PhilHealth – Page 2

While it's important to stay productive during your retirement years, there's no way you can't live a meaningful life without making your health a priority. Fortunately, the government assures senior citizens are well taken care of through the discounts and benefits offered by PhilHealth. DISCLAIMER: This article has been written for general informational purposes only and is not legal advice or a substitute for legal counsel. You should contact your attorney to obtain advice with respect to any particular issue or problem. The use of the information contained herein does not create an attorney-client relationship between the author and the user/reader. Go back to the main article: How to Welcome Old Age: A Complete Guide to Senior Citizen Discount and Benefits Is PhilHealth Free for Senior Citizens? Yes. Thanks to Republic Act No. 106451, all senior citizens, indigent or not, are now automatically covered by PhilHealth. Senior citizens don't need to pay PhilHealth contributions (their benefits are funded from the sin tax and the government's shares from the PAGCOR)2 provided that they are one of the following3: Filipino citizen, aged 60 years or above, resident of the Philippines, and NOT currently covered by any other PhilHealth membership category. This means if you're currently employed (formal economy category) or self-employed (voluntary/informal economy category) with a regular source of income, you will continue paying your premium contributions applicable under your current membership category;Qualified dependent of a PhilHealth member who is also a senior citizen;Qualified dependent of a PhilHealth member who belongs to other membership categories. How To Become a PhilHealth Member if You’re a Senior Citizen If you are not a member yet, there are two ways you can enroll: Option 1: Through the Office of Senior Citizens Affairs (OSCA) Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF);Visit the OSCA of the city or municipality where you reside and submit the duly accomplished PMRF;Wait for the Member Data Record (MDR) and identification card issued by PhilHealth through the OSCA. Option 2: Through PhilHealth Local Health Insurance Office (LHIO) Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF) and attach a 1x1 photo taken within the last six months;Visit LHIO and present the Senior Citizen’s Identification Card issued by the OSCA in the city or municipality where the elderly resides or any valid government-issued ID;Submit the duly accomplished PMRF;Wait for the MDR and the PhilHealth identification card. What Are the PhilHealth Benefits and Entitlements Available to Senior Citizens? You and your qualified dependent/s shall be entitled to the following: Inpatient hospital care;Day/Ambulatory services;Special benefits for catastrophic cases referred to as Z-benefits;Tuberculosis Directly Observed Treatment Short-Course (TB-DOTS) package;Animal bite package;Malaria package;Outpatient HIV/AIDS Treatment package;Blood transfusion package;Maternity and newborn care package;Normal spontaneous delivery package;Prenatal care package;Benefits for voluntary contraceptive surgical procedures;Primary care benefit package: Tamang Serbisyo sa Kalusugan ng Pamilya (Tsekap);No Balance Billing Policy (NBBP) provided the senior citizen is confined in accredited government health care facilities, subject to applicable rules for NBB availment;Forty-five (45) days of confinement coverage every calendar year while declared qualified dependents shall share among themselves another 45 days of confinement every calendar year Related: How to Get Senior Citizen ID in the Philippines: A Definitive Guide How To Claim PhilHealth Benefit if You’re a Senior Citizen For hospitals with an installed Health Care Institution (HCI) Portal, the senior citizen or his or her authorized representative shall present the senior citizen card, MDR, or any acceptable proof of identity and age.The hospital will then print the PhilHealth Benefit Eligibility Form (PBEF). If the PBEF says “YES”, it means the patient is entitled to the benefits. PhilHealth staff will then process the deduction from your hospital bills. What Are Geriatric/Senior Citizens’ Wards? A senior citizen ward shall be established in every government hospital throughout the country for the exclusive use of senior citizens who are in need of hospital confinement Tips and Warnings Senior citizens who are gainfully employed or have a regular source of income shall continue to pay the Philhealth contribution. Frequently Asked Questions 1. Can senior citizens have dependents under their PhilHealth? Who can be dependents? Yes. The dependents can be any of the following: The legitimate spouse who is not enrolled under PhilHealth;Children, legitimate or illegitimate below twenty-one (21) years of age, who is unmarried, or without child/ren, and unemployed;A child who is twenty-one years of age or above suffering from a congenital disability;Foster child as defined by law (“Foster Care Act of 2012”)4 2. If you are a senior citizen and you get hospitalized but were not able to enroll before your hospitalization, can you still avail of the benefits? Yes, you can. Just submit the following documents to the PhilHealth office before discharge: Duly accomplished PhilHealth Member Registration Form (PMRF);Acceptable proof of status as a senior citizen, including but not limited to the Senior Citizen’s Identification Card. The same process will apply if the hospital has no installed HCI Portal or the PBEF says “NO”. 3. How many times can we use PhilHealth in a year? 4. How many percent does PhilHealth cover? References