In the absence of your Birth Certificate, you may submit a clear copy of any two valid IDs/documents instead to register as a Lifetime Member.
One is qualified to register as a Lifetime Member if he/she is already 60 years of age and has made at least 120 monthly contributions to PhilHealth and the previous Medicare. Hence, if you retired for instance, at the age of 50, you must continue paying premiums as an Individually Paying Member until you reach the age of 60 and have made the required number of premium contributions.
YES. As per PhilHealth Circular No. 28, s-2010, retiring employees in the government and private sectors must be enrolled into the Lifetime Member Program and their enrollment must be facilitated by their employers at least three (3) months prior to the date of retirement.
The application for Lifetime Member Program shall be filed with PhilHealth as soon as the employee's retirement application has been approved by the employer. The employer's Human Resource Management Office, through its authorized representative, shall ensure that the documentary requirements for registration are forwarded to PhilHealth for processing.
There is no need for you to personally submit your registration documents. Your representative is allowed to submit your documents to PhilHealth for processing as long as you have affixed your signature/thumbmark (whichever is applicable) on the registration form.
Your PhilHealth coverage as a Lifetime Member is non-transferable.
In case you are hospitalized and it is not easily possible for you to register as a Lifetime Member, yes, you have the option to be declared as a dependent of only one of your children to immediately avail of your benefits.
It is advised, however, that you still register as a Lifetime Member afterward if you have already paid at least 120 monthly premiums.
No. Your privilege as a senior citizen is a separate benefit and the 20% discount must first be deducted from your hospital bill prior to the application of PhilHealth benefits.
If your dependent gets hospitalized and he/she is not listed in your MDR yet, you may submit a clear copy of the following:
Overseas confinements of PhilHealth members, regardless of their membership category, and their dependents are still covered and shall be paid based on Level 3 Hospital benefit rates.
It refers to a confinement or series of confinements for the same illness with intervals of not more than 90 days. In such cases, members are not entitled to another set of benefits/allowances until after 90 days. They can only avail of the unused portion of their benefits, and their room and board allowance until their 45 days allowance in a year is exhausted. Each member is entitled to a maximum of 45 days for room and board allowance per calendar year and another 45 days to be shared by all of the dependents.
However, members can avail themselves of a new set of benefits if succeeding confinements are of different illnesses or conditions.
The following are allowed to sign the said form on your behalf:
|Member Status||Authorized person (in order of priority)|
|Member is married||Legal spouse|
|Child 18 years old and above in the absence of spouse|
|Parent (mother or father) in the absence of spouse and child|
|Member is single||Parent (mother or father)|
|Member is orphaned||Brother/sister/guardian|
|Other individuals as duly Authorized Representative|
Clearly state in the form the reason for signing on behalf of the member, or a certification (on a separate sheet of paper) may also may be issued to this effect, with the full name, complete address and contact number/s of the authorized signatory also indicated.
Provide a photocopy of the authorized signatory's identification card (ID) and/or proof establishing his/her relationship to the member.
Emergency cases as defined by PhilHealth shall be paid.
Claims of members confined in non-accredited hospitals shall not be compensated unless all of the following conditions are met:
Members are sent a benefit payment notice or BPN to report the actual payments made by PhilHealth relative to their confinement/availment. The BPN is sent to the address indicated by the member in their claim form.
Should there be discrepancies in the payments and the actual benefits deducted from your hospital and doctors' bills, you may present your BPN, your copy of the hospital's Statement of Account/Billing Statement, and Official Receipts to your health care provider.
All claims with complete and properly accomplished documents except those under investigation shall be processed and paid within 60 calendar days from receipt thereof.
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