Friday, June 19, 2015

HEALTH INSURANCE COVERAGE AT 60? DEFINITELY!

THROUGH Republic Act 10645 which was signed by President Benigno S. Aquino III on November 5, 2014, all Filipinos 60 years old and above, regardless of their social or economic status, are now mandatorily covered by PhilHealth.

“We are very happy with this law since it will ensure that all senior citizens will be adequately protected,” PhilHealth President and CEO Alexander A. Padilla said.

Immediately, PhilHealth issued the guidelines to operationalize the new development through Circular No. 33, s. 2014 which was published in major newspapers on December 23, 2014. The Circular created a new member category referred to as “Senior Citizen” where elderly Filipinos with no existing coverage can be enrolled.

These include Filipinos, 60 years old and above who are not in any way enrolled with PhilHealth at any point in time; and members in the formal or informal economy who are 60 years old and above but do not have qualifying contributions to be entitled to the benefits.

However, senior citizens who have paid at least 120 monthly contributions with PhilHealth shall be enrolled as Lifetime Members. They are not qualified under the Senior Citizen category as they are already Lifetime Members.

Also, elderly citizens who are gainfully employed or have regular sources of income, shall continue to contribute to PhilHealth and will get coverage as members in the formal or informal economy. Upon ceasing to earn, they will be covered as Lifetime Member or Senior Citizen member if they are not able to accumulate at least 120 monthly contributions.

Similarly, senior citizens who are already covered as members identified through the National Household Targeting Systems for Poverty Reduction or Listahanan of the DSWD and those currently enrolled as Sponsored Members are not qualified under the Senior Citizen category since they are existing members.

To make enrolment easy for the senior citizens, PhilHealth Local Health Insurance Offices (PhilHealth –LHIO) have been coordinating with the Office for Senior Citizens Affairs (OSCA) of municipalities and cities. Instead of asking elderly Filipinos to go to the LHIO, their names can be submitted through the OSCA along with duly accomplished PhilHealth Member Registration Forms (PMRF). Subsequently, Member Data Records (MDRs) and IDs will be released by the LHIOs through the OSCA.

Senior citizens who prefer to file their applications directly at any LHIO nationwide are welcome. If in case they are not able to enroll before confinement, they are still entitled to avail themselves of the benefits. They only need to present their Senior Citizen ID to the hospital. Subsequent steps on how to have PhilHealth benefits automatically deducted from their hospitalization charges will then be provided by the health care institution.

“We are bringing into the National Health Insurance Program all the 7.6 Million senior citizens,” Padilla said, and called on the public to help spread the good news about this development. “We need everyone’s help so that we can fulfill our commitment where RA 10645 is concerned,” he said.

The annual premium contributions of the enrolled senior citizens shall be sourced from the proceeds of Republic Act 10351or the Sin Tax Reform Act. # Adapted News, PHILHEALTH

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