You Can Avail of Philhealth if You’ve Paid 9 Months Within Past 12 Months

Updated January 7, 2021

Mula noong October 1, 2018, requirement na uli ang nine months of premium payment para maka-avail ng Philhealth.
Pero starting November 2019, meron nang Immediate Eligibility policy, meaning kahit hindi mo nabayaran lahat ng required premiums, magagamit mo pa rin ang Philhealth. Pababayaran lang sa iyo ang mga kulang mong premiums, plus interests.
Pero siempre, kahit meron nang Immediate Eligibility policy, maigi pa rin na magbayad ng premiums on time, para hindi ka na maabala kapag na-confine ka o na-confine ang beneficiary mo.

Sa pagbilang ng 9 months within the past 12 months prior to your hospitalization, isama mo sa bilang ang month ng iyong hospitalization.

Nag-increase na rin ang Philhealth premiums! Noon pang January 2020 nag-start. Ngayong January 2021, merong uli panibagong increase.

Marami ang nagagalit sa increase kasi meron ngang pandemic at hindi pa maliwanag sa atin kung ano na ang nangyari doon sa maraming corruption allegations against Philhealth officials.

Philhealth Premium Contributions for this year 2021

As of January 6, 2021, Philhealth has suspended and deferred the premium rate increase scheduled for the year 2021 (which is 3.5% of monthly gross income) dahil sa panawagan ni President Duterte at ng mga legislators.

Sabi ng Philhealth, ang i-implement ay yong premium rate last year, 2020, which is 3% of monthly gross income.

300 pesos pa rin ang minimum premium (for those earning 10k pesos or less).

1,800 pesos pa rin ang maximum premium (for those earning 60k pesos or more).

For those earning between 10k and 60k, multiply your gross monthly income by 3%.

Idinagdag din ng Philhealth na kung walang new legislation na ire-release ng Congress about the increase, itutuloy ng Philhealth yong 3.5% increase this year.

Itong scheduled Philhealth premium increase, presented below, which is 3.5% of gross monthly income, ay suspended muna, habang pinag-uusapan sa Congress ang Philhealth premiums. 

Minimum contribution is 350 pesos — for members earning a monthly income of 10,000 pesos or less

Maximum contribution is 2,450 pesos — for members earning a monthly income of 70,000 pesos or more

For those earning a monthly income between 10,000 pesos and 70,000 pesos, the premium contribution is equal to monthly income multiplied by 3.5%.

Examples:

10,500 pesos — premium is 10,500 x 3.5% = 367.50 pesos

11,000 pesos — premium is 11,000 x 3.5% = 385 pesos

12,000 pesos — premium is 12,000 x 3.5% = 420 pesos

15,000 pesos — premium is 15,000 x 3.5% = 525 pesos

20,000 pesos — premium is 20,000 x 3.5% = 700 pesos

25,000 pesos — premium is 25,000 x 3.5% = 875 pesos

30,000 pesos — premium is 30,000 x 3.5% = 1,050 pesos

70,000 pesos — premium is 70,000 x 3.5% = 2,450 pesos

Para sa mga OFWs:

Walang pagbabago. Ganon pa rin ang eligibility nio na dapat ang hospitalization dates nio ay within the validity dates na nasa inyong Philhealth premium payment receipt. Halimbawa, kung ang receipt nio ay July 31, 2020 to July 30, 2021, dapat ang hospitalization dates nio ay within these dates.

Reference:

Philhealth Circular No. 2017-0021:
Application of Sufficient Regularity of Payment of Premium Contributions to the Required Qualifying Contributions for Eligibility to Philhealth Benefits.

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Hindi na valid ang mga notes below, kasi nag-iba na ang requirement ng Philhealth.

Now, you need only to make 3 monthly payments! 

This is for Individual Payors, Employees and Seafarers.

The nine-month payment requirement has been reduced to 3 monthly premium payments.

To avail of Philhealth coverage, you must pay for at least 3 of the 6 months prior to your hospitalization or treatment.

Kasama sa 6-month counting yong current month.

Read this for updated instructions on Philhealth requirements for Individual Payors.

Para sa mga OFWs:

You can use your Philhealth within the Validity Dates on your premium payment receipt.

Para sa mga Sponsored Members, at Indigent Members:

You can use your Philhealth within the Validity Dates on your Philhealth card.
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HINDI NA VALID ang SINASABI sa BABA.  Statements below are no longer valid. 

Updated Feb 14, 2013:

In September 2010, Philhealth announced that starting July 2011, Employed Members and Individually Paying or Voluntary Members will have the same eligibility requirement — the 9 over 12 requirement — for all types of confinements or treatments.

9 over 12 means that: A member should have paid at least 9 of the 12 months immediately prior to hospitalization, in order to qualify for coverage.

But this order was reversed before July 2011.

As of February 14, 2013, the eligibility requirement is as follows:

Employed Member: 3 over 6 — Member should have paid at least 3 of the 6 months immediately before confinement, for all types of hospitalization.

Individually Paying Member or Voluntary Member:
3 over 6, for non-surgery cases and non-maternity cases
9 over 12, for maternity and surgery cases. Member should have paid at least 9 of the 12 months immediately before surgery or delivery.

Now, Philhealth has launched a new program, the Individually Paying Contract (IPC). I’m still gathering information about it. But if you lack eligibility and you need coverage for maternity or surgery, visit Philhealth and ask. You might become eligible if you commit to pay 1 year, 2 years or 3 years in advance.

September 2010 Circular:
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.

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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