Question & AnswerQ&A (PHILHEALTH CIRCULAR NO. 48, S. 1999)
The primary purpose of the PhilHealth Indigent Program is to provide qualified indigent members and their dependents, who are officially enrolled in the National Health Insurance Program (NHIP), access to Medicare benefits through accredited PhilHealth providers.
Qualified PhilHealth indigent members and their dependents officially enrolled in the NHIP are eligible to avail of Medicare benefits.
Accredited PhilHealth providers are automatically entitled and responsible to participate in the Indigent Sector Component of NHIP by rendering services to the indigent members and their dependents.
Indigent members receive PhilHealth Identification Cards containing pertinent information such as the effectivity, validity of coverage, and names of their legal dependents.
Claims should be filed at the PhilHealth Central Office, 3rd Floor, JOCFER Building, Commonwealth Avenue, Quezon City or at PhilHealth's Regional Health Insurance Office in the provider's area.
Section 4 (a.iv), Rule I; Section 23, Rule IV; and Sections 44(d) and 49, Rule VIII of the Implementing Rules and Regulations provide for these entitlements.
Legal dependents are defined similarly under Program I, as indicated in the PhilHealth Identification Cards.
The benefit package includes the Medicare benefits that indigent members are entitled to under NHIP, as specified and attached in the circular for claims.
They are found in Section 2.1, Part II (Warranties of Accreditation) of the accreditation application of PhilHealth providers.
It officially implements the Indigent Program, guiding accredited providers to provide services and facilitating claims processing for indigent members under the NHIP.