Updated: PhilHealth Benefits June 2018

PhilHealth occasionally makes some changes to its benefit packages, policies, and other membership requirements. It is imperative that one has to be informed of the changes; that way everyone will know what they’ll be getting out of their contributions. This year, there are new PhilHealth benefits update and everyone should be aware of that.

The following are the latest updates to your Philhealth benefits update, contribution changes, and coverage that you should know of:

Higher PhilHealth Contributions

Starting January 2018, the PhilHealth premium contributions went through an increase slightly for all employees, government and private, sea-based overseas Filipino workers, household helpers, and other formal economy members.

The new PhilHealth premium contribution has been raised from 2.5% to 2.75%; up by 0.25%.

PhilHealth also made adjustments for the lowest and highest salary bracket. The lowest bracket which was at Php8, 999.99 is now Php10, 000.00 and for the highest bracket now is Php40, 000.00 from the previous Php35, 000.00.

What has not changed is the equal monthly contribution by both the employee and employer. As for the Kasambahays earning less than Php5, 000.00, the employer will be the one paying the premium contributions. However, Kasambahays receiving higher compensations would need to pay for their share.

With these changes, employees receiving a basic salary of Php40, 000 and above, their premium has been raised to Php1, 100 from the previous Php1, 000. Php550 will be shared by the employee and Php550 by the employer.

In addition, as for employees with a monthly basic salary of Php10, 000 and below, they will be contributing Php275 instead of the previous Php250. Half of which, Php137.50, will be coming from the employee and the other half will be paid by the employer.

Below is the updated PhilHealth contribution table:

Lifting of length-of-stay requirements for Pneumonia, Acute Gastroenteritis, and UTI Patients

Here is a good news to all pneumonia, acute gastroenteritis, or urinary tract infection (UTI) patients or dependents of PhilHealth members. PhilHealth will reimburse your confinement fees no matter how long you or your dependent stayed at the hospital.

This is according to the latest circular from PhilHealth stating the removal of the length-of-stay requirement for reimbursing claims for those three common diseases.

Before this, PhilHealth did not reimburse confinement expenses for patients that did not meet the minimum length of stay requirement. Pneumonia patients who were not confined for 4 days, were not covered. For acute gastroenteritis and UTI patients, they could file reimbursement claims provided they were admitted for at least 3 days for acute gastroenteritis and 4 days for UTI patients.

PhilHealth Coverage Extended to Foreigners and Dual Citizens

Foreigners and expats, as well as those Filipinos with dual citizenship, can now avail of PhilHealth benefits. Foreigners and their qualified dependents can enjoy both in-patient and out-patient benefits in any hospital or clinic accredited by PhiliHealth anywhere in the Philippines. But they cannot avail of the benefits of conditions that trigger prolonged hospitalization and expensive treatments. Also, women who are about to give birth. Reimbursement claims for hospital confinements abroad are also not covered.

For Pinoys with dual citizenship and their qualified dependents may have all the benefits provided by PhilHealth, in accredited healthcare facilities nationwide and abroad. They simply have to pay at least 3 monthly PhilHealth contributions within 6 months before availment to qualify. As we can see, these PhilHealth benefits update are truly music to our ears.

Requirements for PhilHealth membership:

For Filipino with dual citizenship:

• Accomplished PMRF;
• Certificate of Re-acquisition/Retention of Philippine Citizenship (CRPC); and
• Identification Certificate (IC)issued by Philippine Embassy or Philippine Consulate abroad or by the Bureau of Immigration

For Foreign Retirees:

• Registered with the Philippine Retirement Authority (PRA);
• Accomplished PhilHealth Member Registration Form (PMRF) for Foreign Nationals that must be submitted to any PRA office;
• Special Resident Retiree’s Visa (SRRV); and
• Permanent residency status

For foreigners living or working in the Philippines:

• Valid Alien Certificate of Registration Identity Card (ACR I-Card) issued by the Bureau of Immigration;
• Valid working permit; and
• Accomplished PMRF for Foreign Nationals that must be submitted to any Local Health Insurance Office

Annual PhilHealth premium contributions:

• Foreign retirees Php15, 000.
• Expats Php17, 000.
• Dual citizen Php3, 600.

Z Benefits for Premature and Small Newborns

With the PhilHealth benefits update, PhilHealth now will also provide benefit packages for premature babies and pregnant mothers who are at risk of premature delivery, other than maternity benefits or pregnant women and newborns.

Who are covered?

• Premature newborns who weigh from 500 g to 2,499 g fetal weight at 24 weeks to less than 37 weeks (fetal age); and
• PhilHealth members who are 24 to 36 and 6/7 weeks pregnant and at risk of premature birth

Z Benefit Packages and Rates:

• Prevention of premature delivery, ranging from Php600 to Php4,000
• Benefit packages for premature newborns with the fetal age of 24 weeks to less than 32 weeks, ranging from Php35,000 to Php135,000
• Benefit packages for premature newborns with the fetal age of 32 weeks to less than 37 weeks, ranging from Php24,000 to Php71,000

In filing for reimbursement claims, it shall be the health care facility who shall file in behalf of the mother or the baby within 30 calendar days upon discharge. Philhealth does not accept Z benefit claims filed directly by members.

Are these PhilHealth benefit updates reliable and dependable?

As a member of PhlHealth, it is important that you stay updated on whatever policies, benefits, and coverage PhilHealth has changed to maximize your benefits. On PhilHealth’s part, it further improves its services to better serve its members. For sure, updates done on its policies, benefits, and coverage are a product of in-depth study and research, with consultations from different healthcare experts. Maybe pattern it from other countries that are successful when it comes to health care benefits for its citizens.

Yes, these updates are dependable and reliable and can fully aid in the restoration of our country’s health insurance.