Senior citizens automatic members of PhilHealth

File photo
File photo

AGING has its perks.

The Philippine Health Insurance Corp. (PhilHealth) reminds senior citizens that they are mandatorily covered by the state health insurer and that some of them don’t even need to pay any premiums for this coverage.

In a statement, PhilHealth said Filipino citizens residing in the Philippines who are 60 years old and above are covered under the National Health Insurance Program as indicated under Republic Act (RA) 10645 and RA 11223 or the Universal Health Care Act of 2019.

Section 5 of Republic Act 10645 tasks the National Government with funding the annual premium contributions of the senior citizens from the proceeds of RA 10351, more popularly known as the Sin Tax Law, if the senior citizens are not currently covered by any existing membership category of PhilHealth and if they have no regular source of income.

The Sin Tax Law, passed in 2012, provides for incremental revenues from the excise tax on alcohol and tobacco products to be allocated for universal health care under the National Health Insurance Program, and for medical assistance and health enhancement facilities.

To facilitate the registration or updating of senior citizens’ records, PhilHealth said it had partnered with the various local government units’ Office for Senior Citizen Affairs (Osca) to receive two copies of the accomplished PhilHealth Member Registration Form (PMRF) of qualified senior citizens.

After submission, all the senior citizens would have to do is wait to be notified by the Osca that PhilHealth has already sent their Member Data Record and identification card.

Those who choose to register at PhilHealth’s local offices, however, would have to submit a copy of their senior citizen’s identification card or any proof of age with a 1x1 photo taken in the last six months in addition to two copies of the accomplished PMRF.

As of June 2021, PhilHealth had 8.4 million senior citizen members and 1.3 million lifetime members with a combined 3.3 million qualified dependents.

In just the first six months of this year, PhilHealth paid P9.4 billion in benefits for 988,000 claims filed by senior citizens in the country, it added.

Among the top conditions for which PhilHealth paid out the benefits were community-acquired pneumonia, stroke, hypertension, urinary tract infection and congestive heart failure.

Lifetime members are senior citizens who have paid at least 120 monthly contributions with PhilHealth and the former Medicare Programs of the Social Security System (SSS) and the Government Service Insurance System (GSIS); uniformed personnel at least 56 years old or SSS underground miner-retirees at least 55 years old who have paid at least 120 monthly contributions with PhilHealth and the former Medicare Programs of SSS and GSIS; and SSS and GSIS pensioners before March 4, 1995.

Availment of benefits by senior citizens is easy.

If the hospital has an installed HCI Portal, senior citizens need only to present their senior citizen card, Member Data Record or any accepted proof of identity and age, the state insurer said.

If the hospital does not have the portal, or the senior citizen failed to enroll with PhilHealth before his discharge from the hospital, he may simply accomplish the PhilHealth Member Registration Form and attach proof of his status as a senior citizen with his claim documents.

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