PhilHealth supports the call for greater transparency in public governance. The call to serve the rural indigents echoed since early 60's when the Philippine Medical Association introduced the MARIA projects which prioritized aid to communities in need of medical assistance.
Guide for The Lifetime Members;
*The individual 60 years of age and above who complied their 120 months contribution or more on PhilHealth and former Medicare of SSS and GSIS.
*The retired uniformed personnel of AFP, PNP, BJMP and BFP at 56 years of age and above who complied the 120 months contribution or more.
*The retired underground mine workers, members of SSS, 55 years of age and above who complied 120 months contibution or more.
*The GSIS disability pensioners and SSS permanent total disability pensioners before March 4,1995.
*The survivorsship pensioners at SSS before March 4,1995.
Lifetime members who have job considered Formal Economy Members and need a deduction of premium of their employer and remittted to PhilHealth.
Note; All member 60 years of age and above who did not complied 120 months contribution must registered as Informal Economy Member and continue to pay their premium for the completion of needed monthly contribution.
1.Fill up and correct the complete PhilHealth Member Registration form that can be ask at the office of PhilHealth or download online at PhilHealth and submit at the nearest PhilHealth office with the following documents 2x2 ID picture and any document that you are complied the 120 months contibution.
2.For SSS member, a copy of certification of your retirement from SSS. A copy of Death, Disability and retirement (DDR) wherein stated your monthly contribution to PhilHealth.
3.For GSIS member, a certification copy of your retirement from GSIS. Service record from your employer wherein stated your monthly contribution to PhilHealth.
4.For Uniformed Personnel like AFP PNP BJMP and BFP, a copy of General or Special Order wherein stated the months of your retirement and tenure of your service.
5.For GSIS Disability Pensioner, SSS Permanent Total Disability Pensioner before March 4,1995, a copy of certification of being a disability from SSS and GSIS wherein stated the begenning of your monthly pension.
5.For SSS Survivorship Pensioner before March 4,1995, a copy of Survivorship Pensioner certification from SSS wherein stated the effectiveness of your pension.
6.Other Individuals, a copy and receipt of your PhilHealth contributions or any document wherein stated the amount of your contribution applicant.
Declare Your Dependents;
*The wife who is not a PhilHealth member
*Child below 21 years of age,jobless and still single
*Child 21 years of age and above but disable
*Foster Child according to Foster Care Act of 2012
*Parent with permanent disability
After you complied all the registration requirements, you can now received the Health Insurance ID Card for the Lifetime Members contains you a Permanent PhilHealth Identification Number (PIN) and Member Data Record (MDR)
How To Update Your Membership Record;
Submit your PhilHealth Member registration Form (PMRF) to the nearest PhilHealth office with a new and added information of dependent. Dont forget to put check the "For Updating" that can be seen above the PMRF form. And ready all the supporting documents whenever the staff ask for proff of evidence.
*Pneumonia Moderate Risk ---------15,000
*Pneumonia High Risk ---------------32,000
*Stroke- Infaraction -------------------28,000
*Stroke- Hemorrhagic ----------------38,000
*Hypertensive Emergency/Urgency- 9,000
*Dengue Severe------------------------16,000
*Acute Gastroentiritis (AGE)-------- 6,000
*Asthma in Acute Exacerbation ----- 9,000
*Newborn Care Package -------------- 1,750
Worth Benefits of Operation;
Hemodialysis -------------------------------- 4,000
Maternity Care Package ---------------------8,000
Normal Spontaneous Delivery Package ---6,500
Cesarian Section -----------------------------19,000
Radiotheraphy Linear Accelerator --------- 3,000
CataractPackage ------------------------------16,000
Dilatation and Curettage ---------------------11,000
Cholecystectomy ------------------------------31,000
Appendectomy --------------------------------24,000
1.1. Z benefits- this benefits is case rate provided to the patient need a long and costly and expensive treatment. There are pre conditions and selection criteria needs to gain the benefits to the selected government hospitals.
Acute Lymphocytic Leukemia ------------ 210,000
Breast Cancer stage 0 to 3 ------------------ 100,000
Prostate Cancer,low and immediate risk -- 100,000
Kidney Transplant,low risk ---------------- 600,000
Coronary Artery Bypass Graft Surgery --- 550,000
Surgery of Tetralogy of Fallot in children-- 320,000
Ventricular Septal Defect Surgery in children 250,000
Cervical Cancer low and high dose --------- 120,000
External Lower Limb Prosthesis ------------ 15,000
Outpatient Benefits Under All Case Rates;
Tubercolosis-Directly Observed Treatment Short-course ------ 4,000
Malaria Treatment -------------------------------------------------- 600
Outpatient HIV/AIDS treatment ---------------------------------- 30,000
Animal Bites Treatment ------------------------------------------- 3,000
Vasectomy and Tubal Ligation ------------------------------------- 4,000
Reminder;There are 45 days of hospitalization in one year to one member and separated 45 days to be devided of the dependents.
How To Use The Benefits Of The PhilHealth Accredited Facilities:
Before leaving the hospital,submit the following to the billing section of the hospital.PhilHealth Claim Form 1 must be orderly filled.... The medecine that purchased outside the hospital must be reimburse while the patient is still confine.
How to deduct the PhilHealth Benefits From Hospital Payments if you have Senior Citizen's Discount? First deducted to the Hospital payments the 12% Value Added Tax (VAT) following the 20% senior citizen discount,and deducted the benefits of PhilHealth after. If the senior citizen is disable only one senior citizen is discounted and might be deducted to the hospital billing.
Example; Essential Hypertension with Case Rate ---- 9,000.00
Full Billing of Hospital ----------------------- 20,000.00
Less 12% VAT --------------------------------- 2,400.00
Less 20% Senior Citizen (PWD) ------------ 3,520.00
Less PhilHealth -------------------------------- 9,000.00
Balance billing --------------------------------- 5,080.00
Good News; Because of partnership of PhilHealth and Merck Sharp & Dohme (MSD) all eligible PhilHealth members and qualified dependents with 50 years of age and above,there's possibility of availing the 60% discount to the Pneumococcal Vacine to the Vaccine Access Point (VAPs) Only 600 will be paid from the original price of 1,500.
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