Philhealth for Seaman — OFW or Employed?
What is the Philhealth category for a Seaman? OFW or Employed?
According to Philhealth, a SEAMAN is considered an EMPLOYED member. Hindi siya OFW sa Philhealth.
Philhealth says that all SEA-based OFWs are EMPLOYED members. This is because seamen receive their salaries through allotments facilitated by their maritime manning agencies based in the Philippines.
Dahil EMPLOYED ang category ng SEAMAN sa Philhealth, ibig sabihin ang eligibility niya for Philhealth benefits ay katulad sa eligibility ng mga Employed members na working in the Philippines.
For EMPLOYED members, they are eligible for Philhealth benefits if they have paid at least 3 monthly contributions within the 6-month period immediately prior to month of hospitalization.
Magbilang ka ng 6 months immediately before month of hospitalization. Sa six months na yan, meron ka bang nabayarang 3 months? Kung oo, eligible ka for Philhealth benefits.
Minsan, merong healthcare provider na nire-require nila ang 6 months or 9 months. Naninigurado sila. Call Philhealth Call Center 441-7442 and ask for help.
Prepare your Philhealth documents and submit to the hospital before discharge para hindi ka na magproblema sa pagfa-file after discharge. Bakit mo pahirapan pa ang sarili mo? Matagal ang processing ng reimbursement, sa dami ng nagfa-file sa Pilipinas. Suerte ka kung matanggap mo ang reimbursement mo within 2 or 3 months.
Documents to submit to the hospital:
1. Philhealth Claim Form 1 — filled-up, signed by you (Philhealth member) and your company
2. Member Data Form (MDR) — Get this from Philhealth
Kung ang naospital ay dependent at hindi pa nakasulat sa MDR ang kanyang pangalan, submit birth certificate (kung anak o magulang) o marriage certificate (kung asawa).
3. For Maternity Patients, submit official receipts of prenatal care (total is at least 1,500 pesos) to get reimbursement of up to 1,500 pesos. This is optional and this is only for normal delivery cases.
Pag nasa BAKASYON kayo or ON LEAVE WITHOUT PAY, at hindi babayaran ng company ninyo ang Philhealth premiums ninyo, pay your Philhealth premiums as Individually Paying members.
Philhealth for Seaman — Employed Category, Not OFW