5.4 M Pinoys unaware of PhilHealth coverage

MANILA, Philippines - The Department of Health (DOH) is tracking down indigents who have PhilHealth coverage but are not aware of it.

Health Secretary Enrique Ona said the Philippine Health Insurance Corp. noted that 5.4 million poor individuals have been enrolled in PhilHealth by the national government but they do not know about their benefits.

“You have to look for them, tell them that they are enrolled and give them the PhilHealth card. It is not easy because the poor are very mobile. For instance, there are construction workers who have jobs in Laguna so they live there. After six months or a year, they will go to Samar for work,” Ona said.

PhilHealth is paying P1.2 billion in weekly reimbursements or refunds to hospitals and medical centers and they want the poor to be among its beneficiaries.

PhilHealth president and chief executive officer Alexander Padilla said they have adopted the “point-of-care enrolment” system to track down indigent PhilHealth members.

Padilla said the system is also expected to capture poor patients who do not have PhilHealth coverage yet.

“If there are still poor who have not been covered by the mapping system of the DSWD (Department of Social Welfare and Development), or the LGUs (local government units), when they get sick and they go to a hospital and they are determined to be poor, they will immediately become a member,” he said.

The DOH and PhilHealth plan to expand the coverage of sponsored families from 5.4 million to 10.2 million next year.

The expansion would increase the PhilHealth budget from P13 billion to P24.5 billion.

“In terms of benefits payment, PhilhHealth paid more than 4.80 million claims in 2012 amounting to P47.2 billion or an average of P9,400 per claim,” Ona said.

The amount is P30.50 billion or 19 percent higher than the P7,930 average claim in 2010.

Padilla said the expanded coverage would be made possible by proceeds from sin taxes to be earmarked for the DOH.