7 Types of Philhealth Members

These are the 7 types of PHILHEALTH MEMBERS.

1.  EMPLOYED

or MEMBERS  in the FORMAL ECONOMY

These are employees. They have employers.

Included in this type are SEAMEN or SEA-BASED WORKERS.  They are not OFWs. Why?  Because their maritime companies or agencies are based in the Philippines.  Their  employers —  manning agencies or maritime companies — pay and remit premiums to Philhealth for their employed seafarers.

Also included here are household helpers.

How much is the monthly premium?  It ranges from 200 to 875 pesos a month, depending on the monthly salary.  The employee pays 1/2 and the employer pays the other half.

For the lowest  premium, which is 200 pesos,  the employee pays 100 pesos and the employer adds 100 pesos.  This is for employees earning less than 9,000 pesos per month.

For the biggest premium, the employee pays 437.50 and the employer adds 437.50.   This is for employees earning 35,000 pesos or more per month.

Eligibility for Philhealth benefits:  Member should have paid at least 3 months of the six months prior to treatment or hospitalization.  Current month is included in the 6-month count.

 

2.  INDIVIDUALLY PAYING, or SELF-EMPLOYED, or VOLUNTARY

or MEMBERS in the INFORMAL ECONOMY

These are voluntary members.  Can be self-employed, professionals, businesspeople, farmers, young retirees, etc.

Quarterly Premium:  600 pesos per quarter

Quarterly Premium for Professionals like Doctors, Lawyers, Dentists, Architects, Teachers, Engineers, Accountants, etc. or those earning 25,000 pesos or more a month):  900 pesos per quarter

Foreigners living or working in the Philippines can register as individually paying or self-employed.  They need to submit a copy of their Alien Certificate of Registration (ACR) issued by the Bureau of Immigration.

Eligibility for Philhealth benefit?  Before treatment or hospitalization, the member should have paid at least 3 months  of the 6 months prior to treatment or confinement.  The 6-month count includes the current month or the confinement month.

 

3.  OVERSEAS WORKERS or OFWS

These are OFWs who pass through the POEA and who pay their OEC fees whenever they leave the country for work abroad.

Annual premium:  2,400 pesos per year.

Eligibility for Philhealth benefit?  The date of hospitalization or treatment is within the Validity Dates written on the Philhealth payment receipt.

 

4.  SPONSORED

These are members whose Philhealth membership fees are paid by nonprofits, non-governmental organizations or other institutions. They are sponsored because they are serving the community or the organization or they are chosen for certain reasons.

Annual premium paid for by the sponsor?  2,400 pesos per year

Eligibility for Philhealth benefits:  The date of treatment or hospitalization is within the Validity Dates written on their Sponsored Health Card or Member Data Record.

 

5.  INDIGENT

These are members who have no source of income or whose incomes are not sufficient for family subsistence. They are identified by the Department of Social Welfare and Development through the National Household Targeting System for Poverty Reduction. It’s usually the mother who is enrolled as primary Philhealth member.

Eligibility for Philhealth coverage:  The date of treatment or hospitalization should be within the Validity Dates written on their Family Health Card or Member Data Record.

 

6.  LIFETIME

These are members who are 60 years old or older who have paid at least 120 premiums to Philhealth (Medicare included).

Annual premium:  NONE. ZERO. FREE.

Eligibility for Philhealth coverage:  Philhealth card

 

7.  SENIOR CITIZENS

These are members who are 60 years old or older and who are not members under any other membership type.

Annual premium?  NONE. ZERO. FREE.

Eligibility to Philhealth benefits:  Bring your Philhealth Lifetime ID Card, or Senior Citizen’s Card issued by the OSCA in the city or town where the member lives. There are hospitals that accept any government-issued ID that shows the member’s date of birth.

 

REMINDER:  INDIVIDUALLY PAYING or VOLUNTARY or SELF-EMPLOYED or INFORMAL SECTOR membership is the default membership.  What does this mean?

If you’re ON LEAVE WITHOUT PAY,  or you’re on vacation and you don’t have an Overseas Contract, or you’re on vacation as a SEAMAN for more than one month,  or you have lost your job, or you resigned from your company, pay your Philhealth premium as an Individually Paying or Voluntary member, so that your membership is continuous…so that you are covered in case you need treatment or hospitalization. 

  You will return to your status as OFW or Employed member after you return from your long leave or vacation or unemployment.

7 TYPES OF PHILHEALTH MEMBERS

Related Articles:

PHILHEALTH MEMBERSHIP FOR OFWS — DOCUMENTS REQUIRED

PHILHEALTH FOR SEAMAN — OFW OR EMPLOYED?

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