Question & AnswerQ&A (PhilHealth Circular No. 033-2014)
Republic Act No. 10645 mandates the mandatory PhilHealth coverage of all senior citizens in the Philippines.
A senior citizen is a Filipino citizen or dual citizen aged sixty (60) years or above, who is a resident of the Philippines with proof of citizenship and at least six (6) months residency.
The funds are sourced from the National Health Insurance Fund of PhilHealth, utilizing proceeds from Republic Act No. 10351 (Sin Tax Law).
A new membership category called 'Senior Citizen' was created for senior citizens not currently covered under the National Health Insurance Program (NHIP).
No. Gainfully employed senior citizens with regular income exceeding the poverty threshold of their province or city must continue contributing subject to existing rules.
Enrollment is primarily coordinated by the Office for the Senior Citizens Affairs (OSCA) or an office designated by the mayor in the locality where the senior citizen resides.
They must submit a duly accomplished PhilHealth Member Registration Form (PMRF), a 1 x 1 photo taken within six months, and proof of status as senior citizen such as an OSCA issued Senior Citizen ID or other valid IDs like passport, birth certificate, driver's license, etc.
Yes. Qualified dependents include the legitimate spouse not enrolled under NHIP, unmarried and unemployed children below 21 years old, children 21 or above with congenital or total disability, and foster children as defined under RA 10165.
Benefits include inpatient hospital care, ambulatory services, catastrophic case benefits (Z-benefits), tuberculosis treatment, animal bite and malaria packages, outpatient HIV/AIDS treatment, blood transfusion, maternity and newborn care, voluntary contraceptive surgical procedures, among others.
They may still avail benefits by presenting any valid ID proving their status as senior citizen; the absence of the PhilHealth ID does not prejudice their rights.
Premium contributions are sourced from proceeds of Republic Act No. 10351, the Sin Tax Law.
Yes. They are given 60 calendar days from the effectivity of the circular to file benefit claims directly if confined from the law's effectivity date and unable to avail benefits through automatic deduction.
The LHIO issues PhilHealth ID cards and Member Data Records, processes enrollment lists submitted by OSCA/local government units, secures lists of senior citizens from DSWD and NGOs, and facilitates enrollment and benefit claims.
No. The LHIO shall not accept registration of senior citizens represented by unauthorized individuals or entities not identified by PhilHealth, DSWD, or local government units.
Qualified dependents are entitled to program benefits only until the expiration of the coverage period of the deceased principal member.