Complete information about PhilHealth for OFWs

In the 1990s, a vision for a better, more responsive government health care program was prompted by the passage of several bills that had significant implications on health financing. The public’s clamor for a health insurance that is more comprehensive in terms of covered population and benefits led to the development of House Bill 14225 and Senate Bill 01738 which became The National Health Insurance Act of 1995 or Republic Act 7875, signed by President Fidel V. Ramos on February 14, 1995. The law paved the way for the creation of the Philippine Health Insurance Corporation (PhilHealth), mandated to provide social health insurance coverage to all Filipinos in 15 years’ time.

PhilHealth assumed the responsibility of administering the former Medicare program for government and private sector employees from the Government Service Insurance System in October 1997, from the Social Security System in April 1998, and from the Overseas Workers Welfare Administration in March 2005.

How to register for membership

1. If currently in the Philippines, visit the nearest PhilHealth Regional Office, Local Health Insurance Office, PhilHealth Business Center or PhilHealth Express outlet in your locality. (Check location here)

2. If currently overseas,

1. Visit any branch of our accredited collecting partners iRemit and Ventaja Corporation (Check location here)
2. Access the Electronic Registration facility and follow the step-by-step procedure
3. Download the PhilHealth Member Registration Form,
4. fill it out and email to ofp@philhealth.gov.ph

Advantages of being a PhilHealth member

1. Overseas Filipinos may avail themselves of PhilHealth benefits for hospital confinements and out-patient surgeries in the Philippines.
2. Confinements of Overseas Filipinos and their dependents in any accredited health care institution in the Philippines are being paid for by PhilHealth through the All Case Rate payment scheme.
3. Confinements of OFs overseas may be reimbursed
4. Overseas Filipinos confined abroad are entitled to PhilHealth benefits through claim reimbursements.Members are given 180 days upon discharge to submit their claim documents to any of the PhilHealth offices in the Philippines.
5. Qualified dependents of members are entitled to the same set of benefits as the principal members
6. This means reduced stress for OFs from worrying about family members’ health care needs while abroad. Should any of the OF’s qualified dependents gets hospitalized in the Philippines, the same set of benefits shall be available for the dependents to avail themselves of. PhilHealth supports inpatient care through the All Case Rate payment scheme for most illnesses and surgical procedures.
7. OFs may be entitled to Lifetime membership
8. Overseas Filipinos who have reached the age of retirement and have paid at least 120 months’ contribution are automatic Lifetime members of PhilHealth
9. Availment for both the OF and qualified dependents is easy and readily accessible.
10. Should hospitalization become necessary for both the OF and dependents, they need not worry about numerous documents to submit because most accredited healthcare institutions are now connected to the Health Care Institution Portal where eligibility to avail of benefits can readily be checked.
11. PhilHealth covers over 4,600 medical and surgical procedures including cancer cases and other dreaded diseases
12. Most illnesses and other causes of hospitalization are being paid for by PhilHealth. For instance, for dialysis patients, PhilHealth has extended support up to 90 days for hemodialysis sessions per year, and 360 days for peritoneal dialysis sessions per year.

PhilHealth benefits for OFWs

Overseas Filipino members may avail themselves of PhilHealth benefits even if they are confined in hospitals abroad. At the same time, their qualified dependents in the Philippines may avail themselves of the benefits even if the principal is working overseas.

These benefits include:

• Inpatient Benefits
• Outpatient Benefits
• Z Benefits
• MDG-Related Benefits

Conditions for benefit availment

Overseas Filipino members must meet the following conditions to be able to avail of benefits:

1. The availment period falls within the validity period of the Overseas Filipino member’s coverage
2. The 45-day annual benefit limit for hospital room and board allowance has not yet been consumed
3. The health care institution and health care professional are accredited (applicable only for confinements in the Philippines)

Filing a claim for overseas confinements

If an Overseas Filipino member is confined abroad, the following documents must be sent either via overseas courier or electronic mail to the PhilHealth Regional Office or Local Health Insurance Office nearest the OF’s Philippine address within 180 calendar days from the date of discharge:

1. Medical abstract or medical record written in English or copy of Medical Certificate indicating the final diagnosis, confinement period and medical services rendered;
2. Copy of the operative record written in English, if an operation was performed
3. Statement of account
4. Official Receipt issued by the hospital and doctor

Properly filled out PhilHealth Claim Form 1

If an Overseas Filipino member or his qualified dependent is confined in the Philippines, a properly filled out PhilHealth Claim Form 1 must be submitted to the Billing Section of the accredited hospital before being discharged.

Checking one’s Member Data Record

To verify if your PhilHealth Member Data Record contains updated information about your membership profile and your list of qualified dependents, click on the Member Inquiry icon under the Online Services section, follow the log-in procedures and check on the accuracy of your member data.

Updating the Member Data Record

1. Download the PhilHealth Member Registration Form
2. Click FOR UPDATING on the upper right-hand side of the form
3. Indicate the necessary revisions
4. Email the accomplished form to ofp@philhealth.gov.ph
5. Await via email a copy of your updated Member Data Record

Premium contribution rate

The annual premium contribution of land-based Overseas Filipinos is based on the amount prescribed by the Corporation. The minimum current rate is P2,400.00 per year. This can be paid in advance for two years to five years, or depending on the duration of the employment contract with the overseas employer.

For seafarers, the premium contribution rate is salary-based following the premium schedule for the Formal Economy. (Click here for premium contribution schedule)

Where to pay premium contributions

Premium payments may be made overseas through any of our PhilHealth-accredited collecting agents and tie-ups abroad. (Click here for the list of accredited collecting agents and tie-ups abroad)

Payments may also be made at any or our accredited collecting partners in the Philippines or through the PhilHealth Counter at the Philippine Overseas Employment Administration, Ortigas Avenue, Mandaluyong City. (Click here for the list of accredited collecting agents)

Notes for Filipino Seafarers

PhilHealth coverage need not end when your contract with manning agency ends. If vacationing in the Philippines while waiting for contract renewal, sea-based OF members should pay their premium contributions to ensure benefits availment should the need arises.