FAQs

The following also enjoy PhilHealth coverage without additional premiums

• Legitimate spouse who is not a member;

• Child or children - legitimate, legitimated, acknowledged and illegitimate (as appearing in birth certificate) adopted or stepchild or stepchildren below 21 years of age, unmarried and unemployed.

• Children who are twenty-one (21) years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support, as determined by the Corporation;

• Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012;

• Parents who are sixty (60) years old or above, not otherwise an enrolled member, whose monthly income is below an amount to be determined by PhilHealth in accordance with the guiding principles set forth in the NHI Act of 2013; and,

• Parents with permanent disability regardless of age as determined by PhilHealth, that renders them totally dependent on the member for subsistence.

Qualified dependents shall be entitled to a separate coverage of up to 45 days per calendar year. However, the 45 days allowance shall be shared among them.

Important:

Qualified dependents must be declared by the principal member. Their names must be listed under the principal member's Member Data Record (MDR) to ensure hassle-free benefits availment.

• Individuals aged 60 years and above and have paid at least 120 monthly contributions with PhilHealth and the former Medicare Programs of SSS and GSIS;

• Uniformed personnel aged 56 years and above and have paid at least 120 monthly contributions with PhilHealth and the former Medicare Programs of SSS and GSIS;

• SSS underground miner-retirees aged 50 years above and have paid at least 120m monthly contributions with PhilHealth and the former Medicare Programs of SSS and GSIS;

• SSS and GSIS pensioners prior to March 4, 1995

- Members of the informal economy from the lower income segment who do not qualify for full subsidy under the means test rule of the DSWD, whose premium contribution shall be subsidized by the LGUs or shall be through cost-sharing mechanisms between/among LGUs, and/or legislative sponsors, and/or other sponsors and/or the member, including the National Government;

- Orphans, abandoned (children who have no known family willing and capable to take care of them and are under the care of the DSWD, orphanages, churches and other institutions) and abused minors, out-of-school youths, street children, persons with disability (PWD), senior citizens and battered women under the care of the DSWD, or any of its accredited institutions run by NGOs or any non-profit private organizations, whose premium contributions shall be paid for by the DSWD;

- Barangay health workers, nutrition scholars, barangay tanods, and other barangay workers and volunteers, whose premium contributions shall be fully borne by the LGUs concerned; and

- Un-enrolled women who are about to give birth, whose premium contributions shall be fully borne by the National Government and/or LGUs and/or legislative sponsors or the DSWD if such woman is an indigent as determined by it through the means test.

To register their employees:

Government And Private Sectors

Submit the following to any PhilHealth Office:

• Employer Data Record (ER1) Form (in duplicate)

• PhilHealth Membership Registration Form (PMRF)
  for each employee (in duplicate)

Kasambahay Employer

Submit the following to any PhilHealth Office:

• Household Employer Unified Registration Form

• Household Employment Unified Report Form

• Kasambahay Unified Registration Form

After processing, the employer will be issued the following:

• PhilHealth Employer Number (PEN) and the Certificate of Registration

• PhilHealth Identification Number (PIN) and Member Data Record (MDR) of registered employees

Employers (except for household employers) are required to display the Certificate of Registration in conspicuous area of their offices.

Migrant Workers

- documented or undocumented Filipinos who are engaged in a remunerated activity in another country of which they are not citizens.

Informal Sector

- includes among others, street hawkers, market vendors, pedicab and tricycle drivers, small construction workers, and home-based industries and services.

Self-Earning Individuals

- individuals who render services or sell goods as a means of livelihood outside of an employer-employee relationship or as a career. These include professional practitioners including but not limited to doctors, lawyers, engineers, artists, architects and the like, businessmen, entrepreneurs, actors, actresses and other performers, news correspondents, professional athletes, coaches, trainers, and such other individuals.

Filipinos With Dual Citizenship

- Filipinos who are also citizens of other countries.

Naturalized Filipino Citizens

- those who have become Filipino citizens through naturalization as governed by Commonwealth Act No. 473 or the Revised Naturalization Law.

Citizens of other countries working and/or residing in the Philippines

- foreign citizens with valid working permits and/or Alien Certificate of Registrations (ACRs), working and/or residing in the Philippines.

The following also enjoy PhilHealth coverage without additional premiums

• Legitimate spouse who is not a member;

• Child or children - legitimate, legitimated, acknowledged and illegitimate (as appearing in birth certificate) adopted or stepchild or stepchildren below 21 years of age, unmarried and unemployed.

• Children who are twenty-one (21) years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support, as determined by the Corporation;

• Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012;

• Parents who are sixty (60) years old or above, not otherwise an enrolled member, whose monthly income is below an amount to be determined by PhilHealth in accordance with the guiding principles set forth in the NHI Act of 2013; and,

• Parents with permanent disability regardless of age as determined by PhilHealth, that renders them totally dependent on the member for subsistence.

Important:

Qualified dependents must be declared by the principal member. Their names must be listed under the principal member's Member Data Record (MDR) to ensure hassle-free benefits availment.