Expansion of PhilHealth benefits to paying members on the way—Recto

Executive Secretary Ralph Recto said he will meet with officials of the Philippine Health Insurance Corporation (PhilHealth) to discuss the expansion of benefits for contributing members.

According to Recto, paying PhilHealth members should receive benefits commensurate with their monthly contributions.

"Ayon sa batas, iba ang benefit package para sa kanila. Dagdagan natin ito,” said Recto in a radio interview on Friday.
Recto has been recommending expanded benefit packages for contributing PhilHealth members belonging to the middle class.
Recto said he understands the concerns of those who regularly pay their PhilHealth premiums and yet do not receive proportionate benefits.
“Halimbawa, kung ikaw ay empleyado at nagbabayad ng mahigit P30,000 hanggang P60,000 maximum contribution kada taon, P300 billion kada taon ang pondo na ginagastos ng PhilHealth. Kapag nagkasakit ang 10 milyon, samakatuwid ay P30,000 ang support value niyan,” the Executive Secretary explained.

While paying members (direct contributors) share premiums with employers or pay voluntarily (up to 5% of their monthly salary), the coverage they receive at the hospital is the same as non-paying members (indigents), whose premiums are sponsored by the government, based on the current regulation of the state-run health insurer.

Support is usually computed on a per-case, fixed-rate basis rather than the total amount of premiums paid, it said.
“So, kung nagbayad ka (paying member) ng P50,000 to P60,000, ang indigent ay libre. Walang bayad. On average, P30,000 dapat ang bayad, pero indigent ka, wala kang binayaran. So panalo ka. Kaya alam ko, yung mga nagbabayad, dapat taasan natin ang PhilHealth benefits,” he pointed out.
In July last year, the government implemented a zero-balance billing policy wherein all medical expenses in government hospitals are fully covered by PhilHealth.