Certificate of Premium Payment
- A clear copy of the Certificate of Premium Payment issued by PhilHealth is mandatory.
- The certificate must evidence payment of at least three (3) monthly contributions within six (6) months prior to the confinement.
- Exceptions apply for pregnancy-related cases and specific medical procedures, where at least nine (9) monthly contributions within twelve (12) months prior to benefit availment are required.
- A sample Certificate of Premium Payment is provided for reference.
Member Data Record (MDR) Submission
- A clear copy of the Member Data Record must be submitted.
- If a dependent does not appear on the MDR or if there is any discrepancy in the member/dependent record, proof of dependency or appropriate supporting documents as specified in PhilHealth Circular No. 26, s. 2006 must be submitted.
Effective Date
- This Circular takes effect on April 16, 2008.
Accountability
- The directive was adopted and signed by Lorna O. Fajardo, Acting President and CEO, on April 2, 2008.
This comprehensive set of requirements ensures validation of contributions and eligibility, maintaining integrity in the processing of NHIP benefits for members under the Group Enrollment Scheme.