For individual paying members of Philhealth, rate will increase from P100 to P200 effective July 1, 2012. To easily save, you can still pay until June 30, 2012 at the rate of P100 per month. For bigger savings, you can pay at P100 per month until Dec. 31, 2013 (which will be treated as advance payment).
PHILHEALTH CIRCULAR
No. 0202012
SUBJECT :Implementation of the New Premium Contributions and
Requirement of Policy Contracts for the Individually Paying
Program (H'P)
I.RATIONALE AND OBJECTIVES
In response to the thrust of the Aquino Administration for Knltisugtwg Ptmgkalahatan
(KP) to provide universal health care to all Filipinos and in line with the attainment of
the 2015 health targets under the Millenium Development Goals (MDGs), the Philippine
Health Insurance Corporation (PhilHealrh) shall provide enhanced benefits to improve
financial risk protection of its members. Further, PhilHealth shall also provide all
Filipinos with Primary Care Benefit (PCB) Package and an option to avail of the No
Balance Billing (NBB) policy on health care services.
To efficiently implement product improvements and sustain the provision of National
Health Insurance Program (NHIP) benefit packages, increasing investment in health
care through the adjustment of current premium contribution rates for all members is
essential. Thus, through PhilHealth Board Resolution No. 1571, series of 2011, the
PhilHealth Board and Management approved the increase in premium contributions of
those enrolled or to be enrolled under the Individually Paying Program to Two
Thousand Four Hundred Pesos (PhP 2,400) per year effective July t, 2012.
Further, to ensure continuous coverage of members in the Informal Sector, PhilHealth
shall issue a policy contract which provides financial risk protection to the members and
their dependents.
II.COVERAGE
This Circular covers those enrolled or to be enrolled under the Individually-paying
Program (IPP) of PhilHealth such as the following:
a.Self-employed individuals - those who work for themselves and are therefore
both the employer and employee.
b.Separated from employment - those who have been previously employed (with
employer-employee relationship) and are currently without means of income.
c.Employees of international organizations and foreign governments based in the
Philippines who have no prior agreement with PhilHealth for the coverage of
their Filipino employees.
d.Unemployed individuals who are not qualified as indigents.
e.All other individuals not covered under the previous categories mentioned,
including but not limited to the following:
i. Parents who are not qualified as legal dependents, indigents or
retirees/ pensioners;
ii. Retirees who did not meet the minimum of 120 monthly premium
contributions to qualify as non-paying members; and
iii. Children who are not qualified as legal dependents
f.Organized Groups - such as the following:
i. i^isting members under the KaSAPI Program and Group Enrollment
schemes of PhilHealth
ii. Members under the new iGroup Program
III. IMPLEMENTING GUIDELINES
To ensure the proper implementation of the new premium rates for the Individually-
Paying Program, the following guidelines shall be applied:
1. For Individually-Paying Members (IPMs)
a.The annual premium contribution for IPMs earning an average gross monthly
income of Twenty Five Thousand Pesos (PhP 25,000) and below shall be One
Thousand Two Hundred Pesos (PhP 1,200), if paid before July 1, 2012. If paid on
or after July 1, 2012, the annual premium contribution shall be Two Thousand
Four Hundred Pesos (PhP 2,400) per year.
b.IPMs including Self-employed Professionals earning an average gross monthly
income above PhP 25,000.00 shall continue to pay their annual premium
contribution of Three Thousand Six Hundred Pesos (PhP 3,600.00) per year
beginning CY 2012, as provided in PhilHealth Circular No. 24 and Office Order
No. 65, series of 2010.
Those would like to avail the current annual premium rate of One Thousand
Two Hundred Pesos (PhP 1,200), shall be required to perform the following for
the period May 1 to June 30, 2012:
i. Sign an Individually Policy Contract (IPC) with PhilHealth for a lock-in
period of two years; and
ii. Pay in advance the first year premium requirement equivalent to One
Thousand Two Hundred Pesos (PhP 1,200) with the balance to be settled on
a quarterly, semi-armual or annual basis as agreed in the IPC.
d.IPMs who have made advance payments prior to said date shall not be required
to sign a Policy Contract until their next payment.
e.All Contracts shall be effective on the date of initial payment.
f.The separate Circular with implementing guidelines for the issuance of the I PCs
shall be released.
2. For Organized Groups (OGs)
a.Premium rates for OG members enrolled starting July 1, 2012 shall be Two
Thousand Four Hundred Pesos (PhP 2,400) per year.
b.OGs who would like to avail the current annual premium rate of PhP 1,200 per
year shall be required to perform the following for the period May 1 to June 30,
2012:
i. Sign a Memorandum of Agreement (MOA) and Group Policy Contract
(GPC) with PhilHealth with a lock-in period of two years; and
ii. Pay in advance the first year premium requirement equivalent to One
Thousand Two Hundred Pesos (PhP 1,200) for each enrollee with the
the GPC.
done by the OG and shall be remitted directly to the nearest LHIO. The OG shall
periodically inform its members about the remittance of their premiums to
PhilTT, alth.
d.Premium incentives for OGs shall be based on the attached iGroup Premium
Schedule.
e.The Circular and Office Order for the implementation of the iGroup Program
and issuance of GPCs shall be released separately.IV. EFFECTIVITY
This Circular shall take effect immediately after due publication in any newspaper of
general circulation and deposited with the National Administrative Register at the
University of the Philippines Law Center.
All issuances that are inconsistent with the provisions of this Circular are deemed
superseded.
http://www.philhealth.gov.ph/circulars/2012/circ20_2012.pdf
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