Deduct seniors, PWD discounts, PhilHealth warns

The Philippine Health Insurance Corporation, or PhilHealth, has issued a reminder to its accredited health facilities nationwide to deduct the statutory senior citizens or persons with disabilities discounts from their total medical bills before hospital discharge.

PhilHealth president and CEO Emmanuel R. Ledesma, Jr. warned over the weekend that some health facilities have failed to deduct the senior citizen and PWD discounts from their bills.

These reports, Ledesma said, have prompted the release of PhilHealth Advisory 2023-0036, which enjoined partner hospitals to observe the discounts at all times.

Ledesma emphasized that the application of these discounts is mandated under Republic Acts 9994, or the Expanded Senior Citizens Act, and 10754, or the Expanded Benefits and Privileges of Persons with Disability Act.

He also noted that the application of these discounts is provided in the health facilities' Performance Commitment with PhilHealth.

"We have to give whatever the law mandates. This is our responsibility to our members, and one of them is to ensure that their senior citizen or PWD privileges, whichever is applicable, are properly deducted from their hospital bills," Ledesma asserted.

However, in cases where a patient is both an elderly and a PWD, only one discount shall apply.

PhilHealth also clarified that the order of deductions is as follows: 12 percent VAT exemption, 20 percent senior citizen or PWD discount, and then the PhilHealth benefits.

"The remaining balance is what the patient should pay, if any. If our senior citizen member is admitted to public facilities, they do not have to pay anything because of our No Balance Billing policy," Ledesma reiterated. He added that this can be validated by checking billing statements.

Ledesma warned that health facilities that fail to deduct these privileges may face penalties and sanctions, including fines and even suspension or revocation of accreditation as provided for in their Performance Commitment with PhilHealth.

PhilHealth encouraged members and concerned citizens to immediately report instances of non-deduction of these privileges to the Office for Senior Citizens Affairs in their respective local government units, or to the National Council for Disability Affairs.

These can also be reported to PhilHealth Callback Channel 0917-898-7442 or to PhilHealth's Facebook page @PhilHealthofficial and Twitter@teamphilhealth.

"We urge our members to assert their rights because these are mandated by law. We are ready to take action if we receive reports from our members," Ledesma concluded.