The Philippine Health Insurance Corporation, or PhilHealth, was established in 1995 and is affiliated with the Department of Health and is funded through taxes, premiums, and other contributions. It is another government agency that aims to achieve universal health coverage for all Filipinos. This agency makes sure that Filipinos, especially the poor, have access to cheap, reliable, and sustainable health care.
Its vision is to provide sufficient and affordable social health insurance for all Filipinos.
Its mission is to ensure sufficient financial access for all Filipinos to quality healthcare services.
PhilHealth doesn’t discriminate when it comes to who can be a member. It doesn’t matter if you are rich or poor, working or retired, as long as you need medical help, you can use PhilHealth. Here are six major membership types of PhilHealth.
- Formal. These are workers who are employed either in private or public companies.
- Indigent people (PhilHealth ng Masa). These are poor people who were being funded by the government.
- Sponsored Members. People who received funding from Local Government Unit (LGU).
- Lifetime. These are retirees and pensioners who had at least 120-month contribution.
- Senior Citizen. Filipino people who are over the age of 60.
- Informal Economy.
- Overseas Filipino workers (OFWs) also known as Migrant Workers.
- Informal Sector. These are street vendors, market vendors, pedicab and tricycle drivers, construction workers, and home-based workers.
- Filipinos with Dual Citizenship.
- Naturalized Filipino Citizens. These are people who became Filipino citizens by Commonwealth Act No. 473 or the Revised Naturalization Law.
- Citizen of other countries working and/or residing in the Philippines. These are people who are citizens of another country but have a valid working permit or Alien Certificate of Registration (ACRs) and are residing in the Philippines.
PhilHealth is a social insurance program from the government that let poor sick people afford medical care. It is unfortunate to know that not all Filipinos know how to utilize this program. PhilHealth has a wide selection of services from basic care to catastrophic packages. Here is the list of programs and services from PhilHealth:
- Inpatient Benefits. This program covers all kinds of diagnostic or therapeutic procedures and hospital charges such as room, medicines, professional fees, and so on at any PhilHealth-accredited healthcare institution (HCI).
- Requirements: PhilHealth Benefit Eligibility Form (PBEF) or Member Date Record and PhilHealth Claim Form 1
- Outpatient Benefits. This program assists members who don’t require hospital confinement but need procedures and treatments such as minor surgeries, radiotherapy, outpatient blood transfusion, hemodialysis, and so on.
- Requirements: Member Data Record Copies and Complete PhilHealth Claim Form 1.
- Z Benefits. This program provides assistance to members and dependents who have severe conditions and requires expensive treatments such as cancer, kidney transplant, orthopedic implants, and so on.
- SDG-Related Benefits. SDG is an acronym for Sustainable Development Goals and was created by the United Nations. This program provides medical packages to members who are diagnosed and/or undergoing procedures such as malaria, HIV-AIDS, animal bites, and voluntary surgical contraception procedures.
- Maternity Benefits. For soon-to-be mothers with updated contributions to PhilHealth are eligible for this program and can enjoy these medical packages. This benefit only covers the first four normal deliveries of a member.
- Antenatal Care Package. This package has prenatal check-ups such as laboratory tests and ultrasounds.
- Normal Spontaneous Delivery Package. This package is for normal and low-risk vaginal deliveries with postnatal check-ups from three to seven days after the delivery.
- Other Method of Delivery. This package is for mothers who will have a cesarean, breech extraction, vaginal delivery after cesarean section, and complicated vaginal delivery.
- Newborn Care Package. This package is for newborn babies for their newborn screening and hearing test.
PhilHealth Online Services
For all members’ convenience, PhilHealth now offers online services available 24//7 so you can use it anytime and anywhere you are. Here is a list of services you can access online:
- Case Rates Search
- Claims Eligibility Checking
- Electronic Group Enrollment System
- Electronic Collection Reporting System
- Health Care Institutions
- Membership Portal
Video: Registration in PhilHealth Step by Step
Do you want to know how to register online? Watch this video by Info Guide PH and follow these easy steps on how to register, check your contributions and many more.
Frequently Asked Questions
What is PhilHealth?
PhilHealth is owned by the Philippine government and is a controlled Corporation to address Filipino’s medical needs.
Who can be members of PhilHealth?
All Filipino citizens who are registered in National Health Insurance Program.
How do I know if I am already a member of PhilHealth?
PhilHealth members will receive a PhilHealth ID that has a PhilHealth Identification Number (PIN) and a copy of the Member Data Record (MDR).
How much is the premium contribution rate?
The premium contribution rate depends on the membership category (except OFWs).
Where can I pay my contributions?
A member can pay PhilHealth contributions to the following places:
- CIS Bayad Centers
- Collecting Banks
- MLhuillier Philippines Pawnshops
- LBC Express outlets
- Office of the Philippine Postal Corporation
- Selected Local Government Units
For OFWs, you can pay your contribution through
- i-Remit branches
- Foreign offices of the Philippine Veterans Bank
Is membership transferable?
No. PhilHealth does not allow a member to transfer his/her membership to another.
Can an unemployed member still use the PhilHealth benefits?
Yes. You can register as a voluntary member and pays your monthly charges.
Can I use my husband’s PhilHealth for maternity benefits?
Yes. Legal spouses and children are eligible for PhilHealth maternity benefits.
For most Filipinos, getting sick not only affects a sick person but also his/her family. Being sick means a financial burden. As the saying goes, “Mahirap magkasaki.” It is physically, mentally, and emotionally draining.
Fortunately, there is PhilHealth to help us lift the heavy burden we are carrying. It is one of the agencies that helps every Filipino, whether you are young or old, rich or poor, or employed or unemployed, you can still enjoy the benefits it provides.