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Health & Wellness Philhealth for an expat?

Discussion in 'Businesses - Services - Products' started by AlwaysRt, Dec 2, 2016.

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  1. Princeton

    Princeton DI Member

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    Imho many are wrongly looking only at the yearly premium whether p2400 or p18000 is irrellavant when considering the biggest change is the new "Case Rate" payment system.One only needs to check the payments allowed for each treatment to see Philhealth has lost most if not all appeal to an expat.Most illnesses under new case rate qualify for 6k..8k..10k,,,thats it.My recent stay in Siliman qualified me for the max payment of 18,900p on a bill of 160,000p.......
     
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  2. Charlie

    Charlie DI Senior Member Restricted Account Veteran Coast Guard

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    Where do we find these case rates ? I have looked all over and can't find them. If it's on Facebook I don't do Facebook. Hopefully it is shown somewhere else. The Philhealth web site would be a good place one would think to find this case rate info but I haven't seen it there either.
    Thanks
     
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  3. Brian Oinks

    Brian Oinks That's Mr. Pig to you Boy! :) Highly Rated Poster

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    This gives some of the costings of illnesses and procedures but not the reimbursement rates;

    Benefits | PhilHealth

    *EDIT:

    Adding to this; (I Assume this is why they have set each case with a set fee)

    In 2011, PhilHealth has implemented case based payment scheme which offers a more predictable and equitable benefit payment based on patients' medical condition. Along with the introduction of case payment is the introduction of the No Balance Billing (NBB) Policy, which provides that no other fees or expenses shall be charged or be paid for by the indigent patients above and beyond the packaged rates during their confinement period.

    https://www.philhealth.gov.ph/circulars/2017/circ2017-0006.pdf

     
    Last edited: Jun 18, 2017
  4. Brian Oinks

    Brian Oinks That's Mr. Pig to you Boy! :) Highly Rated Poster

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    PhilHealth Expands Coverage to Foreign Nationals (June 7, 2017)

    STARTING July 1, 2017, foreign nationals and former Filipino citizens who have chosen to retire in the Philippines may avail themselves of social health insurance benefits.

    Under a Memorandum of Understanding (MoU) signed in 2015 between the Philippine Health Insurance Corporation (PhilHealth) and the Philippine Retirement Authority (PRA), qualified foreign retirees who are registered with the PRA or former Filipinos may enrol under the Informal Economy member category to gain access to medical care services in the country.

    The MoU aims to further strengthen the collaboration between the two government agencies to promote the country as a retirement haven for qualified foreigners.

    Interested foreign retirees in the country may submit the properly filled out PhilHealth Member Registration Form for Foreign Nationals to the PRA Head Office in Makati City or to any of its satellite offices nationwide. Requirements for their enrolment are Special Resident Retiree’s Visa (SRRV) and a granted permanent residency status pursuant to Section 9 (d) of Executive Order No. 1037. The PRA will facilitate their enrolment into the National Health Insurance Program (NHIP).

    Citizens of other countries residing or working in the Philippines with a valid Alien Certificate of Registration Identity Card (ACR I-Card) issued by the Bureau of Immigration may submit their PMRF for Foreign Nationals to the nearest Local Health Insurance Office (LHIO).

    All member-foreign nationals and their qualified dependents shall be entitled to inpatient and outpatient benefits and other special benefit packages through any of the PhilHealth-accredited health care institutions nationwide. Excluded from their entitlements, however, are the Z Benefit packages, reimbursement for all confinements abroad and benefits for women about to give birth (WATGB).

    The annual premium contribution rate for PRA foreign retirees is P15,000.00, while that of other foreign citizens is P17,000.00. They may pay for their premium contributions either quarterly, semi-annually or annually. (Dahlia D. Benedicto)

    PhilHealth Expands Coverage to Foreign Nationals
     
  5. Notmyrealname

    Notmyrealname DI Forum Luminary Highly Rated Poster Showcase Reviewer

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    Excuse my ignorance on this issue, but I thought "Foreign Nationals" are already permitted to take out Phil Health insurance and that the change taking place is to charge them more and give them less back. ​
     
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  6. Brian Oinks

    Brian Oinks That's Mr. Pig to you Boy! :) Highly Rated Poster

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    I have listed links to the case rates, but there is nothing online regards reimbursements, so I assume we will need to rely on personal accounts like Princeton's, which in my opinion makes Philhealth very unappealing to a foreigner, especially if I recall that they will only cover an illness once in a set period of time with the one reimbursement and only if hospitalised for 3 or 4 days minimum, so you get back your 'investment' but are still out of pocket in a big way...

    Surely there is Private Insurance that covers 'more' and 'more often' in a fairer way?

     
  7. Brian Oinks

    Brian Oinks That's Mr. Pig to you Boy! :) Highly Rated Poster

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    I posted the link due to it being a recent notice. :smile: (I do not recall seeing on here) And to make it clearer regards the two payments that many have asked about and has been answered yet still remains confusing;
    *The annual premium contribution rate for PRA foreign retirees is P15,000.00, while that of other foreign citizens is P17,000.00.
     
  8. OP
    OP
    AlwaysRt

    AlwaysRt DI Forum Patron Highly Rated Poster Blood Donor Veteran Air Force Marines

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    In a country of 100 million people, I am not sure if expat premiums at the existing or new rates, or expat claims, add up to a significant enough financial amount to justify the change. Of the low percentage of expats that have gotten coverage, what amount will bother to stick with it? The combination of drastic increase in premium and reduction in benefit are pushing many to either self insure or make the now much smaller jump to private (real) insurance.

    Facility costs are often reduced or paid for by aid organizations/charity, acquiring outdated (last year's model) equipment, reduced profit margin to be able to make a sale, restrictions on adding R&D to production costs so it ends up being fully funded by US customers.....
     
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  9. Jack Peterson

    Jack Peterson DI Forum Luminary Highly Rated Poster SC Connoisseur Veteran Air Force

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    How So? I pay the Premiums in this House and I ain't from there
     
  10. OP
    OP
    AlwaysRt

    AlwaysRt DI Forum Patron Highly Rated Poster Blood Donor Veteran Air Force Marines

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    Sorry I must have been unclear. I was referring to the prices charged by companies within the US vs the same product in other countries.

    Moreso related to pharmaceuticals but medical research & development (R&D) is not allowed to be added as a cost of manufacturing by many countries. It is allowed in the US to amortize this cost and results in a lower calculated accounting markup for profit. R&D costs are often added exclusively in the US market and accounts for some of the price disparity between the US and Canada for the same medication for example.
     
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