PhilHealth is our government’s solution to our healthcare needs. It is therefore a need to understand how it works and how it can benefit you. Thus in this article, let me share to you what PhilHealth is, it’s requirements and how to register as a member.
What is PhilHealth?
The Philippine Health Insurance Corporation or PhilHealth is a Government Owned and Controlled Corporation (GOCC) established on February 14, 1995. Its objective is to secure the health of every Filipino through social health insurance.
It is based on the concept of community cooperation or social solidarity like in “bayanihan” – a trait of the Filipino country where the whole community is helping each other in times of need. Therefore it is the objective of PhilHealth to devise a mechanism where every Filipino is helping each other, hand-in-hand where:
- the community helps the needy
- the younger generation helps the elderly
- the healthy helps those who are sick
Every one of us will get old and get sick, so it aims that every Filipino will contribute to the National Health Program to ensure everyone’s health.
Who can be members of PhilHealth?
PhilHealth is for everybody. May you be rich or poor, young or old, healthy or sick, with a job or none, every Filipino should be a member.
Here are the membership categories of PhilHealth
1. Formal Economy Members
These members are employees, business owners (whether big or small), house help and family drivers.
2. Informal Economy Members
These are also known as voluntary or individually-paying members. They include Overseas Filipino Workers (OFW), self-earning individuals, naturalized Filipinos or dual citizens and foreigners living in the Philippines
3. Sponsored Members
These are members whose contributions are shouldered by a sponsor. The sponsor could be the local government, agency or private agency/individual. This also includes the individuals in the lower income segment who are not indigent like the barangay health workers, nutrition scholars, etc.
Also registered here are those under the custody of DSWD who are orphans and abandoned children, out-of-school youth, street children, Persons with Disabilities (PWDs), abused women and women giving birth.
4. Indigent Members
These are poor families chosen by DSWD using the method of identification called National Household Targeting System for Poverty Reduction (NHTS-PR). The system determines which families are legible to be part of the government’s program to ease poverty.
5. Lifetime Members
These are members 60 years old and above and are retired employees who were able to contribute not less than 120 months to PhilHealth.
6. Senior Citizens
According to the Expanded Senior Citizen Act (RA 10645), PhilHealth covers all Filipinos 60 years old and above.
PhilHealth Requirements and Registration
Registration is easy in whichever membership category. Go to the nearest PhilHealth Office and submit completely-filled-up PhilHealth Member Registration Form or PMRF. There is no need for any supporting documents except when asked for as proof.
Reminder: To avoid penalty under law, make sure that all the information on the PMRF are all true and nothing but the truth.
Philhealth Requirements for Individually Paying Member
As mentioned above, these include unemployed, self-employed (often referred as “voluntary member”) and/or you are a foreigner living in the Philippines.
Here are the following requirements:
- PMRF (Philhealth Member Registration Form) – Accomplished and properly filled out. This form is also downloadable online for free.
- NSO authenticated Birth Certificate (photocopy) or valid IDs or any supporting documents to prove identity
- Supporting documents for your beneficiaries (photocopy)
- Photocopy of Alien Certificate of Registration (ACR) issued by the Bureau of Immigration (for foreigners only)
You will then be given and issued your PhilHealth Number (PN) and will be asked to pay your contributions. Keep your PN because this will be used for life. Make sure you will be paying your premiums continuously to ensure you can avail benefits any time.
PhilHealth Requirements for Employed Members
The requirements for employed members are the same as listed above for Individually Paying Member. Just include your employed status in the PMRF
PhilHealth Requirements for OFW
For OFW (Overseas Filipino Workers), you can register and pay your contributions once you register at the POEA as OFW.
Here are the requirements:
- PMRF
- Supporting documents of beneficiaries
- Any proof of being an active OFW
If you already are a member of Philhealth, you can just pay your contributions and update your status as OFW.
If you are outside the Philippines and wants to become a member of Philhealth, you can just submit the following requirements to any PhilHealth office:
- PMRF
- Philhealth Premium Payment Slip (PPPS)
- Photocopy of acceptable valid IDs
Then, pay your contributions to accredited collecting agents of PhilHealth abroad
About the Member Data Record (MDR) and PhilHealth ID
If registered with PhilHealth, the new member will receive:
- His/her PhilHealth Identification Number (PIN) – a permanent number of every member
- PhilHealth ID – where the following are present:
- PhilHealth Identification Number (PIN)
- Member’s name
- Member’s signature
- End of validity date of membership for Sponsored/Indigent Member
- Member Data Record (MDR) – where the follwing are present: name of member, address, list of legal dependents, insurance validity date for Sponsored/Indigent/OFW Members
Keep the ID and MDR. As these are what you need to avail of the benefits and other transactions with PhilHealth. For now, only the MDR is issued to the Indigent, Sponsored Members and Senior Citizens. But this document is enough to avail of the benefits.
For Indigent/Sponsored PhilHealth Members:
To know who are considered in the Indigent/Sponsored Members in an area, you may connect with the local government or LGU. PhilHealth ensures that every LGU has a list of names of members who are part of the program.
Who are the Qualified Dependents in PhilHealth?
PhilHealth covers the whole family! Therefore, the member and his family may avail of the benefits of PhilHealth.
Qualified dependents are the following:
1. Legal spouse, who is not a member of PhilHealth
2. Child 20 years old and below, without work and without children (this includes stepchildren, adopted, illegitimate and legitimated/recognized children)
3. Parents 60 years old and above who are not members of PhilHealth
4. Foster child who has undergone the process of DSWD following the Foster Care Act of 2012 or RA 10165.
5. Child or spouse with permanent disability
How to Update your PhilHealth Member’s Record?
If the list of qualified dependents are lacking, or a detail has to be changed or corrected to the ones written in the MDR, then fill-up a new form of PMRF. And then check the “FOR UPDATING” check box in the upper right-hand area. Finally, submit to any PhilHealth Office.
Submit a copy of the related supporting document as proof of the information changed, if needed. To avoid delays in claiming your benefits, make sure your PhilHealth record is always updated.
Contact PhilHealth
If you have additional questions, go to the nearest PhilHealth office. You can also visit PhilHealth’s Official Website: www.philhealth.gov.ph
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