With the government now changing the people’s health-seeking behavior through the Konsulta Package, the PhilHealth is urging Filipinos to start availing of simple primary health care services and education from their Rural Health Units. Photo shows PhilHealth RVP Marjorie Cabrieto (center) and Philhealth 7 Public Relations Officer Dina Marie Cinchez during the Kapihan sa PIA in Bohol. (PIA Bohol)
TAGBILARAN CITY, Bohol (PIA)— Filipinos can now get a free medical consultation and laboratory testing and medicines, thanks to the enactment of the Universal Health Care Act.
The enactment of the law has automatically placed every Filipino in the National Health Insurance Program (NHIP), which has allowed accredited medical facilities to offer the free consultation package that the state insurance now provides for all Filipinos.
“With the enactment of Republic Act 11223, which was effective February 20, 2019, this paved the way for PhilHealth to put up some reforms, including amending the PhilHealth Law in Republic Act 7875 and Republic Act 10606 with the new salient points,” said PhilHealth 7 regional vice president Marjorie Cabrieto during the recent Kapihan sa PIA program here.
The salient points of the new law include the memberships to keep the population covered.
Membership in the program has been simplified into two types.
One is Direct Contributors for those who have the capacity to pay like employees, self-earning individuals, professional practitioners, migrant workers and lifetime members with their dependents.
Indirect Contributors cover qualified dependents whose premiums are subsidized by operation of special laws like the indigents listed in the Listahanan, Pantawid Pamilyang Pilipino Program, or those under the Department of Social Welfare and Development’s Modified Conditional Cash Transfer Program, senior citizens, persons with disabilities registered under the Philippine Registry and their dependents.
They are subsidized by the national government, although they do not directly pay for their contributions, the national government pays for them from the proceeds of the Sin tax.
The universal health care law allows portions of PAGCOR and PCSO incomes to go to the funds to implement the health care insurance, plus dividends from government investments, PhilHealth shared.
Based on Section 10 of RA 11223, starting 2019, those earning from P10,000 to P49,999.99 pay a premium rate of 2.75 percent, or from P275 to P1,375 at most.
By 2020, those earning P10,000 to P59,999.99 get a premium rate of 3 percent or a maximum of from P300 to P1,800.
By 2021, those earning P10,000 to P69,999.99 pay a maximum of from P350 to P2,400 at 3.5 percent in 2021.
By 2022, those earning P10,000 to P17,999.99 has a 4 percent premium rate or a maximum of P400 from P3,200, and in 2023, those earning P10,000 to P89,999.99 gets a 4.5 percent premium rate or from P450 to P4,050 maximum.
In 2024 to 2025, those earnings P10,000 to P99,999.99 pay from P500 to P5,000 for the 5 percent premium rate.
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“For these, everyone gets immediate eligibility,” said PhilHealth 7 Public Relations Officer Dina Marie Cinchez.
While some insurers make sure that one can only avail of the insurance coverage as long as he qualifies based on a number of months that he has put in premiums prior to coverage, Philhealth now covers everyone as long as he is in the Philhealth database.
“Sufficient regularity of payments rule was followed before, that members have paid at least three months within 6 months for new members, or at least 9 months of the nearest 12 months before he can use the coverage, but now with the immediate eligibility under the new law, you can always avail even if you have missed payments,” Cinchez said.
However, unlike before when PhilHealth did not collect missed premiums, under Section 9 of the new law, missed payments, plus compounded interest would now be collected.
Starting November 2019, PhilHealth would start collecting missed payments, plus the compounded interest based on the Implementing Rules and Regulations of the new law, said Cinchez.
“This is the law, and we in the Philhealth only have to implement and follow what is being told of us,” Cabrieto added.
From these premiums, Philhealth is now able to spend for every Filipino’s primary preventive care in their Konsultasyong Sulit at Tama (Konsulta) Package.
The Konsulta includes first-contact, comprehensive, continuing and coordinated primary care services that include consultation and case management of all conditions, including individual health education managed by a Primary Care Physician and team as determined by the legal scope of practice.
Konsulta also provides preventive health services, assisting eligible beneficiaries access to facilities, referrals to specialty care, some laboratory or diagnostic examinations needed as part of case management by the PhilHealth Konsulta primary care team.
There are also select drugs and medicines as part of case management that are for free.
“Every Filipino, every member of Philhealth can avail of the Konsulta package,” Cabrieto stressed.
Konsulta aims to change the healthcare availability program with people getting first to the Rural Health Units for simple health problems.
To avail of the Konsulta services, patients are advised to go to the nearest accredited health facility and check if they are already registered, or have themselves registered. (RAHC/PIA Bohol)
