State health insurer explains COVID-19 coverage, issues circular on contributions
Highlights
Dubai: Under Philippine law, every Filipino expatriate worker must pay a 3% monthly premium to the Philippine Health Insurance Corporation (PhilHealth) this 2020.
The increase in PhilHealth premiums covers all overseas Filipinos, including their dependents. It was rolled out late last year.
On April 22, the state-owned health insurer published a circular explaining the tiered contributions and collection of payment from overseas Filipino members.
All overseas Filipinos working or residing overseas, including those who are on holiday or waiting for their overseas work documents, whether they are unregistered or registered with the National Health Insurance Program (NHIP).
PhilHealth stated that circular clarifies details of the law that provides for the collection of PhilHlealth premiums from Overseas Filipinos.
By law, it means Overseas Filipinos (OFs) and their dependents:
It's a tiered payment computation, which gradually increases each year from 2019 to 2025 — 2.5% in 2019, 3% in 2020, 3.5% in 20201, 4% in 2022, 4.5% in 2023, 5% in 2024 and 2025.
Universal Health Care (UHC) Law (RA 11223)
On February 20, 2019, the Universal Health Care (UHC) Bill was signed into law (Republic Act No. 11223) by President Rodrigo Duterte. It automatically lists all Filipino citizens in the National Health Insurance Programme (NHIP).
The law provides a minimum (floor) income of Php10,000 and a maximum income of Php60,000 this 2020. If your salary is Php60,000 or above, you are mandated by law to pay Php1,800 ($36) per month or Php21,600 this year ($434.23).
By 2021, the minimum stays the same, but the ceiling increases to Php70,000. It gradually increases by P10,000 each per year till the maximum of Php100,000 is reached by 2024/25.
This means that if your monthly salary is >Php60,000 (Dh4,430) per month, your monthly premium will be computed only against the Php60,000 ceiling — Php1,800 per month, or Php21,600 per year.
Php600 ($12, or Dh44.30) per month x 12 = Php7,200 ($145/Dh531.65) per year.
By 2021, the maximum amount against which the premium is computed will be Php70,000. Then it goes up Php80,000 in 2022, Php90,000 in 2023 and Ph100,000 in 2024/25.
That means by 2024, an OFW who earns Php100,000 (about $2,000) must pay a monthly PhilHealth premium of Php5,000 ($100) or Php60,000 ($1,200) per year.
2.3 million Overseas Filipino workers
The number of Overseas Filipino Workers (OFWs) who worked abroad at anytime during the period April to September 2018 was estimated at 2.3 million. Overseas Contract Workers (OCWs) with existing work contract comprised 96.2 percent of the total OFWs during the period April to September 2018.The rest (3.8%) worked overseas without contract (Table 1). There were more females than males among the OFWs, with the female OFWs comprising 55.8 percent of the total. Female OFWs were generally younger than male OFWs, with about half (47.5%) of the female OFWs belonging to the age group 25 to 34 years. In comparison, male OFWs in this age group made up 38.9 percent. Male OFWs aged 45 years and older accounted for 21.2 percent of all male OFWs while their female counterparts in this age group made up 14.5 percent. [Philippine Statistics Authority https://bit.ly/3fhOlsr]
It's a rule that sets the maximum amount that the state insurer will pay for the treatment of a patient for a certain ailment.
In case a patient falls ill, hospital charges over and above that amount stipulated in the case rate package must be borned by the patient out of pocket — or through a personal health insurance.
Yes. PhilHealth currently pays all the hospitalization and treatment costs incurred by patients who contracted SARS-CoV-2, the virus that causes the acute respiratory disease.
Philippine President Rodrigo Duterte has declared PhilHealth benefits for COVID-19 cases would cover medical expenses ranging from P8,150 for testing to P786,834 for critical cases of pneumonia.
Duterte also stated that the coverage of the benefit packages both for COVID-19-related pneumonia and community isolation will undergo a 30-day review to adjust the rates.
PhilHealth coverage for COVID-19 patients is arranged into four categories, depending on the severity of condition.
Coverage will be based on the following:
PhilHealth president and CEO Ricardo Morales explained that the package was so designed since pneumonia was a serious complication brought about by COVID-19.
It was enforced on April 15. It also means that PhilHealth will still cover all costs incurred by patients hospitalised prior to that date.
In April, PhilHealth has announce a P30 billion allocation for hospital reimbursements covering COVID-19 patients, for which P6 billion had already been disbursed, Morales said.
He assured hospitals that PhilHealth was already coordinating with the banks to expedite fund releases. The Philippine Charity Sweepstakes Office last month stated that it would transfer about P420.6 million to PhilHealth to cover its COVID-19-related packages.
Send your questions re: PhilHealth to readers@gulfnews.com.
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