New rules issued on mandatory PhilHealth enrollment of Pinoys

MANILA, Philippines - The Philippine Health Insurance Corp. (PhilHealth) has come up with the implementing rules and regulations (IRR) of amended Republic Act 7875, which provides for mandatory PhilHealth enrollment of all Filipinos.

Known as the National Health Insurance Act of 2013, the law mandates Philhealth membership in all province, cities and municipalities, “notwithstanding the existence of local government unit (LGU)-based health insurance programs.”

The IRR, which The STAR published yesterday, states that Philhealth, Department of Health (DOH), LGUs and other government and non-government agencies “shall ensure that members shall have access to quality and cost-effective health care services.”

Philhealth also requires all employers to register their household helpers and their dependents. The helpers must be reported to Philhealth within 30 days upon employment.

“Employers of household-helpers who have registered with the Social Security System prior to July 1, 1999 are considered automatically registered. They shall be required to update their records with the corporation,” the IRR stated.

The amended law also provides protection to unmarried parents who are minors. It stipulates that “any person below 21 years of age, married or unmarried, but with a child, shall be enrolled as a member” of Philhealth.

The IRR also stated that all indigent individuals identified by the Department of Social Welfare and Development (DSWD) through its National Housing Targeting System shall be fully subsidized by the national government.

The funds needed for the program would be included in the annual budget of the DOH.

The IRR also states that lifetime membership may be provided to any person who has reached the retirement age and has paid at least 120 monthly contributions.

“A lifetime member who obtains a regular source of income from employment, practice of profession, and other means shall resume paying the required monthly premium contribution until finally ceasing to earn, provided that said income is above the poverty threshold,” the IRR stated.

The IRR said DSWD-identified indigents would not be charged any fee in government health care facilities under Philhealth’s “no balance billing” program.