PhilHealth Turns 22
FEBRUARY is National Health Insurance Program (NHIP) Month by virtue of Proclamation 1400 series of 2007. It is also during this month that the Philippine Health Insurance Corporation (PhilHealth) celebrates its 22nd Anniversary as the government agency mandated to ensure that all Filipinos are provided with social health insurance protection against the rising cost of medical care services.
This year’s anniversary is focused on the theme ‘’Challenged by Change, Empowered by Unity.” It emphasizes PhilHealth’s resilience amid the changes taking place in the health care and health insurance industries, both locally and globally. It also highlights the role of strategic institutional linkages in enabling the organization to carry out its mandate efficiently and effectively for the benefit of its nearly a hundred million members and beneficiaries.
Activities lined up for the month-long observance include a simultaneous, nationwide Thanksgiving celebration on February 14, and ReachOut with members through health care facility visits to be undertaken by PhilHealth’s Regional Offices until February 16. The latest benefit products and services will be showcased in the PhilHealth Forward onFebruary 15, after which a Press Conference will be held to relay to the public the major strides done by the agency, as well as its plans and programs for 2017.
A two-day PhilHealth Symposium will bring together experts from The Netherlands, Mexico, Republic of China, and the Philippines who will share with the audience their respective countries’ journey towards Universal Health Coverage. Employee engagement activities will also be organized towards the end of the month.
The PhilHealth was created in 1995 through Republic Act 7875 or the National Health Insurance Act of 1995. The enabling law has been amended twice to ensure that the agency is able to cope with the demands of a national program that seeks to protect Filipinos from financial risks brought about by medical necessities. (END
PhilHealth Develops Medical Detoxification Package
THE Philippine Health Insurance Corporation (PhilHealth) reiterates its support for the National Government’s campaign to stop drug addiction in the country by developing a package designed to provide medical detoxification to drug dependents who desire to get rid of their addiction to illegal substances.
PhilHealth Acting President and CEO Ramon F. Aristoza Jr. said that “PhilHealth is mandated to provide health insurance coverage for all Filipinos and supports the government’s efforts in the fight against drugs. It is one with the government in achieving long-term abstinence from the use of illicit substances.”
Aristoza said that through the medical detoxification package, PhilHealth will ensure the provision of the minimum standards of medical interventions to safely manage the acute physical symptoms of withdrawal associated with stopping drug use.
The PhilHealth benefit rate for medical detoxification package is Php10, 000 as articulated in PhilHealth Circular No. 2016-0030. However, the state-run agency emphasized that the medical detoxification is only the first stage or the precursor to effective drug addiction treatment. The success of the medical detoxification depends on the collaborative and concerted efforts of pertinent agencies that shall address the challenges of drug addiction in terms of the personal, health and societal aspects of drug rehabilitation.
The medical detoxification package is available to PhilHealth members with acute physical symptoms of use of amphetamine-type stimulants such as methamphetamine, cocaine or ecstasy or a combination of these. However, if there is a documented indication to treat a common co-morbidity associated with withdrawal symptoms arising from the substance, a case rate corresponding to the co-morbidity may also be availed of.
Aristoza added that “all PhilHealth eligible members and dependents can avail themselves of the benefit package as a one-time benefit”, and emphasized that, “the No Balance Billing policy will be applied at all times to indigent, sponsored, kasambahay, lifetime and senior citizen members who are admitted in ward accommodation in accredited government Health Care Institutions (HCIs).
On the other hand, PhilHealth members who are admitted in government HCIs but are not eligible to NBB will have a co-payment that should not exceed the package rate.
Payments for medical detoxification package can be paid in a single tranche to the accredited HCI.
The package can be availed of in all accredited levels 1, 2 and 3 government hospitals and in Drug Abuse Treatment and Rehabilitation Centers that are licensed or certified by the Department of Health and accredited by PhilHealth. (END)
PhilHealth to Migrant Workers: Ensure Updated Records and Contributions
OVERSEAS Filipino Workers (OFWs) should make sure that their membership with the Philippine Health Insurance Corporation (PhilHealth) is updated before leaving the country.
Updated member records and premium contributions will help ensure that migrant worker-members of PhilHealth, including their legal dependents, will be able to avail themselves of their benefits when the need arises.
This reminder was issued by PhilHealth in view of misconceptions that payment by Overseas Filipino Workers (OFWs) of their PhilHealth contributions is no longer necessary due to Philippine Overseas Employment Administration’s (POEA) implementation of a single collection policy starting last April 1.
“We want to emphasize among Overseas Filipinos (OFs) that PhilHealth membership is mandatory and that premium contributions may be paid through any of our accredited collecting partners nationwide prior to securing their overseas employment certificates,” said PhilHealth President and CEO Alexander A. Padilla.
The PhilHealth Chief also stressed that OFWs can very well use their PhilHealth membership even if admitted in health care facilities overseas and that even their legal dependents in the Philippines may avail themselves of the benefits, as long as the member records and premium contributions are up-to-date.
Updating of records is needed when an OFW has changes to make in his/her membership profile such as, but not limited to adding or removing a dependent, changing residence address, correcting the spelling of basic information entries, among others. The changes should be captured in the PhilHealth Member Registration Form (PMRF) which can be downloaded from the website, www.philhealth.gov.ph, and immediately submitted to any of PhilHealth’s Regional Offices or Local Health Insurance Offices, or email@example.com.
The annual premium contribution rate for land-based OFWs is P2,400.00 and already includes coverage for all qualified legal dependents. The amount may be paid annually or depending on the length of duration of the employment contract, but not to exceed five (5) years. In view of the POEA’s single collection policy, PhilHealth OFW-members may pay their premium contributions through any of the 5,000 plus PhilHealth-accredited collecting agents nationwide, including the Post Office and payment centers abroad.
Entitlement to health care benefits for OFWs and their legal dependents begins on the day the premium is paid, and is effective for the period covered by the contribution. To update, OFWs may pay through PhilHealth-accredited collecting partners overseas, or may ask their next-of-kin in the Philippines to pay the premium for them.
“We want our OFWs to have peace of mind while they are abroad and away from their families,” Padilla said. “Maliit na halaga lamang ito nguni’t mangangahulugan ng katiwasayan ng kanilang isip at kalooban, gayundin ng kanilang mga dependents kung sakaling silaý maospital. That’s why we are issuing this reminder for their benefit, since the premium payments will guarantee that their dependents will be protected while they are abroad,” he added.
PhilHealth’s case rate reimbursement covers for hospital room and board, drugs and medicines, laboratory exams, as well as operating room and professional fees for hospital confinements of not less than 24 hours. It also covers an increasing number of outpatient services, such as day surgeries, radiotherapy, hemodialysis, and out-patient blood transfusion, among others. OFWs and their qualified dependents are also entitled to Primary Care Benefit Package I (PCB I) which includes consultations, diagnostics, preventive and promotive services without having to pay additional premiums.
The Z Benefits are packages of benefits that will primarily address catastrophic cases. Cases identified under the ‘Z’ benefit are childhood Acute Lymphocytic Leukemia (ALL), Breast Cancer, Prostate Cancer, Coronary Artery Bypass Graft Surgery, Surgery for Tetralogy of Fallot, Surgery for Ventricular Septal Defect, Cervical Cancer, Z MORPH, Kidney Transplantation, Peritoneal Dialysis (PD) First, and selected Orthopedic Implants.
Qualified dependents of OFWs who are active PhilHealth members are entitled to a separate coverage of up to 45 days confinement per calendar year and shall be shared amongst them.
These include the OFW’s legal spouse who is not a PhilHealth member, or whose membership is inactive; the OFW’s children below 21 years of age, unmarried and unemployed; children above 21 years old but are suffering from illnesses/diseases which rendered them to total dependency to the member (congenital or acquired); and parents below 60 years of age but with total disability and are totally dependent on the OFW for subsistence.
As of December 2014, benefit availments by OFWs and their dependents already reached P1.2B affirming the fact that indeed, PhilHealth remains useful to the migrant sector. (Emy Retuta)