Philhealth Requires Nine Months of Prior Payments

November 4, 2010 · Filed Under philhealth 

Update as of August 19, 2011: Hindi natuloy ang implementation nito last July 1, 2011. Pinag-iisipan pa.  Kaya puede pa yong dating 3 months of payment within the prior 6-month period. Yong maternity cases and certain other medical cases na dati nang 9-month-within-the-prior-12-month period, ito ang mga 9-month requirement pa rin.

Starting July 1, 2011, the required number of monthly Philhealth payments prior to month of hospital admission or treatment has been increased from THREE months to NINE months.

This means that you should have PAID NINE monthly Philhealth premiums within the 12-month period immediately prior to your month of hospitalization or treatment.

For example, a person named Jose is hospitalized on July 10, 2011. For him to avail of Philhealth benefits, he should have PAID NINE Philhealth monthly contributions within the 12-month period from July 2010 to June 2011.

The nine-month requirement is for all types of members except those under the Overseas Workers Program, Sponsored Program, and Non-Paying Lifetime Program.

This info is based on Philhealth Circular No. 25, s. 2010,signed by Philhealth President and CEO, Dr. Rey B. Aquino on September 8,2010, as published on philhealth.gov.ph.

What’s the meaning of this Philhealth circular for us?

We can’t afford missing our monthly Philhealth payments for longer than three consecutive months within a 12-month period. Why take the risk? Let’s pay the premiums monthly.

Related Articles:

No Philhealth Payments Prior, No Philhealth Benefits

Philhealth Branches — Membership Reactivation

Philhealth Branches in South Metro, Laguna, Cavite, Batangas, Lucena

 

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41 Responses to “Philhealth Requires Nine Months of Prior Payments”

  1. EDISA JANE FRANCISCO on November 16th, 2010 7:53 pm

    ask ko lang kung active pa yung account ko? kasi i opened it last february 2009,tapos Php1100 lang laman ng account ko,i nahiya na ako bumalik kasi nagkasakit ako at matagal bago nagka pera kaya nahiya na akong mag tanung sa office ng BDO? accessible pa po ba yun?

  2. Nors on November 16th, 2010 9:41 pm

    Hi, Edisa, (sana sa under ng article on BDO ito) Anyway, yong BDO account mo ba ay savings account? If it’s a savings account na ATM or passbook, palagay ko naubos na yong laman, kasi 200 pesos per month ang BDO charge for less-than-maintaining balance. At baka closed na rin ang account kasi wala nang laman for a long time. 2k ang maintaining for savings ATM, 5k for passbook. Pero, kung BDO cash card, dapat andon pa yong 1100, kasi walang maintaining bal ang cash card. Kung payroll ATM, may possibility na andon pa pera mo kasi hindi required ang maintaining bal sa payroll accounts, lalo na kung active depositor pa yong employer mo. Wala ba sa iyo ang ATM mo, para ma-inquire sa ATM machine?

  3. Top 10 Illnesses in the Philippines, Based on Philhealth Claims | Working Pinoy on May 28th, 2011 4:31 pm

    [...] Articles: Philhealth Requires Nine Months of Prior Payments Late Philhealth Payments — Can I Make Retroactive Payments? Philhealth Branches — Membership [...]

  4. kimberly cariño on August 16th, 2011 2:42 pm

    ask ko lng po panu po pag naemployed aq ng june so june plng po aq ngkaroon ng philhealth eh pregnant aq so mga december aq mgdedeliver ng baby..eh sabi sa circular dapat 9 months eh panu yun di ko ba magagamit philhealth ko di ba pwedeng bayaran ko yung ntitirang months paera maging 9 months..thanks
    looking forward for your reply

  5. Nors on August 16th, 2011 4:16 pm

    Hi Kimberly, June to Nov is 6 months lang, kaya kulang. So sad, pero ayaw tanggapin ng Philhealth ang payment for past quarters. Anyway, for future health needs na lang yong Philhealth mo. Pero magtanong ka pa rin sa iba, para doubly sure. Best regards.

  6. Makie Mendoz on August 30th, 2011 3:30 am

    Ask ko lang po, I became a Philhealth Individually Paying Member last 29th July 2011 and I paid up PHP900.00 as my premium, cover na po ba ako just in case ma hospitalize ako? or do I have to wait for 6 months to be covered? Hindi ko po kasi gaanong maintindihan yun isa sa requirement ng Philhealth “Payment of at least 3 months premium within 6 months prior to confinement” Thank you!

  7. Nors on August 30th, 2011 4:12 am

    Hi Mackie, anong mga months ang pinabayad sa iyo? July 2011 to Mar 2012 or May 2011 to Dec 2011? Nakalagay sa receipt. Ang pagbilang ganito: Count 6 months pabalik from month of hospitalization. Halimbawa, Sept naospital. Ang 6 months pabalik ay Aug July June May April Mar. Meron ka bang 3 months na nabayaran diyan? Magkakasunod o may laktaw, basta may 3 months, okay. Pero sa certain illnesses lang ito, maternity at certain surgeries, 9 months within 12 months. May order nga last year na 9 months na lahat, na-hold lang. Puedeng mag-comment ka uli kung anong months ang pinabayaran sa iyo, para malaman ko rin kung hindi sila fixed sa Jan-March o Apr-June o July-Sep, Oct-Dec na quarters, at makatulong tayo sa pagsagot, and thanks.

  8. Makie Mendoza on September 1st, 2011 1:14 am

    ito po na receipt ko Premium-vol/self-employed for July 1 2011-Mar. 31 2012- 900.00
    so bale nabayaran ko po yun 9 months.until March 2012. Gusto ko lang po malaman kung sakaling nahospitalized ako, example na hospitalized ako ng Sept.1 2011. cover na po ba ako? or I have to wait for 6 months pa(Dec 2011). Thanks!

  9. Makie Mendoza on September 1st, 2011 1:16 am

    by the way male po ako. Mother ko po yun dependent ko

  10. Nors on September 1st, 2011 8:24 am

    Hi Makie, pag naospital ka this Sep, hindi ka pa covered, kasi 2 months (July August) pa lang yong nabayaran mo before Sep. Hindi binibilang yong advanced payments. Pag naospital ka Oct, Nov, Dec… covered ka na kasi meron ka nang 3 months before Oct, Nov, Dec, huwag lang yong mga special surgeries na kelangan ang 9 months. Sori I misspelled your name. Best regards.

  11. Makie Mendoza on September 3rd, 2011 6:10 am

    Thanx for your help, at least malinaw na po yun mga tanung ko.

  12. ipang on September 11th, 2011 4:58 pm

    ask lang po., confine ako sept 2011.. pwede ba ang contribution feb march apr may jul aug 2011.. miss ko ang june 2011? valid pa rin po ba

  13. RJ on September 16th, 2011 12:41 am

    Ask lng po ako, hindi po nabayaran ang philhealth ng mom ko for the previous quarters this year and I planned to pay for.Pwede pa po ba yun?And if pwede, how many days bago xa maconfine if magkasakit xa?Thank you po.

  14. Naya on September 16th, 2011 11:56 am

    Yes, RJ, this month of September, ang puede mong bayarang months na nakalipas na are July Aug Sep. Puede ding dagdagan at magbayad in advance. Sa maraming sakit, 3 months prior payments before month of hospitalization ang kelangan. Pag maternity and certain other surgeries and treatments, 9 prior months ang kelangan.

  15. Nors on September 19th, 2011 7:07 am

    Hi RJ, puede mong ituloy na bayaran ang Philhealth ng mom mo. This month of Sep, puede mong bayaran ang July August Sept (300 pesos). Puede nang isabay ang 4th quarter of Oct-Nov-Dec (300 pesos). Dalhin mo ang previous receipt para makuha mo yong Philhealth number. Dapat merong 3 months of payments bago hospitalization para makakuha ng benefit. For certain surgeries and maternity care, 9 months of prior payments ang kelangan.

  16. Lerma on September 23rd, 2011 1:26 pm

    Gud pm po,malapit na po ako manganak cguro po last week ng sept.delivery ko,ask ko lang po kung pwde na ako maka avail ng discount gamit ang philhealth ng husband ko,last sept 21 2011 lang po sya nag member ng philhealt,300 pa lang po nabayaran nya..ano po pwDE gawin para maka avail po ng maternity benefits?may chance pa po ba na magamit ko ang philhealth sa aking panganganak?

  17. Lerma on September 23rd, 2011 1:48 pm

    Gud pm po,ask ko lang po kung pwde pa ako maka avail ng maternity benefits,new philhealth member lang po husband ko at 300 pa lang nabyaran nya,.pwde po ba bayaran ng advance ang contribution para maging 9months or 1 yr. ang contribution sa philhealth,malapit na po ako manganak,last week of sept..reply asap,salamat po

  18. Nors on September 23rd, 2011 2:58 pm

    Hi Lerma, sad to say, 9 months before month of panganganak ang kelangan pag Individually Paying o Voluntary Member. Kahit nabayaran niya ang July August, 2 months lang ito. Puedeng advance ang pagbayad, pero hindi puede yong lumipas nang matagal na quarters. Kung employed siya, magtanong na lang siya sa HR nila.

  19. madelyn on October 5th, 2011 7:20 pm

    gud pm mam ask ko lang po sa scenario ko, bayad po ako sa philhealth hanggang april 2011 3years na po akong member, unfortunately natangal ako sa work by april 2011 kaya di ko nabayaran and di ko naman alam na nine months prior, buntis ako and due ako this october 2011, puede kaya ako maka avail nung maternity? thanks po

  20. Nors on October 6th, 2011 2:11 am

    Hi Madelyn, I suggest punta ka agad today sa Philhealth, baka puede mo pang mabayaran yong July Aug Sep. Kung tatanggapin nila, okay ka na, eligible ka na, kasi meron kang 9 months within the 12-month period prior to delivery — Nov Dec Jan Feb Mar Apr Jul Aug Sep. Sabihin mo 3 years ka nang continuous na nagbabayad. Puedeng mag-comment ka rito later on kung nakabayad ka ng Jul Aug Sep? Best regards.

  21. Grace on January 26th, 2012 9:13 pm

    This means that you should have PAID NINE monthly Philhealth premiums within the 12-month period immediately prior to your month of hospitalization or treatment. – REQUIRED PO BA NA 9 CONSECUTIVE MONTHS ANG NABAYARAN OR A TOTAL OF 9 MONTHS PRIOR TO AVAILMENT? kasi in my mom’s case, she missed the 2nd quarter eh. magagamit na ba nya this January ang Philhealth nya for hemodialysis or hindi pa? thanks po.

  22. Nors on January 26th, 2012 9:45 pm

    Hi Grace, yon nga ang problem, kasi yong mga ibang health care providers, hindi nila alam lahat ng rules, naninigurado sila. Hindi kelangang consecutive, basta yong 9 months na yon nasa loob ng prior 12-month period. Tama yong natanungan mo sa Philhealth na kung this month of January ang treatment, the prior 12-month is Jan to Dec 2011, and since paid yong 3 quarters, meron kayong 9 months. Hanapin ko yong circular sa Philhealth, yong merong illustration, at i-print mo na lang ito at ipakita mo sa hospital. Pero meron pala kayong availment certificate, bakit ayaw pa nila? Wala bang ibang hospital? Baka merong ibang dahilan kaya ayaw nila. Gusto nila cash lang? Magagalit ang Philhealth niyan sa kanila kung nagpa-Philhealth-accredit sila, tapos ayaw din nilang tumanggap ng Philhealth patient.

  23. Grace on January 30th, 2012 11:10 pm

    Thanks po talaga nito. By the way, the hospital ask me to ask a note from PhilHealth and have it signed from one of its officer, nakakainis po talaga because PHIC for sure, will not issue any note since they have already provided the Certificate, so ang nangyari, nainis na yung in charge sa Claims dun sa PHIC and she even provided me her direct line number and have the Hospital call her. So bale, yung rep ng PHIC updated the hospital incharge kung anu yung bagong policies ng PHIC, so ayun, tinanggap na nila yung PHIC Cerificate ng mother ku. Kelangan lang talaga kapalan ang mukha to face these people from the hospital ant kailangan talaga tatagan ng loob. Thanks po!

  24. Nors on February 1st, 2012 2:05 am

    Hi Grace, thanks for sharing your experiences. This will help other people asking about Philhealth. I applaud you for being determined and strong. Hindi lang sarili mo ang natulongan mo, pati na rin all other patients with the same case as yours sa ospital na yan — di na nila kelangang pagdaanan ang mga dinaanan mo, kasi nilakad mo na :) and they should thank you. Best regards Grace.

  25. Vel on February 9th, 2012 6:22 am

    ask ko lang po kasi nung nanganak ako sa first baby ko, nov. 2008, employed po ako nung nov. 2007-april 2008, dpat po ba kasali parin ako sa maternity benefits ng phil health? 19years old that time,phil health accredited ung lying-in clinic ko nun, pro sabi nila hindi ako accredited but on what u had stated, 3mos. kung employed pa. eh di dpat sna ksali pako nun, marereimburse ko pa kaya un? and btw manganganak po ulit ako this june 2012, nagpay napo ako cntribution nung oct2011-june’12.. makakakuha po kaya ako ng maternity benefits ng PH. thanks po!

  26. Nors on February 9th, 2012 11:39 pm

    Hi Vel, oo, 3 months, pero 3 months within the 6-month period before delivery. Ang 6-month-period before Nov 2008 ay May 2008 to Oct 2008. Kung wala kang bayad within sa 6 months na yan, hindi eligible for maternity benefits.
    June 2012 ang delivery? Voluntary member ka? Tama ba ang bilang ko kung 8 months lang ang Oct 2011 to May 2012? Dapat 9 monthly payments within the 12-month period before delivery (for voluntary members). Pero magtanong ka rin sa iba. Take care.

  27. Vel on February 11th, 2012 12:08 am

    bago lang kasi ako napasok sa trabaho nung nov. 2008.. anyway, sa pregnancy ko ngaun, nkpag bayad nako ng oct. 2011-june 2012.. ang sabi sakin sa callcenter ng phil health nung nag inquire ako.. makakakuha daw ako.. kaso may doubts parin eh.. kaya po ako nag ask.. thank you po!

  28. Nors on February 11th, 2012 3:57 pm

    Hi Vel, kelan ba ang delivery date mo? Tama ba ang assumption ko na voluntary member ka kasi nagbayad ka na until June? Kung voluntary ka, at July ka manganganak, or August or further pa, qualified ka na for maternity benefits kasi meron ka nang 9 months, basta ituloy mo lang ang pagbayad after June, kung August o further pa ang delivery date mo. Pero kung June o May o April ang delivery date mo, kulang yata sa 9 months (requirement for voluntary for maternity benefits: 9 months of payments within the 12-month period before month of delivery). Tama ba ako sa pagbilang? Pero kung employed ka, 3 months lang ang kelangan, so qualified ka.

  29. Vel on February 12th, 2012 3:18 am

    june 12 2012, opo voluntary, kasi nung nagwork ako hindi nman pla nila hinulugan ung phil health ko since august, kaya ako na nagstart ng hulog ng oct’11-june’12.. ang sabi nman sa lying-in clinic ko qualified nman daw ako, and then dun sa call center ng phil health sabi kasi ang first month ko is october kaya maququalified pako..tlga bang ung lying-in clinic pwede cla maglakad ng phil health benefits ko? sabi nila ipasa ko lng daw ung requirements sknla?thanks po sa mga reply “)

  30. Nors on February 12th, 2012 8:34 am

    Yes, Vel, much better if you give all documents required before discharge para hindi mo na problem ang mag-file. Madeduct na agad ang benefits from your bill. Aside from filing work, matagal pa ang reimbursement, takes more than 3 months na ngayon, accdg to what I read from comments. Meron pang 7 months, wala pa raw. Lying-in o hospital, sila ang nagfa-file. Kahit reimbursement, sila pa rin ang mag-fill-up and sign ng claim forms, so involved pa rin sila. By the way, that’s great kung sabi nila qualified ka — are you employed now? And your former employee, binayaran ba nila ang June and July 2011?

  31. Vel on February 13th, 2012 4:09 am

    hindi napo eh, ung work ko nagstart ng aug’11-nov’11 nung tumawag ako sa phil health nung october to check my status, wla nman daw hulog from my employer pero sabi ko kung ako nlng maghuhulog, kahit employed ako ok lng nman daw.. kasi kng 1st month ko is october, maququalify parin ako to get the maternity benefits..(sana lang) bka kasi mamaya masayang lang din ung binyaran ko :( just want to make it sure.. tnx

  32. Vel on February 13th, 2012 4:11 am

    nung nag update din kasi ako employed ako nun eh, pero ako na mismo nagbbyad ng phil health ko.. gulo po kasi nng pinagtratrabahuhan ko. haizt

  33. Nors on February 13th, 2012 6:00 am

    Hi Vel, yong payslip mo ba noong nagwo-work ka, merong nakalagay na deduction for Philhealth? Inisip ko lang na kung nakalagay sa payslip, baka puedeng kausapin ang Philhealth na bayaran yong September 2011, kasi hindi iniremit ng employer. Binibilang ko kc yong Oct to May ay 8 months lang (June ang delivery), pero sabi mo naman, tumawag ka na sa Philhealth, at sabi nila qualified ka, pero sana kung mabayaran yong Sept 2011, mas maganda. Pero sana, qualified ka na lang talaga, kahit ano pa ang bilang ko :)

  34. Vel on February 15th, 2012 3:39 am

    kakabadtrip nga, wla man lang bnbgay na payslip, plagi ko nga nirerequest kasi nga hinahbol ko ung maternty benefits ko.. oo sabi nung nakausap ko sa call center na kung qualified pa ko kasi nung nalaman nila na mag1month plng akong preggy ng oct., abot pa daw un kung june ang due ko..hay sana nga po. tnx :)

  35. Vel on February 15th, 2012 3:39 am

    kakabadtrip nga, wla man lang bnbgay na payslip, plagi ko nga nirerequest kasi nga hinahbol ko ung maternty benefits ko.. oo sabi nung nakausap ko sa call center na kung qualified pa ko kasi nung nalaman nila na mag1month plng akong preggy ng oct., abot pa daw un kung june ang due ko..hay sana nga po. tnx :) puro phil health lang po ba tlga ung mga question dito hehe.. ask ko din po sna ung sss ko

  36. Nors on February 17th, 2012 8:48 am

    Hi Vel, ito may mga comments about SSS dito http://www.workingpinoy.com/2011/01/sss-membership-tulong-pamilya/

  37. jane on April 9th, 2012 1:15 am

    hi ms nors.. ask ko lang po sana ako ng further explanation of below statement na nabasa ko sa isang article applicable po ba ito to all senior citizen. thanks a lot po

    “(2) Mandatory PhilHealth Coverage

    “All indigent senior citizens shall be covered by the national health insurance program of PhilHealth. The LGUs where the indigent senior citizens resides shall allocate the necessary funds to ensure the enrollment of their indigent senior citizens in accordance with the pertinent laws and regulations.

  38. Nors on April 9th, 2012 1:46 am

    Hi Jane, yes and no, kahit sinabing mandatory, depende pa rin sa funds ng local government unit (LGU) nio. Mas malamang na puede pag Metro Mla, lalo na sa Makati. According to Philhealth, to be a Sponsored member, punta raw sa DSWD sa place ninyo, and ask for Philhealth sponsorship. DSWD will evaluate and then refer your father to your LGU. Since andiyan ka na sa Philhealth website, click mo Members, then Sponsored — may info diyan. Best regards — it’s good that you’re researching.

  39. Nors on April 9th, 2012 1:55 am

    Hi Jane, kung medyo malaki ang bill, at hindi pa paid, puede ring lumapit sa PCSO. Pero kelangang ilapit muna sa charity dept or social welfare dept ng hospital, kasi sila ang gagawa ng request. Hihingan lang kayo ng barangay clearance or certificate of indigency. At 5 am, dapat nakapila na doon sa PCSO.

  40. jane on April 9th, 2012 8:00 am

    Maramaing salamat po sa lhat ng information.. Napakalaking tulong po nito at ang dami kung natutunan. Mabuhay po kayo!

  41. Nors on April 9th, 2012 11:07 am

    Thanks, Jane, hope your father will get well soon.

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