THE Philippine Health Insurance Corporation (PhilHealth) today downplayed immediate plans to increase the premium contributions of its members, especially in the employed sector.
Dr. Eduardo P. Banzon, PhilHealth President and CEO assured members that in the next eight (8) months, PhilHealth will enhance both inpatient and outpatient benefits without any increase in premium. At the same time, Banzon reiterated his call for increased financial risk protection for the poorest of the poor through the new case rates and the 'no balance billing' or the 'walang dagdag bayad' policy which came with the new method of paying for health insurance benefits. "We will aggressively implement the 'no balance billing' or the 'walang dagdag bayad' policy for our Sponsored Program members in government hospitals, while ensuring that government hospitals comply with their responsibilities to provide all necessary drugs and diagnostics," he said. "We expect government hospitals not to send out our Sponsored Program members to purchase drugs and diagnostics outside the hospital."
Sponsored Program members include those whose enrolment into PhilHealth was made possible by either the local government units, or corporate or individual sponsors. Also included are families listed under the National Household Targetting System for Poverty Reduction (NHTS-PR) of the Department of Social Welfare and Development (DSWD).
"Sustaining the enhanced benefits in general and moving forward with Universal Health Care will eventually require an increase in premium, a move that is critical for attaining the goals of the UHC which is to provide financial protection against ill health and reducing household out-of-pocket health spending," Banzon emphasized. "While the sustainability of the benefits we provide under the National Health Insurance Program will definitely require an increase in premium rates, we are of course, taking into consideration several factors including economic challenges, as to when the premium shall be increased." he added.
At present, the monthly health insurance premium of a formal sector employee is pegged at 2.5 percent of the salary base of the range within which their basic monthly salary belongs. Only half of the required monthly premium is shouldered by the employee and is automatically deducted and withheld from their salary, while the other half is paid for by the employer. The amount ranges from P100.00 per month for those earning P4,999.99 and below, to P750.00 for those earning P30,000.00 and above.
On the other hand, individually paying members (IPMs) earning an average monthly income of P25,000 and below pay P300.00 quarterly while those earning above P25,000.00 pay P600.00 quarterly. Members of organized groups under the Kalusugang Sigurado sa PhilHealth Insurance (KaSAPI) pay their contributions through their organizations at P1,200.00 per year under flexible payment schemes.
Meanwhile, PhilHealth members under the Overseas Workers Program (OWP) continue to pay P900.00 per year. Since the transfer of the former Medicare program from the Overseas Workers Welfare Administration (OWWA) in 2005, these members have been availing themselves of the same inpatient and outpatient benefits that members from other categories are entitled to. Retirees and pensioners who have made at least 120 monthly contributions during their active years in service are qualified under the Lifetime Member Program where they are covered by PhilHealth for life without having to pay any premium.
The PhilHealth Chief also said that the PhilHealth fully recognizes its role in improving financial protection against ill-health and the need for all stakeholders, including hospitals and doctors, and members to change in order to improve financial protection. "The uncontrolled itemized fee-for-service payment system has to be changed to the more equitable case payment system. The enhanced benefits will not just improve financial protection but will facilitate changes for the better," Banzon said. (END)
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