Philhealth and the Private Health Insurance Part One

The Philippines health care condition has improved in the last two decades but not as much compared to other Southeast-Asian countries. Factors such as climate change, high population density, rapid urbanization contributes to new infectious diseases, thus the demand for health insurance is rapidly increasing. The need for health care insurance is carried by both public and private institutions.

PhilHealth The government mandatory health insurance provider is the Philippine Health Insurance Corporation or PhilHealth. It is mandated to provide universal health insurance coverage and ensured affordable, acceptable, available, accessible, and quality health care services for all Filipinos. Philhealth has five different programs each has its own distinct conditions of access, benefits and financing. The private health care insurance company also provides similar program but the difference in the word affordability.

Employed Sector Program is a compulsory coverage of all employees in government and the private sector. Half of the amount of the monthly premium is shoulder by the employer. The amount could be as low as PHP 87.50 for employees with a PHP 7,000 base salary to as high as PHP 437 for those earning PHP 35,000. Also included are seafarers. Sponsored Program covers the extremely poor. Members are those indigents belonging to the lowest 25% of the population

Individually Paying Program voluntary coverage of the self-employed and others not covered by the rest of the programs. For those earning PHP 25,000 below PHP 450 per quarter or annual PHP 1,800. Above PHP 25,000, PHP 3,600 annual or PHP 900 quarterly Overseas Filipino Workers for land based Filipinos working outside the country and their dependents.

Lifetime Member Program free for members that have already completed their 120 monthly contributions. With PhilHealth, there is no additional premium on the members dependent and no limit on the number of dependants. Benefit coverage for inpatient provides subsidy for room, medicines, laboratories, operating room and professional fee for confinement. Outpatient covers consultation, diagnostic services, visual acuity examination, psychological evaluation, preventive and promotive health service and others.

Application can be done can also be done directly on their branch offices or via online enrollment. Payments can be made through banks and authorized payment center. In the next part, we will discuss the private health insurance sector and look at the difference in terms of affordability, acceptability, availability, accessibility, and quality.

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