philhealth faqs

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FAQs

Transcript of philhealth faqs

  • Philippine Health Insurance Corporation

    May 2012

    Updated May 20, 2012

    TamangSagot (TS) PhilHealths Frequently Asked Questions

  • Page 2 of 47

    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 PhilHealths 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 PhilHealths Board of Directors? Who composes it? .................................................................................................. 10

    What is PhilHealths 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 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 whos 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

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