PhilHealth set to implement increase in monthly premium

CEBU, Philippines —  The Philippine Health Insurance Corporation (PhilHealth) is implementing the scheduled contribution rate and adjustment in income ceiling for 2021 starting this month.

PhilHealth-7 information officer Dina Cinchez said yesterday that the agency is bound to implement the 0.5 percent increase (from three percent to 3.5 percent) of its members’ monthly premium as it is provided for by law.

“Dili man ni buot-buot sa PhilHealth nga mag-increase. We can only stop the implementation if Congress amends the law,” Cinchez told The Freeman.

(This is not the decision of PhilHealth to increase. We can only stop the implementation if Congress amends the law.)

In an official statement, PhilHealth President and Chief Executive Officer Dante Gierran said that while PhilHealth fully recognizes how the pandemic is taking a toll on many businesses and livelihood, the agency is bound implement Republic Act No. 11223 or the Universal Health Law.

The increase in the monthly premium also help ensure sufficient funding for the healthcare benefits of PhilHealth’s 110 million members.

Reprieve

Meanwhile, in a separate statement, AnaKalusugan Partylist Rep. Mike Defensor said PhilHealth members ought to enjoy a six-month reprieve from higher premium contributions due to a “fortuitous event” – the COVID-19 crisis.

“We are in the middle of a once-in-a-century pandemic. Even private pre-need companies are declaring a ‘fortuitous event’ to justify delays in the payment of their contractual obligations to thousands of plan holders,” Defensor said.

Defensor said based on their rough estimate, Philhealth will be postponing less than P500 million worth of incremental premiums on an annual basis from direct contributors.

“The P500 million is a drop in the bucket for Philhealth. However, if the money is taken from the pockets of salaried employees, especially minimum wage earners, it will add to their financial hardship,” Defensor added.

If necessary, Defensor said, Congress should pass a joint resolution calling for the six-month deferment of the increase in premium contributions.

Law

Under the Universal Health Care Law of 2018, premium contributions to PhilHealth will increase by half a percentage point every January 1 until it reaches 5.0 percent of a member’s monthly earnings by 2024.

PhilHealth said the premium adjustment is provided for in Section 10 of the UHC Law and its implementing rules and regulations, the guidelines of which are contained in Circular 2020-005 published by PhilHealth on March 5, 2020.

For calendar year 2021, contributions of Direct Contributors with 3.50 percent premium rate are as follows: P350 for those with a monthly basic salary P10,000 and below; P350 to P2,449.99 for those with a monthly basic salary of P10,000.01 to P69,999.99; and P2,450 for those with a monthly basic salary of P70,000.00 and above.

PhilHealth added contributions of those earning below P10,000 shall be fixed at P350 per month while contributions of those earning P70,000 per month or higher is fixed at P2,450 per month.

Contributions of employed members, including house helps, shall be shared equally between employees and employers, while those of self-paying members, professional practitioners and land-based migrant workers and other direct contributors with no employee- employer relationship are computed straight based on their monthly earnings and paid wholly by the member.

Gierran said the law emphasized the importance of members' social health insurance contributions to provide the necessary funding for various reforms under the UHC that are now being availed of by Filipinos such as but not limited to the following:

Automatic membership of all Filipinos into the National Health Insurance Program, ensuring access to quality healthcare as a fundamental right and not for the privileged few; immediate eligibility of all Filipinos to PhilHealth benefits each time they seek treatment at and confinement in any accredited hospitals in the country and even overseas; assignment of every Filipino to a primary care provider of their choice initially in pilot areas to be identified in each region in 2021; no co-payment (or No Balance Billing) for confinements in basic or ward accommodations in both government and private healthcare facilities, except when availing of amenities, for which PhilHealth will develop co-payment limits to make costs predictable;  lifetime PhilHealth coverage for all members upon reaching the age of retirement and after contributing at least 120 months to the program, ensuring continuing financial protection from health risks brought about by old age.

“These reforms and those that are still in the pipeline as mandated by the UHC Law are for the benefit of all and sundry, regardless of their station in life. Everyone's heartfelt contributions to the National Health Insurance Fund is each one's share in the health and well-being of all,” Gierran said. — JMO (FREEMAN)