporation attached to DOH, some functions are very hands-on. PhilHealth is actively present during the pandemic because they give all of their Covid-19 patient members a coverage where the said agency covers the huge percentage of the Covid patient’s bill.
- PhilHealth mandates gives assistance to the National Health Insurance Program.
- The agency formulates new policies that are linked to health programs
- It several provisions of standard health benefits for each Filipino people.
- Ensures the quality of care, member satisfaction, and overall fund capability of the Filipino people.
- The agency formulates and Implement guidelines of how the contributions and benefits are being processed.
- Create arrangements between the health care provider and the patient, and even assessing payments and methods.
- PhilHealth manages donations, grants, and other forms of financial assistance.
- It collects, deposits, administer, and disburse the National Health Insurance funds according to the provisions of the health care Act.
- It’s also part of their job to negotiate with health care institutions and professionals regarding the pricing, payment modes, procedure, and the actual delivery of health care service to its members.
- PhilHealth is also responsible for inspecting health care facilities during office hours.
- They also check and compile medical and financial records that are involved with claims, contributions, accreditations, and members.
- One of their role is to organize and fix compensation and appoint specific personnel to assess recommendations of the corporations ceo.
- The agency also has an electronic database wherein all member’s data are stored. It is the agency’s duty to maintain this database and provide intensive security for more efficient services.
- PhiliHealth invest to its information technology system, because they know the acceleration begins here.
How to Apply for a PhilHealth Membership?
For Newly Hired Employees Without Membership Yet
- Fill out PhilHealth Member Registration Form (PMRF)
- Submit the registration form to your company’s HR department or anyone who is in charge of it inside the company.
- Wait for your employer’s announcement for the release of your Member Data Record (MDR) and PhilHealth ID.
Note: If the company took charge of your PhilHealth membership, then you may need to wait for a few days or weeks before you receive the MDR and PhilHealth ID.
For Self-Employed and Voluntary
- Go to the nearest branch of PhilHealth.
- Fill out PhilHealth Member Registration Form. (2 copies)
- Present your Birth Certificate or ID
- Wait for your Member Data Records (MDR) and PhilHealth ID Card to be released.
- Pay a contribution using your PhilHealth ID number.
Video: PhilHealth Registration Process
Please check out this video below which outlines the registration process on how you can become a member of PhilHealth
Video: Comprehensive Report about PhilHealth by GMA News
GMA News has published a special report about the Philippine Health Insurance Corporation so please watch this below so you can have a better idea about the benefits, limitations, and coverage you can get as a PhilHealth member:
Frequently Asked Questions
Here are some common questions and answers about the PhilHealth membership:
1. Who are 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 of a membership and become an active member to get your benefits.
2. Can I avail my PhilHealth benefits even if I already stop contributing for a year?
Due to the new PhilHealth regulation signed by the present president of the Philippines, you should have paid atleast 3 months of contribution prior to hospitalization to use your membership.
3. I’m a college student, and my school requires PhilHealth Membership before I participate to face-to-face class, 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 the all students will be covered by a specific amount of funds if ever they got 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 was 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 with. For employed there is Formal Economy, for unemployed you will under Informal Economy.
6. How much is the monthly contributions for PhilHealth? Can I afford it?
The monthly contribution on 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 necessary documents with you.
7. How to change your PhilHealth membership status online?
- Get your PRMF online, you can download it @ https://www.philhealth.gov.ph/downloads/membership/pmrf_012020.pdf
- Fill-up the form and don’t forget to check the box at the upper right corner of the form and choose “For Updating”
- Submit your accomplished PRMF (for self-employed go to the nearest PhilHealth branch) For OFWs, you can email it @ email@example.com
- After doing the said steps, you just need to wait for a printed copy or email of your updated PhilHealth Member Data Record (MDR)
Let’s admit it, not all Filipinos have savings, not all of us have a wealthy life, not all people give importance to “health insurance.” But did you know that even though this topic least talked and least prioritized by Filipino families, it is still one of the most important membership the we need.
If you can’t afford premium health insurance plans or you do not have self-ready emergency funds – get a PhilHealth membership now. The government has made it possible for less fortunate people to avail utmost care even if without handful of money.
Remember, it is normal to get sick because we’re only humans and we cannot avoid it as much as we want to. What we can do is to give some security for ourselves and our family.
Think of it, what if you get sick and you are the bread winner of your family? How would you pay for your medications and hospitalization if you solely depend on your active income job?
PhilHealth is a big thing for Filipinos. It can give coverage on both private and public hospitalizations, there are also surgeries that are covered by the said agency. In fact, some check-ups of specific illnesses are covered by PhilHealth.
Even if you’re a student or an adult, it is never too late for you to secure some health benefits. If you are already a parent, you can set your children as dependents so they will also get covered too. You might not know how your little contributions each month can save you a lot of money in the future.