Change in PhilHealth contributions minimal

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Thursday, January 16, 2014


THERE's only minimal change to the premium contributions of the employed members of the Philippine Health Insurance Corporation (PHIC), as it remains at 2.5 percent of the employees' monthly salary.

PHIC-Davao Informal Economy Management Section head Germaine M. Tam, during the Orientation on Premium Contributions and All Case Rates at The Ritz Hotel at Garden Oases, said the only thing that increased is the salary bracket floor from P7,000 to P30,000 before to P8,000 to P35,000 now.

She said the increase in the salary bracket floor came after the minimum wages increased.

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"It (the contribution) remains at 2.5% based on their monthly salary," she said.

The premium contribution increase and the all case rates were implemented on January 1, 2014.

"Since 2012, the agency issued a circular informing the public of an increase. The public requested the increase to be gradual, so in 2013 the agency increased it by 50 percent and now it is fully increased to 100 percent by 2014," she said.

Tan said the agency did not increase the premium in 2012 due to the calamities that hit country, affecting many of its members. That is why, they implemented the partial increase in 2013, and then the full implementation this year.

Tan said those who are really affected by the increase are those who have big salaries since the salary bracket ceiling increased from P30,000 to P35,000. However, if computed, the deduction still stands at 2.5 percent. Individually paying members and Overseas Welfare Program (OWP) members are also affected by the change.

For the individually paying members, those who have an income of less than P25,000 were paying P100 a month before the increase, but now premiums stand at P200 a month. OWP members used to pay P600 semi-annually, now they are paying P1,200 semi-annually or P2400 per year.

The employed sector comprises about 60 percent of the total Davao Region members.

Aside from the orientation on the increase in premium contributions, PHIC-Davao also oriented the stakeholders of the new case-based payment scheme - the All Case Rates.

"Before, what we used was Fee for Service wherein we pay per expense like room and board, medicines, and laboratories and for a type of expense we have a maximum benefit members can receive like for example in room and board, if you are in a level 3 hospital, you have a maximum benefit of P500 per day," Tan said.

Before, payments can't be released immediately because an assessment on the type of illnesses, or which hospital the patient was confined, was required.

"It is not transparent because you as a member, you do not know how much money was to be released," Tan said.

She said they are able to give an exact amount to the patient using the latest All Case Rates scheme.

"With this, if the member says they have pneumonia, we are able to determine how much the benefit will be," Tan said.

She said another good thing about the All Case Rate is they will not base the reimbursement on the main diagnosis but the agency will now pay a maximum of two conditions with the most resources used.

In the old scheme, PhilHealth will only pay for the main diagnosis.

"For example, when main diagnosis is pneumonia but the expenses for the patient's diabetes or hypertension are larger, then we will pay for the larger one. The member will be able to feel the benefits better with the new scheme," Tan said.

Currently, PhilHealth covers 83 percent of the Davao region population, including its dependents. About 3.5 million are registered including beneficiaries and dependents.

PhilHealth collected P1.3 billion premium contributions as of November 2013. Tan said they are anticipating a 10 percent increase in collection revenues for 2014.

Published in the Sun.Star Davao newspaper on January 17, 2014.

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