Health insurance for all senior citizens starts November 25

PhilHealth President Alexander Padilla acknowledges there will be ‘transition difficulties’ as they implement the new PhilHealth law, but government wants to implement it as soon as possible

MANILA, Philippines – Starting Tuesday, November 25, the estimated 2.16 million senior citizens without PhilHealth coverage can already avail all privileges and benefits the country’s health insurance program offer.

As Republic Act (RA) 10645 takes effect Tuesday, PhilHealth President Alexander Padilla told Rappler they will honor cards issued by the Office for Senior Citizens Affairs (OSCA) or any other identification cards that will prove the citizen is 60 years old and above.

This is PhilHealth’s initial arrangement while the law’s implementing rules and regulations are still being drafted. Padilla said the IRR will be out within the year.

In the event a hospital is not yet aware of the new law and doesn’t grant the senior citizen his or her privileges, Padilla said the patient can go to PhilHealth and get reimbursed for what they paid for, or the amount of the privilege they were denied of.

“They can make a direct file of their claims to us. We will come out with the IRR to make it easier for them, and that’s it – we’re going to pay them accordingly,” Padilla told Rappler on Monday, November 24, after the health department’s budget hearing at the Senate.

President Benigno Aquino III signed RA 10645 on November 5, amending RA 9994 or the Expanded Senior Citizens’ Act of 2010. It removed the qualification that a senior citizen has to be an indigent before being covered by PhilHealth.

PhilHealth, or Philippine Health Insurance Corporation, is the government’s national health insurance program aimed at providing affordable health care to Filipinos. (READ: 2014 target: More than 90% PhilHealth coverage)

‘Transition difficulties’

Padilla admitted there will be “transition difficulties” and it won’t be smooth sailing for those who will now be covered by health insurance. He said, however, they want to implement the law as soon as possible – starting Tuesday.

For better services, he advised senior citizens to look for PhilHealth’s Customer Assistance, Relations and Empowerment Staff (CARES) nurses who can help senior citizens navigate through the nitty-gritty of health insurance in hospitals.

Around 600 hospitals out of the 1,600 licensed ones in the country have PhilHealth CARES, but Padilla said it will be better if patients can go to government hospitals.

Before the law was signed, only 3.94 million out of 6.1 million senior citizens were covered by PhilHealth – either as indigent, sponsored, lifetime member, or dependent.

To ensure implementation, the necessary funds will be sourced from the National Health Insurance Fund of PhilHealth, which is from proceeds of RA 10351 or the Sin Tax Reform Act of 2012.

Senators said they will clarify with the Department of Budget and Management on Tuesday how much in the 2015 budget will be appropriated to implement the new law. – Rappler.com