PhilHealth
| Korporasyon para sa Pasigurohan sa Kalusugan ng Pilipinas | |
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| Agency overview | |
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| Parent agency | Department of Health |
| Website | www |
The Philippine Health Insurance Corporation (PhilHealth) was created in 1995 to implement universal health coverage in the Philippines. It is a tax-exempt, government-owned and government-controlled corporation (GOCC) of the Philippines, and is attached to the Department of Health. Its stated goal is to ensure a sustainable national health insurance program for all. In 2010, it claimed to have achieved "universal" coverage at 86% of the population, although the 2008 National Demographic Health Survey showed that only 38 percent of respondents were aware of at least one household member being enrolled in PhilHealth. Nevertheless, this social insurance program provides a means for the healthy to pay for the care of the sick and for those who can afford medical care to subsidize those who cannot. Both local and national governments allocate funds to subsidize the indigent.
In 2010 and 2015, reform efforts were outlined to make decentralization and health insurance work more effectively, including an expanded government subsidy for the enrollment of the poor, the creation of local health service delivery/planning units to reduce fragmentation, and a stronger DOH role in regulation. Also the shifting from Fee-for-service to Case Rate payment scheme and IHCP Portal System is established to provide a link between accredited institutional health care providers and Philhealth through online connections.
PhilHealth have six major membership categories covering nearly the entire population. Those who count under the (1) "Formal" sector are workers employed by public and private companies and other institutions. (2) "Indigents" also called "Philhealth sa Masa" are subsidized by National Government the National Household Targeting System for Poverty Reduction. (3) "Sponsored Members" are subsidized by their respective Local Governments (LGU). (4) "Lifetime" (non-paying members) are retirees and pensioners and have already paid premiums for 120 months of membership and are 60 or older. (5) "Senior Citizen" under RA 10645 that all citizen ages 60 years old above are eligible to have free philhealth coverage. (6) The "Informal Economy" is composed of Informal Sectors, Self-Earning Individuals, Organized Group, Filipino with Dual Citizenship, Naturalized Born Citizen. Although treated separately, the Overseas Filipino Workers (OFW) program or Migrant Workers is as part of the Informal Economy. Migrant Worker is sub-categorized as whether Land Based or Sea Based (for Sea Fearers).
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Wikipedia