What is the Universal Health Care Act? How does it affect my PhilHealth coverage?

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The Universal Health Care law, signed in February 2019, introduces significant reforms to make healthcare services in the Philippines more affordable and comprehensive.

As of this writing, the DOH and PhilHealth are still drafting the new law’s implementing rules and regulations (IRR). This means PhilHealth’s existing policies on membership, benefits, and contributions are still in effect.

Once the IRR is released, expect some changes in your PhilHealth coverage. Here are the most notable reforms of the Universal Health Care Act:

  • All Filipinos will automatically become PhilHealth members.
  • PhilHealth membership will be classified into two categories only: direct contributors (those who pay their contributions) and indirect contributors (those whose contributions are shouldered by the government).
  • All members can avail of PhilHealth benefits immediately, even those with unpaid contributions. However, direct contributors should retroactively settle the unpaid contributions plus interest.
  • The MDR and PhilHealth ID will no longer be required when availing of PhilHealth benefits.
  • The contribution rate for direct contributors will increase to 3% in 2020 and by increments of 0.50% every year until it reaches 5% by 2025.
  • Outpatient benefits, including outpatient medicines and emergency medical services, will become more comprehensive.

Go back to the main article: How to Register in PhilHealth Online: A Complete Guide for New Members