How to Avail of PhilHealth Discount and Benefits for Senior Citizen


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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) 2provided that they are one of the following3:

  • Filipino citizen, aged 60 years old 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).

  1. Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF);
  2. Visit the OSCA of the city or municipality where you reside and submit the duly accomplished PMRF;
  3. 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).

  1. Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF) and attach 1×1 photo taken within the last six months;
  2. 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;
  3. Submit the duly accomplished PMRF;
  4. Wait for the MDR and the PhilHealth identification card.

 

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.

 

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

 

How to Claim PhilHealth Benefit if You’re a Senior Citizen.

  1. For hospitals with 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.
  2. 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.

 

If you are a senior citizen and you get hospitalized but you were not able to enroll prior to your hospitalization, can you still avail of the benefits?

Yes, you can. Just submit the following documents to the PhilHealth office prior to 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”.

 

What are Geriatric/Senior Citizens’ Wards?

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.

 

About the Author.

Kareen Lucero is a lawyer previously doing litigation before working for different agencies in the government and for a multinational corporation. She has traveled to 52+ countries including a 3-month solo backpacking in South East Asia and more than 1 year of solo traveling across four continents in the world. As part of giving back, she is passionate about sharing her knowledge of law and travel. She is currently doing consulting work for a government agency. Connect with her on Facebook.

 

References.

  1. Official Gazette of the Republic of the Philippines. An Act Providing for the Mandatory Philhealth Coverage of Senior Citizens (2014).
  2. Official Gazette of the Republic of the Philippines. An Act Restructuring the Excise Tax on Alcohol and Tobacco Products by Amending Sections 141, 142, 143, 144, 145, 8, 131, and 288 of Republic Act No. 8424. Otherwise Known as the National Internal Revenue Code of 1997, as Amended by Republic Act No. 9334, and For Other Purposes (2012).
  3. Senior Citizens. Retrieved 26 March 2020, from https://www.philhealth.gov.ph/members/senior/
  4. Official Gazette of the Republic of the Philippines. An Act to Strengthen and Propagate Foster Care and to Provide Funds Therefor (2012).

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2 thoughts on “How to Avail of PhilHealth Discount and Benefits for Senior Citizen

  1. Pingback: PhilHealth Online Registration: A Complete Guide for New Members
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