OFWs can soon file claims with PhilHealth through the Internet

TACLOBAN CITY—Overseas Filipino Workers (OFWs) who are members of the Philippine Health Insurance Corp. (PhilHealth) may soon file claims through the Internet for hospital bills incurred abroad, according to an agency official.

Dr. Eduardo Banzon, PhilHealth president and CEO said the plan is to install a system that will allow OFWs to simply submit online their individual claims for repayment.

“We want to grant  financial relief to workers in the event they become ill and seek hospitalization in their host countries,” Bazon said during his recent visit to Eastern Visayas.

“We hope to start doing this in selected foreign cities with large concentrations of OFWs,” Banzon said.

At present, workers hospitalized abroad may file claims for reimbursement only by submitting hard copies of the paperwork within six months to the PhilHealth office nearest their Philippine residence.

The papers to be submitted are PhilHealth claim form 1; a photocopy of the claimant’s latest member data record, or contribution payment receipt; a medical certificate with complete diagnosis, period of confinement and services rendered; and a hospital statement of account and/or official receipts with itemized charges and other supporting documents in English.

The Philippine-based dependents of workers may readily avail themselves of benefits via accredited local hospitals and outpatient service providers.

3PhilHealth helps pay for the room and board, medicines, laboratory exams, as well as operating room and professional fees for every hospital confinement of not less than 24 hours of the workers’ spouse and other dependents.

Qualified dependents are active Philhealth members are entitled to a separate coverage of up to 45 days confinement per calendar year. The 45-day allowance is shared among all dependents.

Eligible dependents include the OFW’s legal spouse who is not a Philhealth member, or whose membership is inactive; the OFW’s children below 21 years of age, unmarried and unemployed; and the OFW’s parents who are 60 years old and above.

The spouses and children of male OFWs also receive ample medical subsidy in the form of prenatal, maternity and newborn care benefits.

A 1995 law requires all citizens of the Philippines “to enroll in the National Health Insurance Program (NHIP) in order to avoid adverse selection and social inequity.”

Under the law, compulsory coverage is based on community spirit and social solidarity, which call for risk-sharing among diverse income and age groups, persons of varied health status, and those residing in different locations.

Banzon said PhilHealth is bound to carry out the law, which mandates compulsory membership and coverage of all Filipinos, including workers.

To enlarge benefit payments and cope with the rising cost of hospitalization and out-patient services, PhilHealth has adjusted annual premium contributions.

In the case of workers, their more than 10-year-old annual premium of P900 (or P2.50 per day) has been revised in phases to P1,200 (or P3.30 per day) effective January 1, 2012, and to P2,400 (P6.55 per day) starting Jan. 1, 2013. (REYAN L. ARINTO)

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Posted by lsde on Aug 29 2012. Filed under Second Story. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.