PhilHealth contribution itinaas na sa 5% ngayong taon | Newsroom Ngayon - video Dailymotion

CNN Philippines

Itinaas ng PhilHealth ang premium contribution rate ng mga miyembro sa 5%, alinsunod sa Universal Healthcare Law.  Ano ang epekto nito sa mga miyembro, at saan mapupunta ang kita mula sa premium hike?  Makakapanayam natin si Rey Baleña, PhilHealth acting vice president for corporate affairs.  Visit our website for more #NewsYouCanTrust: https://www.cnnphilippines.com/  Follow our social media pages:  • Facebook: https://www.facebook.com/CNNPhilippines • Instagram: https://www.instagram.com/cnnphilippines/ • Twitter: https://twitter.com/cnnphilippines

Transcript

00:00 [Music]

00:04 PhilHealth is expecting to earn P17 billion

00:07 in order to increase the contribution of its employees by 5%.

00:13 PhilHealth also promised that it will provide more benefit packages to its members.

00:19 We will discuss this in our service today with PhilHealth Corporate Affairs Group,

00:24 Acting Vice President Ray Balenya.

00:27 You can also join us and post your questions or comments on our Facebook Live.

00:32 Good afternoon, Sir Ray.

00:33 Good afternoon and Happy New Year, Ma'am Ruth.

00:36 And of course, to all of our viewers.

00:39 Please explain first how we will implement the increase in premiums

00:44 for example, in giving sample computations.

00:47 I know that last year, we talked about moving it,

00:51 but now, it's continuing, right?

00:53 You're right, Ma'am Ruth. Last year, there was supposed to be a free contribution adjustment

01:00 from 4% to 4.5%.

01:03 But this was suspended, so 4% remained.

01:07 Now, in 2024, according to Universal Health Care,

01:11 we will implement what is in the law.

01:15 And this is the 5% contribution rate for 2024.

01:21 So, it will be from 4% to 5%, which is 1% will be our adjustment.

01:27 It's still remaining, Ma'am Ruth, that our income floor is P10,000.

01:32 And now, the income ceiling is P100,000.

01:36 So, our lowest monthly payment is P500.

01:42 And if there's an employer, our payment will be divided in half, P250.

01:48 And if P100,000 is the salary of our countrymen,

01:52 that's P5,000 per month,

01:56 and if we divide it between employer and employee, P2,500.

02:00 And if we earn more than P100,000,

02:04 their contribution will remain at P5,000.

02:09 So, what you mentioned is the same for all, even the voluntary members,

02:15 including them, Jaan.

02:19 That's right, Ma'am Ruth.

02:21 The contribution adjustment is for all direct contributors.

02:26 By law, they have the right to pay.

02:29 Including the employees and all self-paying individuals,

02:35 including our OFWs.

02:38 I know you explained this last year,

02:42 but why does the premium need to be increased, sir?

02:45 Well, first of all, Ma'am Ruth, this is in accordance with the law.

02:51 And as an agency that implements the UNHCR,

02:56 we are responsible for implementing this.

03:00 Secondly, the law also states that for every adjustment of contribution,

03:06 there will be an increase in our benefit.

03:10 And that's where our contribution to TILHELP will go,

03:14 in the continued expansion and improvement of our benefits.

03:19 So, you mentioned the increase, of course,

03:22 that our fellow citizens are anticipating,

03:24 the increased benefits.

03:27 What are the things we can expect this year?

03:30 Well, first of all, Ma'am Ruth,

03:33 last year, we started to increase and enhance our benefit packages.

03:39 The contribution adjustment did not continue.

03:43 If you remember, our diagnosis coverage,

03:47 from 90 sessions per year,

03:49 the PhilHealth Board did 156 sessions.

03:53 Now, the conditions that are very heavy for the patient,

03:59 what we call the "burden of disease",

04:03 we also started to increase that.

04:05 We started with three, Ma'am Ruth, last year.

04:08 The pneumonia high risk,

04:11 before, it was P32,000.

04:14 It became P90,100, so more than triple.

04:18 It became almost triple.

04:21 And the stroke, for example, the ischemic stroke,

04:25 it was from P28,000,

04:27 we made it P76,000.

04:30 And the hemorrhagic stroke,

04:32 before, P38,000, it became P80,000.

04:35 So, more than double the increase

04:39 of those three benefits.

04:43 And for this year, we are still looking at, Ma'am Ruth,

04:46 six burdensome diseases and conditions.

04:50 We are studying this.

04:51 And this will be included in the studies.

04:54 I expect, our countrymen,

04:57 that we will be able to release this this year.

04:59 Aside from that,

05:01 of course, all the other case rates, Ma'am Ruth,

05:04 it will be subject to as much as 30% increase.

05:08 It is included in the current field health management.

05:12 Okay.

05:12 Later, we will continue our discussion

05:14 about the possible increase in benefits

05:18 because of the increase in premiums that are being paid.

05:21 We are still with the field health corporate affairs group

05:23 acting Vice President Ray Balena

05:26 in the newsroom.

05:27 Here in CNN Philippines.

05:30 Let's go back to our service.

05:31 We are talking about the additional contributions

05:34 to field health and the promise

05:36 of the agency that there will be additional benefits.

05:39 They are still with their corporate affairs group

05:41 acting Vice President Ray Balena.

05:44 Sir, I will just go to the questions here

05:46 on Facebook Live.

05:48 You mentioned who the beneficiaries are earlier.

05:50 But maybe to be clear,

05:51 Espinoza said to Ronald,

05:53 you only increased 4% to 5%.

05:55 What do you think about the OFWs?

06:00 Well, thank you for the question, Sir Ronald.

06:03 The OFWs are included

06:07 among the direct contributors

06:09 according to the Universal Health Care Law.

06:11 So in the case of OFWs

06:13 and other self-paying members,

06:16 Sir Ronald,

06:17 5% of our monthly income

06:20 is what we will pay for the program.

06:24 So the ceiling is P100,000.

06:27 So the maximum is P5,000 per month

06:31 that we will pay for field health.

06:33 Sir, I have another question.

06:35 For example, you've been working for 30 years

06:38 because you're an employee.

06:39 And then you retired or resigned.

06:42 What will happen to field health?

06:44 Are you still a beneficiary after 30 years?

06:47 And then you're not a senior.

06:49 Okay.

06:52 We have what we call a lifetime membership.

06:55 There are two conditions that a member must meet

06:59 before becoming a lifetime member.

07:02 Lifetime members are a group

07:04 that no longer pay contributions

07:06 and their field health benefits are lifelong.

07:10 So the first condition is

07:12 that they must reach their age of retirement,

07:15 which is 60,

07:16 and have paid

07:18 less than P120,000

07:20 monthly contributions to the program.

07:23 So these two conditions must be met

07:27 before they become lifetime members.

07:30 If they're not yet reaching 60,

07:33 for example, they're only 58,

07:35 then the remaining two years

07:38 before they become senior citizens,

07:41 we recommend that they continue

07:44 as a self-paying member.

07:46 Okay, so the two conditions must be met,

07:50 not just one, right?

07:52 For the age, yes.

07:54 Okay.

07:55 Sir, we're also with you.

07:57 I'll just go over the claims

08:00 from other hospitals.

08:01 What is your status, Anne?

08:03 Have you already paid, Anne?

08:05 Well, as announced during our press conference

08:08 last week,

08:10 between August 2 and December 31 of 2023,

08:15 field health has already paid

08:18 P46.4 million.

08:22 And that is our payment

08:23 to both government

08:25 and private healthcare facilities.

08:27 So we even exceeded,

08:29 Ma'am Ruth,

08:30 our commitment to the Congress

08:32 last September

08:34 that we will settle P27 billion

08:38 to our partner providers.

08:40 So we exceeded that

08:42 and we will continue to pay

08:45 to our partner hospitals.

08:47 I saw that recently,

08:49 you released a release

08:51 about your consultation program

08:53 because you're encouraging

08:55 members to register

08:57 or avail it.

08:58 Please explain again.

09:00 Ma'am Ruth, thank you very much

09:03 for bringing that up.

09:04 Because this consultation is very important

09:06 because this is the field health benefit

09:09 that members no longer need to get sick.

09:12 In fact, this will help

09:14 us not to get sick

09:17 because this is part of prevention.

09:19 In the field health consultation package,

09:22 the consultation with a primary care physician,

09:26 laboratories like X-ray, ECG,

09:31 and others,

09:32 depends on the patient's needs

09:35 and as will be recommended

09:37 by the provider.

09:39 There are also 21 molecules of medicines,

09:45 and the main ones are maintenance meds

09:48 for diabetes,

09:50 for those with high blood.

09:53 So it depends on the patient's needs

09:55 and what will be determined

09:57 by their consultant provider

09:59 to allow this to the patient

10:01 when they are not being paid.

10:03 So our call is

10:05 to enroll in a consultant provider

10:08 that we will choose

10:10 because we should choose a provider.

10:14 That's according to the law.

10:15 But what I remember here,

10:17 the clinic you go to

10:20 should be the only one

10:22 that will be targeted.

10:24 So this is the only way to get better.

10:26 You're right, Ma'am Ruth.

10:28 If we enroll in a consultant provider,

10:32 we should be able to stay

10:34 with that provider for the whole year.

10:36 Now, if we are going to move house,

10:39 we need to move to a consultant provider.

10:43 So next year,

10:44 we can do a transfer.

10:46 Last but not least,

10:48 what is the contact information

10:50 in case they want to know more from you?

10:52 So,

10:54 we can call

10:56 our call center.

11:02 But for now,

11:04 we want to encourage our members

11:06 to post on our Facebook page

11:10 so that we can answer them right away.

11:14 So Ma'am Ruth,

11:16 on our Facebook page, PhilHealthOfficial,

11:18 and on X,

11:20 we also have an X account.

11:22 They can post their questions there.

11:26 Thank you very much to PhilHealth Corporate Affairs Group

11:30 Acting Vice President Ray Balenya.

PhilHealth contribution itinaas na sa 5% ngayong taon | Newsroom Ngayon

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