PhilHealth Palawan starts new rule on benefit eligibility

(File photo)


The Philippine Health Insurance Corporation (PHIC or PhilHealth) in Palawan will start implementing the nine-month contribution rule this January before members can avail of benefits.

PhilHealth provincial spokesperson Marianne Carlos said Thursday in a Philippine Information Agency (PIA)-hosted Kapihan that failure to meet the policy on sufficient regularity of payment (SRP) will mean a member cannot avail of their benefits regardless of the number of years he or she has paid contributions.

“Nag-take effect na din po yung nine months na contribution within 12 months prior po ‘yong month na i-avail nila. So ibig sabihin po noon lahat ng old members ni PhilHealth dapat meron na tayong nine months contribution bago maka-avail. Kapag kulang ang contribution, hindi siya makaka-avail ng benefits regardless kung ilang taon na siyang nakapaghulog,” Carlos pointed out.

(The nine-month contribution rule within 12 months prior to the month they can avail of benefits. This means all old members of PhilHealth should have paid nine months of contribution before they can avail of the benefits regardless of how many years they have contributed.)

She said the policy can now be implemented because PhilHealth is now connected to accredited hospitals. The system will prompt them if a member has met all the requirements or otherwise.

She said they have deployed personnel in “PhilHealth Cares” desks in hospitals and clinics to assist the members in checking their qualifications and processing their applications.

Carlos added a patient may be denied benefits if the details in his or her member’s data have errors.

The PhilHealth encourages members to regularly update their records.

“Talaga pong ini-encourage natin si members na dapat mag-update palagi kung ano man po ang mga pagbabago sa kanilang record… sabihin natin na mga minor problem pero ‘yon po ang nagiging dahilan kung kaya nagkakaroon sila ng problem,” Carlos said.

(We are really encouraging members to regularly update their data for anything that will change in their status… they may be minor but they can cause problems.)

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