Title
PhilHealth Document Req. for IPMs Benefits
Law
Philhealth Circular No. 05, S. 2008
Decision Date
Apr 2, 2008
Individually Paying Members (IPMs) must submit specific documents, including a PhilHealth Claim Form and proof of premium payments, to access National Health Insurance Program benefits, effective April 16, 2008.
A

Q&A (PHILHEALTH CIRCULAR NO. 05, S. 2008)

The circular serves as an addendum to PhilHealth Circular No. 18, s. 2007, specifying additional documentary requirements for benefit availment of Individually Paying Members (IPMs) under the Group Enrollment Scheme.

All members and their qualified dependents covered under this scheme are subject to the documentary requirements for National Health Insurance Program (NHIP) benefits.

At least three (3) monthly contributions within six (6) months prior to confinement are required.

The member must have paid at least nine (9) monthly contributions within twelve (12) months prior to availment of benefits.

A clear copy of the Certificate of Premium Payment issued by PhilHealth.

The MDR is a document listing member/dependent details; if dependents do not appear or there is a discrepancy, the member/dependent must submit proof of dependency or appropriate supporting documents as per PhilHealth Circular No. 26, s. 2006.

It took effect on April 16, 2008.

It was adopted and promulgated by Lorna O. Fajardo, the Acting President and CEO of PhilHealth at the time.

It is a required documentary form for processing and claiming NHIP benefits under the Group Enrollment Scheme.

The text sample is available at the Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.


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