Wednesday, July 3, 2013

My Philhealth 101

I'm sharing this information so if anyone in the future have the same situation as mine, you'll know what to do.

Photo Credit: http://kalusugan.ph/listahan-ng-mga-benepisyo-ng-philhealth/
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First Scenario: This is all based on our experience last February 2012 when my father was hospitalized. All of us were caught off guard. My mother thought it was a common case of flu due to the weather changes but it led to a more frightening ailment - heart attack/stroke (almost).

From emergency room, he was transferred to ICU due to his low blood and to monitor his heartbeat as well and his breathing. My father had a history of heart palpitation before due to his smoking so we were not surprise when he was brought to the ICU.

During this time, we decided to use Philhealth to minimize the cost that we have to pay. I made a few calls to their call center to check the status of my father's account. Though he is a member, the account is inactive so he can't use the benefits. And here's what I learned from going back and forth with Philhealth on how to avail the Philhealth benefits for inactive members.

* If the member is inactive, he is still a member of Philhealth. Inactive means that a person has an existing PIN # but contribution is not updated and according to Philhealth, you cannot enroll as a dependent those who are inactive member. Either you have to cancel the membership or update the contribution. By the way, we stated on the letter the reason why we are cancelling the Philhealth membership and that is to enroll my father as a dependent.

* For senior citizens who are inactive member, you need to create a letter address to Philhealth to cancel or terminate your membership. You can do this for urgent matters such as our case. Once, the membership is deactivated, any son/daughter of the SC (senior citizen) can add him/her as dependent. Yup, 60 years old and above can be declared as dependent on Philhealth. You need to sign M2 form then attach the active Philhealth member's birth certificate, photocopy of valid IDs, dependent's birth certificate and Senior Citizen ID (photocopy). Now if there are instances that there's a discrepancy with the name of the soon-to-be -enroll dependent, you will need to create a notarized letter or document stating that the person that your enrolling as dependent and the one whose name appeared on birth certificate or any government ID is the same person. Any notarized office has a template for this type of document so just ask them about it. I think I paid Php50-100 for this letter.

On this crucial moment, I decided to declare my father as my dependent since my office can process my request through sending an errand to a messenger. No need for me to process it by myself. Within the day, I got my updated MDR from Philhealth and I'm glad. Who would've thought that it can be easy peasy. But I was wrong....

I was busy preparing the supporting documents to avail the Philhealth benefits and that includes getting a signed form from HR regarding my Philheath contributions. As it turns out, my contribution is not enough or eligible for me to use Philhealth for my father's hospitalization during that time since I'm still a probationary employee and the fact that my Philhealth contribution is not updated. Our HR said that I need at least 6 months contribution and during this time I only have 3 months of contribution as it was stopped when I got laid off. Since we are aiming to cut down the cost of the hospital bills, I remembered my sister paying her Philhealth contribution for one year as an OFW when she went to POEA. Time is crunching so I have to create another letter to Philhealth requesting to remove my father as my dependent and instead he will be my sister's dependent. I don't remember how long it took for my father's name to reflect on my sister's Philhealth record but it didn't take one week. I'd say 2-3 days as we made it just on time before my father was given a go signal to go home. It was a relief on our part that we were able to avail Philhealth since my father doesn't have a medical card (HMO).

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Second Scenario: A couple of months back, I resigned as a full-time employee in a corporate environment. Having my lesson learned from the past year on my father's case, I was determined to continue my Philhealth contribution as a voluntary member. I called up Philhealth's hotline to inquire about the process of changing my status from employee to voluntary. She gave the ff. as requirements:
- Accomplished Philhealth Membership Registration Form (PMRF)
- Photocopy of my birth certificate
- Photocopy of marriage certificate if married
- Photocopy of your dependent's birth certificate. In this case, I declared my father since his already 63 years old.

The requirements above will be used to update my information on Philhealth's database. Then I was told to secure myself a copy of Philhealth Premium Payment Slip which is downloadable from their website and a certification from my previous employer with regards to my Philhealth Contribution while I was under their employment. After hearing this I hurriedly requested for one from the company creating a request letter and my reason that I need it to continue my contribution in Philhealth as a voluntary member. Once I have the certification of Philhealth Contribution, signed PMRF and supporting documents, I went to Philhealth.

First step is I need to update my status to voluntary then I can pay my contributions. My first attempt to do this was two weeks ago but end up going home instead due to the long queue and the fact that I can only update my information but cannot pay the premium. I went back last June 30 (talk about last minute cramming) and arrived at their Philhealth's Makati branch at 1pm. Though I have the downloaded payment slip form, they have another slip which you can get inside the branch so I signed one just to be safe. As expected, there were a lot of people in the queue. Good thing at around 2pm or 2:30pm, a security guard started calling out those people who will be voluntary members and will be paying the premium at the same time to expedite the process. He collected the forms and docs and presented it to one of the Philhealth staff. Once the record has been updated, we are given our own Philhealth ID cards and redirected to the cashier. We just have to wait for our names to be called. Once your name is called on the cashier, you just have to present the signed payment slip form. On the form you will need to declare the coverage of your contribution, your name, Philhealth number and total amount of payment. For Philhealth coverage, it's by quarter payment and since my April contribution is paid, I declared May to June then added July to September. Philhealth payment contribution per month is now Php 150. I also presented my Certificate of Philhealth Contribution from my employer as proof of my updated contribution. I have to make a photocopy of this certificate since Philhealth wanted to secure a copy of their own. After the payment and getting my receipt, I'm done and was out by 3:15pm. Whew!

Tip: Call Philhealth's hotline (02) 441-7442 to inquire about the requirements needed and ask the process/ procedure so once you go to any Philhealth's office, you won't have trouble making a transaction and your time and effort is not put to waste. In all honesty, this hotline was very helpful for me.
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