PhilHealth to implement 9-month contribution rule to avail of benefits

ZAMBOANGA CITY -- The Philippine Health Insurance Corp. (PhilHealth) has announced that the sufficient regularity of payment (SRP) rule will be required for all benefit availments, effective October 1.

Philip Cataylo, assistant information officer of PhilHealth 9 (Zamboanga Peninsula), said Friday the SRP rule is contained in PhilHealth Circular No. 2017-0021, which states that “to establish sufficient regularity payment, members should have paid six months contribution preceding the three months qualifying contributions within the 12-month period prior to the first day of confinement.”

“In effect, to be eligible to PhilHealth benefits, a member should have paid at least nine months’ worth of premiums in the 12 months preceding the confinements, including the confinement month of the patient,” Cataylo quoted the circular.

Previously, he said a member can already avail of the benefits with only three months of contribution within a six-month period.
Cataylo said the circular also aims to ensure that PhilHealth members are diligently paying their monthly premiums.

“Effective October 1, 2018, it is already required for a member to have nine months premium contribution to avail of the PhilHealth benefit. Mahirap kasi, naaalala lang ang PhilHealth kung nagkakasakit at saka magbabayad ng contribution (Members tend to remember PhilHealth only when they are sick, and only then would they pay their contribution),” he added.

PhilHealth members, both in the formal and informal sectors, are covered by the new circular.

The formal sector members are those working in private and government institutions while the informal sector members consist of those self-employed, such as vendors, actors, physicians, lawyers, and others.

There are 2.2 million PhilHealth members here in the Zamboanga Peninsula, 609,474 of whom are from this city. (PNA)