TAGBILARAN CITY, Bohol, December 12 (PIA)—Why pay when there is free?
Now, Filipinos can get a free medical consultation, laboratory testing and medicines, thanks to the enactment of the Universal Health Care Act.
The enactment of the law has automatically placed every Filipino in the National Health Insurance Program (NHIP), which has opened up the gates for accredited medical facilities to dispense of free consultation package that the state insurance now provides for all Filipinos, explains PhilHealth 7 Regional Vice President Marjorie Cabrieto.
Speaking at the Kapihan sa PIA, a radio and internet-streamed talk program by the Philippine Information Agency in Bohol, Cabrieto who came to the program with PhilHealth 7 Public Relations Officer Dina Marie Cinchez announced that the day, December 12 also happens to be Universal Health Care Day.
“With the enactment of Republic Act 11223, which was effective February 20, 2019, this paved the way for PhilHealth to put up some reforms, including amending The PhilHealth Law in Republic Act 7875 and Republic Act 10606 with the new salient points,” Cabrieto said.
Salient points of the new law include the memberships, to keep the population covered.
Membership in the program has been simplified into two types” Direct Contributors for those who have the capacity to pay like employees, self-earning individuals, professional practitioners, migrant workers and lifetime members with their dependents, and the Indirect contributors such as qualified dependents whose premiums are subsidized by operation of special laws like the indigents listed in the Listahanan, Pantawid Pamilyang Pilipino Program, or those under the Department of Social Welfare and Development’s Modified Conditional Cash Transfer Program, senior citizens, persons with disabilities registered under the Philippine Registry and their dependents, Philhealth authorities said.
They are subsidized by the national government, although they do not directly pay for their contributions, the national government pays for them, from the proceeds of the Sin tax, and the universal health care law talks about the portions of PAGCOR and PCSO incomes go to the funds to implement the health care insurance, plus dividends from government investments, PhilHealth shared.
Based on Section 10 of RA 11223, starting 2019, those earning from 10,000 to 49,999.99 pays a premium rate of 2.75 percent, or from P275.00 to P1,375 at most, by 2020, those earning 10,000 to P59,999.99 gets a premium rate of 3 percent or a maximum of from 300.00 to P1800; and by 2021, those earning 10,000 to 69,999.99 pays a maximum of from P350.00 to P2,400 at 3.5 percent in 2021.
By 2022, those earning 10,000 to 17,999.99 has a 4 percent premium rate or a maximum of P400 from P3,200.00, and in 2023, those earning 10,000 to 89,999.99 gets a 4.5 percent premium rate or from P450.00 to P4,050.00 maximum.
In 2024 to 2025, those earnings 10,000 to 99,999.99 pay from 500 to P5,000.00 for the 5 percent premium rate.
“For these everyone gets immediate eligibility,” says Cinchez, meaning even if there are times when he missed putting up the premiums.
While some insurers do make sure that one can only avail of the insurance coverage as long as he qualifies based on a number of months that he has put in premiums prior to coverage, Philhealth now, by operation of law, covers everyone as long as he is in the Philhealth database.
“Sufficient regularity of payments rule was followed before, that members have paid at least three months within 6 months for new members, or at least 9 months of the nearest 12 months before he can use the coverage, but now with the immediate eligibility under the new law, you can always avail even if you have missed payments,” Cinchez remarked.
However, unlike before when PhilHealth does not collect anymore missed premiums, by Section 9 of the new law, missed payments, plus compounded interest would now be collected, Cabrieto said.
Starting November of 2019, PhilHealth would start collecting missed payments, plus the compounded interest, based on the Implementing Rules and Regulations of the new law, Cinchez also reminded.
This is the law, and we in the Philhealth only have to implement and follow what is being told of us, Cabrieto added.
From these premiums, Philhealth is now able to spend for every Filipino’s primary preventive care in their Konsultasyong Sulit at Tama (Konsulta) Package.
The Konsulta includes first-contact, comprehensive, continuing and coordinative primary care services that include consultation and case management all conditions, including individual health education, managed by a Primary Care Physician and team as determined by the legal scope of practice.
This plus provision of preventive health services, assisting eligible beneficiaries access to facilities, referrals to specialty care, some laboratory or diagnostic examinations needed as part of case management by PhilHealth Konsulta primary care team.
And then, there are select drugs and medicines as part of case management, all for free.
Every Filipino, every member of Philhealth can avail of the Konsulta package, Cabrieto stressed.
Konsulta attempts to change the healthcare availment program with people getting first to the Rural Health Units for simple health problems, as local culture demands that patients only need to go to hospitals when the pain has become unbearable.
That time when they get to hospitals, the disease is already complicated and may need difficult procedure, something that a simple primary preventive care could have already addressed.
Stroke, for example can be managed right with the primary preventive care because at the Konsulta’s laboratory examinations, one can see a person’s profiles which indicate constricted blood flow, which can be solved by blood thinners, medicine which is also included in the Konsulta package.
How do we get that?
Philhealth says simply go to your accredited health facility, check if you are already registered, or have yourself registered and then avail of the service.
Or, simply present your PhilHealth ID number, and get the service from your Rural Health Unit, where medical practitioners may refer you to the next Philhealth accredited medical facility for appropriate care. (rach/PIAbohol)
