Title
PhilHealth Coverage of AFP Pensioners
Law
Philhealth Circular No. 009, S. 2012
Decision Date
Mar 6, 2012
PhilHealth and the Armed Forces of the Philippines have established a partnership to ensure continuous health insurance coverage for AFP pensioners through premium deductions from their pensions, facilitating access to universal health care.
A

Key Definitions

  • AFP Finance Center: Manages pension payments.
  • AFP Pension and Gratuity Management Center (PGMC): Handles pension and separation benefits.
  • Authority to Deduct (ATD) PhilHealth Premium: Consent form signed by pensioners to authorize PhilHealth premium deduction.
  • Certificate of Qualified AFP Pensioner: Certification issued by AFP Finance Center confirming eligibility for pension premium deduction.
  • Pension: Monthly retirement benefits from which PhilHealth premiums are deducted.
  • Pensioner (AFP): Retired military personnel or their legal beneficiaries receiving pension, including optional retirees and CDD retirees.

Enrollment and Registration

  • AFP pensioners must complete the PhilHealth Member Registration Form.
  • Attach photocopies of valid documents for dependents and pensioner ID.
  • Submit Authority to Deduct (ATD) form to authorize premium deductions from pensions.

Submission of Documents

  • Documents can be submitted at PhilHealth Regional Offices, Service Offices, Branches, and AFP Camps including AFP PGMC at Camp Aguinaldo.
  • Forms are available at PhilHealth offices, AFP camps, and downloadable from official websites.

Premium Contributions

  • AFP Finance Center deducts premiums from pensions based on signed ATDs.
  • Optional retirees receiving lump sum pensions must prepay contributions for periods without pension payments.
  • AFP remits collected premiums to PhilHealth by the 10th day of the following month.

Benefit Availment

  • Benefits are subject to PhilHealth Circular No. 24, s-2003 regarding NHIP entitlement.
  • Required documents for benefit claims:
    • PhilHealth Claim Form 1 (duly accomplished)
    • Certificate of Premium Payment or Certificate of Qualified AFP Pensioner
    • Member Data Record (MDR)
  • Record updating and other requirements governed by PhilHealth Circular No. 26, s-2006.

Claims Processing

  • Claims processing follows PhilHealth Circular No. 26, s-2006, covering documentary requirements and procedures for local and overseas confinement.
  • Provides guidelines for automatic deductions and direct filing of claims.

Effectivity

  • Circular becomes effective 15 days after publication in a newspaper of general circulation.
  • The circular is deposited with the National Administrative Register at the University of the Philippines Law Centre.
  • Adopted on March 6, 2012, signed by Dr. Eduardo P. Banzon, PhilHealth President and CEO.

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