Understand PhilHealth Contribution & Rates in 2024
In 2019, President Duterte signed the Universal Health Care (UHC) Act into law to provide all Filipinos with access to quality healthcare services. As part of this law, the Philippine Health Insurance Corporation (PhilHealth) is set to implement new contribution rates for its members in 2024.
Starting January 2024, PhilHealth members’ monthly contribution rate will increase from 4% to 5% of their monthly basic salary. This increase aligns with the UHC law and is expected to help fund the government’s goal of providing better healthcare services to all Filipinos. Increasing contribution rates will also increase benefits for PhilHealth members, including wider coverage for various medical services and treatments.
However, this increase in PhilHealth contribution rates has also raised concerns among some Filipinos, particularly those struggling to make ends meet. Some have questioned the timing of the increase, given the ongoing COVID-19 pandemic and its impact on the economy. Nonetheless, PhilHealth remains committed to implementing the new contribution rates and ensuring that all Filipinos have access to quality healthcare services.
PhilHealth Overview
Philippine Health Insurance Corporation
The Philippine Health Insurance Corporation, also known as PhilHealth, is a government-owned and controlled corporation that provides health insurance coverage to Filipinos. It was established in 1995 through the National Health Insurance Act of 1995 (Republic Act No. 7875). Its main objective is to ensure that every Filipino has access to affordable and quality healthcare services.
PhilHealth operates on a contributory system, where members pay monthly premiums to avail of its benefits. The premium rates are determined based on the member’s monthly income, with a minimum of Php 350 and a maximum of Php 2,400 per month. Members who are unable to pay their premiums are covered by the government’s subsidy program.
Universal Health Care (UHC) Law
In 2019, the Philippine government enacted the Universal Health Care (UHC) Law, which aims to provide all Filipinos with access to quality and affordable healthcare services. The law mandates the automatic enrollment of all Filipinos in PhilHealth, regardless of their income or employment status. This means that even those unable to pay their premiums are still entitled to PhilHealth benefits.
Under the UHC Law, PhilHealth is tasked with implementing various healthcare programs and services, such as primary healthcare, disease prevention and control, and health promotion. It also provides financial risk protection to its members by covering the costs of hospitalization, outpatient care, and other medical services.
Contribution Rates and Premiums
Income-Based Contribution Scale
PhilHealth contribution rates for 2024 are based on an income-based contribution scale. The new contribution rates will be implemented starting January 2024. According to Philstar.com, individuals earning P10,000 will now be required to contribute P500 to PhilHealth, while monthly incomes ranging from P10,000.01 to P99,999.99 will face deductions varying from P500 to P5,000. Those earning P100,000 and above will have a fixed monthly contribution of P5,000. The new rates are expected to generate additional funds for PhilHealth to provide better healthcare services to its members.
Premium Rate Adjustments
PhilHealth premiums for 2024 will see an increase in rates. According to CloudCFO.ph, the increase was planned earlier but delayed due to the pandemic’s impact on businesses. Starting in 2024, the monthly contribution rate for PhilHealth will increase from 3% to 5% of the employee’s monthly income. PhilHealth will also collect premiums from direct contributors using the 4% instead of the supposed increase of 4.5% contribution rate and will follow the P80,000 instead of the P90,000 ceiling set for 2023.
Employer and Employee Contributions
Employers are required to contribute to PhilHealth on behalf of their employees. The employer’s share will be 2.75% of the employee’s monthly salary, while the employee’s share will be 2.75% of their monthly salary. The total contribution rate will be 5.5% of the employee’s monthly salary. Employers are required to submit their contributions on or before the 10th day of the following month.
Benefits and Coverage
PhilHealth offers a range of benefit packages to its members to help them pay for their healthcare needs. These packages include inpatient and outpatient services, as well as case rate benefits. Here are some of the key benefits and coverage available to PhilHealth members in 2024.
Benefit Packages
PhilHealth offers several benefit packages that cover different types of medical services. These packages include inpatient, outpatient, and emergency care. Members can choose from a range of packages depending on their healthcare needs and budget. The benefit packages include coverage for hospital room and board, professional fees, medicines, and laboratory tests.
Outpatient Mental Health Package
PhilHealth also offers an outpatient mental health package that covers consultations with psychiatrists and psychologists. The package includes up to six sessions per year, with a maximum benefit of Php 3,000 per session. Members can avail of this benefit by presenting a valid PhilHealth ID and a prescription from their doctor.
Case Rate System
PhilHealth also uses a case rate system to provide benefits for certain medical conditions. Under this system, PhilHealth pays a fixed amount for a specific medical condition, regardless of the actual cost of treatment. For example, the case rate for dengue fever is Php 10,000, while the case rate for pneumonia is Php 15,000. Members can avail of this benefit by presenting a valid PhilHealth ID and a prescription from their doctor.
Membership and Contributions
Filipino Workers and PhilHealth
PhilHealth is a government-owned and controlled corporation that provides health insurance coverage to Filipinos. Its primary objective is to ensure that every Filipino has access to quality and affordable healthcare services. PhilHealth membership is mandatory for all Filipino workers, whether employed or self-employed. The premium contribution rate for direct contributors is based on their monthly income, with a minimum of Php 275 and a maximum of Php 1,650. The contribution rate for direct contributors is set to increase from 4% to 5% starting in 2024, in accordance with the Universal Health Care (UHC) law.
Indirect Contributors
Indirect contributors are those who are not employed or self-employed, such as dependents of PhilHealth members. They can also avail of PhilHealth benefits, but their premium contribution rate is based on a fixed amount, which is Php 2,400 per year. Indirect contributors include spouses who are not working, children who are below 21 years old, and parents who are 60 years old and above.
PhilHealth contributions are a small price to pay for the peace of mind it provides. By becoming a member of PhilHealth, Filipinos can have access to quality healthcare services without worrying about the high cost of medical expenses.
Policy and Administration
PhilHealth Leadership
The PhilHealth leadership, headed by President and Chief Executive Officer Emmanuel Ledesma Jr., has been working to ensure the stability of the state health insurer. Under his leadership, PhilHealth has been implementing changes to improve the delivery of health services to Filipinos. One of the changes that will take effect in 2024 is the increase in PhilHealth contribution rates from 4% to 5% of the monthly basic salary.
Government Support and Stability
The government has been providing support to PhilHealth to ensure its stability and continuity. President Duterte has been vocal about his commitment to provide quality healthcare to Filipinos. In fact, he signed the Universal Health Care Act in 2019, which aims to provide all Filipinos with access to affordable and quality healthcare services.
Moreover, the government has been stable under the leadership of President Duterte. His administration has been implementing policies and programs that aim to improve the lives of Filipinos. With the support of the government, PhilHealth is expected to continue providing quality healthcare services to Filipinos.
Recent Developments
Pandemic Response
The COVID-19 pandemic has affected the Philippine Health Insurance Corporation (PhilHealth) in various ways. The government allocated funds for the corporation to provide financial assistance to its members who were affected by the pandemic. PhilHealth also extended the deadline for the payment of premiums to help its members cope with the economic challenges brought about by the pandemic.
Economic Challenges and Inflation
The economic challenges brought about by the pandemic have also affected PhilHealth’s operations. Despite the challenges, PhilHealth has continued to serve its members and has implemented measures to ensure that its services are not disrupted. In 2024, PhilHealth’s contributions are set to increase to 5% from the previous 4% of the monthly basic salary. This comes after an announcement that PhilHealth has updated its premium schedule effective January 1, 2024. The adjustment applies to income levels ranging from P10,000 to P100,000. The increase in contributions is expected to help PhilHealth sustain its operations and continue providing quality healthcare services to its members.
Policy Adjustments and Circulars
To address the challenges brought about by the pandemic and inflation, PhilHealth has implemented policy adjustments and circulars. PhilHealth has issued circulars that provide guidelines for the payment of premiums, claims processing, and other related matters. These circulars aim to ensure that PhilHealth’s services are accessible, affordable, and of high quality. PhilHealth has also implemented measures to prevent fraud and abuse in its operations. These measures include the use of technology to enhance its monitoring and surveillance systems.
Navigating PhilHealth Services
PhilHealth is a government-owned corporation that provides health insurance coverage to Filipinos. Members can avail of various health services, including inpatient and outpatient care, maternity services, and preventive health services, among others.
Navigating PhilHealth services can be challenging, especially when dealing with out-of-pocket expenses. Members need to understand their benefits and coverage to avoid unnecessary expenses.
One of the ways to navigate PhilHealth services is to consult with a PhilHealth representative. Rey Baleña, the Corporate Affairs Group Head of PhilHealth, encourages members to seek assistance from PhilHealth representatives to get accurate information about their benefits and coverage.
Another way to navigate PhilHealth services is to monitor changes in PhilHealth policies and contribution rates. In 2024, PhilHealth contribution rates are set to increase to 5% from the previous 4% of the monthly basic salary. Members need to be aware of these changes to avoid discrepancies in their contributions and benefits.
Health Events and Coverage
Coverage for Major Health Events
PhilHealth provides coverage for various health events, including hospitalization, surgeries, and other medical procedures. Members can also avail of outpatient benefits and primary care services.
For instance, PhilHealth covers the expenses for treating hemorrhagic stroke, which is a type of stroke caused by bleeding in the brain. Members can avail of up to Php 620,000 worth of benefits for this type of medical condition.
In addition, PhilHealth also covers the expenses for other major health events such as cancer, kidney transplantation, and other critical illnesses. Members can refer to the PhilHealth website or their nearest PhilHealth office for more information on the coverage and benefits for these health events.
It is important to note that the coverage and benefits for these health events may vary depending on the type of membership and the amount of contributions made by the member. Members are advised to keep their contributions up-to-date to ensure that they can avail of the maximum benefits provided by PhilHealth.
Frequently Asked Questions
What are the updated PhilHealth contribution rates for 2024?
The Philippine Health Insurance Corporation (PhilHealth) has announced that the contribution rate for 2024 will be 5% of the monthly basic salary. This is an increase from the previous year’s rate of 4%. The new rate applies to both employed and self-employed members.
How can I calculate my PhilHealth contribution for 2024?
To calculate your PhilHealth contribution for 2024, multiply your monthly basic salary by the 5% contribution rate. For example, if your monthly basic salary is Php 20,000, your PhilHealth contribution for 2024 will be Php 1,000 per month.
When will the new PhilHealth contribution rates for 2024 take effect?
The new PhilHealth contribution rates for 2024 took effect on January 1, 2024. Employers are required to deduct the new contribution rate from their employees’ salaries starting from that date.
What is the PhilHealth contribution schedule for voluntary members in 2024?
Voluntary members of PhilHealth can choose to pay their contributions either on a monthly or quarterly basis. The contribution schedule for voluntary members in 2024 is as follows:
- Monthly: 5% of the monthly basic salary
- Quarterly: 15% of the quarterly basic salary
How does the 3-month rule apply to PhilHealth contributions in 2024?
The 3-month rule applies to PhilHealth contributions in 2024. This means that members who have at least 3 months of paid contributions within the immediate 6-month period prior to their confinement are eligible for PhilHealth benefits.
What is the minimum number of years required for PhilHealth contributions?
There is no minimum number of years required for PhilHealth contributions. As long as a member has paid the required contributions, he or she is eligible for PhilHealth benefits. However, members are required to have at least 9 months of paid contributions within the immediate 12-month period prior to their confinement to be eligible for maternity benefits.
Like, Follow, and Subscribe to OutofTownBlog.com on Facebook, Twitter, Instagram, and Pinterest, and Team Out Of Town on YouTube for more travel tips.
Read:
