TamangSagot (TS) - Philippine Health Insurance Corporation

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Table of Contents A. THE ORGANIZATION .............................................................................................................................................................. 9 What is PhilHealth? ............................................................................................................................................................................................................. 9 What is the National Health Insurance Program (NHIP)? .................................................................................................................................. 9 What are the underlying principles/concepts behind the NHIP? ................................................................................................................... 9 What is PhilHealth‟s purpose of being? ..................................................................................................................................................................... 9 When was PhilHealth created? ...................................................................................................................................................................................... 9 What are its enabling laws or legal bases? ............................................................................................................................................................... 9 What is its vision? ................................................................................................................................................................................................................ 9 What is its mission? ............................................................................................................................................................................................................ 9 What is the role of PhilHealth‟s Board of Directors? Who composes it? .................................................................................................. 10 What is PhilHealth‟s classification as a government agency?........................................................................................................................ 10 What are its fund sources? ........................................................................................................................................................................................... 10 Why does PhilHealth have to keep a reserve fund? .......................................................................................................................................... 10 With what organizations is it affiliated? .................................................................................................................................................................. 10 How do I contact PhilHealth? ...................................................................................................................................................................................... 10 B. MEMBERSHIP ......................................................................................................................................................................... 11 Who can be members of PhilHealth? ...................................................................................................................................................................... 11 What are the different membership types at PhilHealth? ............................................................................................................................... 11 Who can enrol under these different programs? ............................................................................................................................................... 11 What are the fundamental processes that each member should know? ................................................................................................. 13 What is my proof that I am already a registered member? ........................................................................................................................... 13 C. REGISTRATION/ENROLLMENT ............................................................................................................................................ 13 Who should enrol? ........................................................................................................................................................................................................... 13 Is there any age limit for prospective members?................................................................................................................................................ 13 How do members enrol into the program? Where can they enrol?........................................................................................................... 13 What are the documents required for the registration of employers (and their employees) in the Government Sector and Private Sector? ................................................................................................................................................................................................................... 16 How can LGUs enrol their underprivileged constituents into the Sponsored Program? ................................................................... 16 Who can be declared as legal dependents? ......................................................................................................................................................... 16 How do I activate my membership? ......................................................................................................................................................................... 16 Where else can I register? ............................................................................................................................................................................................. 17 Situationers for Registration/Enrolment ............................................................................................................ 17 Can foreign nationals working in the Philippines enrol? .................................................................................................................... 17 Page 2 of 47
Page 3 of 47 Can minors and orphaned children enrol? ............................................................................................................................................... 17 In case of early retirement, can I already register as a Lifetime Member? .................................................................................. 17 Is it true that retiring employees can now be automatically enrolled by the employer in the Lifetime Member Program? ................................................................................................................................................................................................................. 17 Can foreign spouses of Filipino nationals be declared as dependents? ...................................................................................... 17 Can unmarried members declare nephews or nieces as dependents? ........................................................................................ 18 If both parents are members, can they both declare their children as dependents? ............................................................. 18 How can a member declare his spouse whose membership is inactive as a dependent? ................................................... 18 If all siblings are active members, can each of them declare their parents as dependents? .............................................. 18 Can disabled parents (physically or mentally incapacitated) who are below 60 years old be declared as dependents? .......................................................................................................................................................................................................... 18 Can my live in partner be declared as a legal dependent? How about our children? ........................................................... 18 My daughter who‟s still my dependent (under 21) is about to give birth. Will my membership be able to cover her? ............................................................................................................................................................................................................................ 18 Do I need to personally submit my registration documents or can I ask my representative to do so? ......................... 18 D. UPDATING MEMBERSHIP RECORDS .................................................................................................................................. 18 When should I update my MDR? How is this done? ......................................................................................................................................... 18 How do I shift membership categories? ................................................................................................................................................................. 19 Are we going to use the same PhilHealth Identification Number (PIN) if we are shifting to another membership category?.............................................................................................................................................................................................................................. 19 Situationers for Updating Membership Records ................................................................................................ 19 I was given a PhilHealth card by our LGU, but my name was misspelled and data provided were also erroneous. How do I correct this information? .............................................................................................................................................................. 19 E. CONTRIBUTIONS AND MEMBERSHIP RENEWAL .............................................................................................................. 19 Why must a member pay his premiums regularly? ........................................................................................................................................... 19 How much is the premium contribution rate? ..................................................................................................................................................... 19 Why is there a need for an increase in premium contributions? ................................................................................................................. 20 Are overtime pay, commissions, and allowances included in the computation of premium contributions of employees? .................................................................................................................................................................................................................................................. 20 Where can the members remit their contributions? ......................................................................................................................................... 20 Aside from paying through service offices and collecting agents, is there another way for me to pay my premiums easily? .................................................................................................................................................................................................................................... 21 What if I want to view my payment history for Text 7442? ............................................................................................................................ 21 When is the deadline for paying my premium contribution? ....................................................................................................................... 21 What is the effectivity date of PhilHealth coverage? ........................................................................................................................................ 23 What are the requirements for eligibility? When is a member eligible to claim? ................................................................................. 23 How do I maintain my eligibility? .............................................................................................................................................................................. 23
Page 1: TamangSagot (TS) PhilHealth’s Fre
Page 5 and 6: Page 5 of 47 Were OFW members consu
Page 7 and 8: Page 7 of 47 Why shift to case rate
Page 9 and 10: Page 9 of 47 A. THE ORGANIZATION Wh
Page 11 and 12: Page 11 of 47 B. MEMBERSHIP Who can
Page 13 and 14: Page 13 of 47 What are the fundamen
Page 15 and 16: Page 15 of 47 ii. Valid overseas em
Page 17 and 18: Page 17 of 47 Where else can I regi
Page 19 and 20: Page 19 of 47 3. New dependents sha
Page 21 and 22: Page 21 of 47 Aside from paying thr
Page 23 and 24: Page 23 of 47 2011 2012 J F M A M J
Page 25 and 26: Page 25 of 47 shall be given a grac
Page 27 and 28: Page 27 of 47 I am a PhilHealth mem
Page 29 and 30: Page 29 of 47 2. Cash remittance fr
Page 31 and 32: Page 31 of 47 If I missed the sched
Page 33 and 34: Page 33 of 47 Can I update my MDR o
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Page 39 and 40: Page 39 of 47 Where can these benef
Page 41 and 42: Page 41 of 47 Situationers: Benefi
Page 43 and 44: Page 43 of 47 Freestanding Dialysis
Page 45 and 46: Page 45 of 47 If the Sponsored memb
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