88% of Filipinos Covered by PhilHealth in 2015
As of June 30, 2015, a total of 89,417,720 beneficiaries, equivalent to 88% of the Filipino population, are already covered by PhilHealth.
A member is considered an “enrolled member” if he/she is registered to the program.
A member, on the other hand, is considered a “covered member” if he/she is registered AND ELIGIBLE TO AVAIL OF THE BENEFITS provided by the program.
A member must first meet the following requirements to avail of his/her PhilHealth benefits:
- Payment of at least three (3) months monthly premiums within six (6) months prior to the month of confinement. For example, if a member gets confined in June, he/she must have given three months of monthly premium from December to May. The contributions need not be consecutive. They just have to fall within the six month period prior to the confinement.
- Confinement in an accredited hospital for at least 24 hours (except when availing of outpatient care and special packages) due to illness or injury requiring hospitalization.
- Attending physicians must also be PhilHealth-accredited.
- The 45 days allowance for hospital room and board is not consumed yet.
A factor that greatly contributed to the huge leap in PhilHealth coverage rate is the expansion of the national government-sponsored families from 5.2 million indigent families in 2013 to 14.7 million in 2014.
Source: 2014 SONA Technical Report