Hospital expenses and other healthcare costs are unquestionably among the most significant and often unforeseen financial burdens that impact individuals, particularly self-employed individuals/professionals, and solopreneurs. As a solopreneur, you have likely invested a substantial portion, if not all, of your resources into your business. Therefore, in the event of a severe illness or accident, this could lead to substantial financial trouble.
In this second installment of a three-part series aimed at helping self-employed individuals/professionals and solopreneurs protect themselves against life’s uncertainties, we will guide you through the process of independently registering and making contributions to the Philippine Health Insurance Corporation (PhilHealth).
How can I enroll for voluntary contributions?
For those who are venturing into freelancing or online selling as their first occupation, you need to initiate your PhilHealth membership. The following are the essential requirements:
- Two valid IDs or a PSA Birth Certificate.
- Two copies of the PhilHealth Member Registration Form (PMRF), can be obtained here.
- Two passport-sized photos (1×1).
Once you have gathered the necessary documents, follow these steps:
- Visit your nearest Local Health Insurance Office or PhilHealth branch.
- If you haven’t yet filled out a PMRF, you can obtain the forms at the branch you are visiting.
- Submit the completed forms along with your IDs and photos.
- Wait for the staff to provide you with your PhilHealth Member Data Record (MDR) and ID.
If you have previous experience with an employer who handled your PhilHealth contributions, you need to update your membership using the following procedure:
- Acquire a PMRF and mark the “Updating/Amendment” box with a checkmark (✓) located in the upper right corner.
- Under “Member Type,” select “Self-Earning Individual” and mark the box (✓) next to “Individual” or “Sole Proprietor” as applicable.
- Submit your completed PMRF to the nearest PhilHealth branch.
- Wait for the printed copy or email of your updated PhilHealth Member Data Record (MDR).
How do I determine the payment amount?
Your monthly premium or contribution corresponds to 3.5% of your monthly earnings or the amount specified in your PMRF. For example, if you stated on your PMRF that you earn ₱35,000 per month, your monthly contribution would be ₱1,225 (₱35,000 x 0.035).
The income floor and ceiling for voluntary members, such as solopreneurs, are fixed at ₱10,000 and ₱70,000, respectively. Consequently:
- Monthly income of ₱10,000 or less corresponds to a monthly contribution of ₱350.
- Monthly income ranging from ₱10,001.01 to ₱69,999.99 results in a monthly contribution ranging from ₱350 to ₱2,449.99.
- Monthly income of ₱70,000 or more leads to a fixed monthly contribution of ₱2,450.
It is worth noting that the income ceiling is slated to increase by ₱10,000 each year until it reaches ₱100,000 by 2024 or 2025. To ensure accurate premium calculations, PhilHealth may request an affidavit of income declaration or your latest income tax return. Otherwise, they will apply the highest computed rate.
Note: PhilHealth had planned to change their premium rate in 2021, but they were awaiting a decision from Congress. Therefore, it’s wise to stay informed about PhilHealth contribution updates by keeping an eye on the news.
Where can I make PhilHealth contributions?
Before making a payment, ensure you have your PhilHealth Identification Number (PIN) and Statement of Premium Account (SPA), which serves as your billing statement.
You can obtain your SPA from the PhilHealth Member Portal (if you haven’t created an account yet, you can do so here). While it is not mandatory, it’s advisable to have a PhilHealth ID on hand, as some cashiers may request it.
Once you have your PIN and SPA, you can proceed to one of the PhilHealth-accredited collecting agents, which include:
- PhilHealth Regional Offices or Local Health Insurance Offices: When visiting these offices, ask for a PhilHealth Premium Payment Slip. To save time, consider downloading, printing, and filling it out before your visit.
- Over-the-counter collecting partners: If you opt to pay through these agents, request a payment, deposit, or transaction slip for PhilHealth contributions.
The partners you can pay at include:
- Asia United Bank
- Bank of Commerce
- Bank One Savings & Trust Corporation
- Bayad Center outlets and accredited agents
- Camalig Bank
- Century Rural Bank
- Century Savings Bank
- China Bank
- China Bank Savings
- Citystate Savings Bank
- Development Bank of the Philippines (DBP)
- EastWest Rural Bank
- Select local government units
- Money Mall Rural Bank
- One Network Bank
- Overseas Filipino Bank
- Philippine Business Bank
- Philippine Veterans Bank
- RCBC Savings Bank
- Robinsons Bank
- Rural Bank of Bambang
- Rural Bank of Jose Panganiban
- Rural Bank of Sta. Catalina
- Saviour Rural Bank
- SM Business Centers and bills payment counters in SM Supermarket, SM Hypermarket, and Savemore
- UCPB Savings Bank
Payment made at a PhilHealth office ensures that your contribution is posted in real-time, while payments at collecting partners may take one or two days to be processed. Keep your validated payment slip as proof of your contribution.
Can I pay my PhilHealth contributions online?
Self-employed individuals/professionals can make online payments using the PhilHealth Member Portal. However, it’s crucial to ensure that your Member Information is updated and complete. If you haven’t declared your monthly income, visit the nearest PhilHealth office to submit tax documents and update your declared monthly income.
To use the portal, follow these steps:
- Access the PhilHealth Member Portal and click “Online Services.”
- Under Member Portal, click “Register/Login.” You’ll need a PhilHealth Online account for payment service access. You can either “Create Account” if you haven’t registered (ensure you have your PhilHealth number), or log in if you already have an account.
- Go to “Payment Management” and select “Generate SPA” to obtain your billing statement.
- Choose the number of months you intend to pay for under the “Premium Payment Option” (between 1 to 36 months).
- Wait for the Member Portal to calculate the payment amount based on your declared monthly income.
- Click “Generate Statement of Premium Account (SPA).”
- Select “MYEG Philippines” as the Accredited Collecting Agent (the only option available at the moment).
- Follow the instructions and proceed with the payment through GCash or debit/credit card.
- Upon completing the transaction, you will receive a confirmation message. You can access your official receipt or Electronic Acknowledgment Receipt (ePAR) by clicking “View SPA History” under the “Payment Management” module. It’s advisable to save this receipt for your records, as it will also be sent to your email or mobile phone via text message.
Note: There is a 2.5% service charge for GCash and a 3% service charge for debit/credit cards, in addition to the ₱25 convenience fee.
When is the deadline for PhilHealth payments?
As health-related expenses can arise unexpectedly, it is advisable to make regular and timely payments for your PhilHealth contributions. You can choose to make premium payments on a monthly, quarterly, semi-annual, or annual basis. The deadlines are as follows:
- Monthly: Last working day of the applicable month (e.g., the deadline for July payment is January 31).
- Quarterly: Last working day of the applicable quarter (e.g., the deadline for payments covering July to September is September 30).
- Semi-annually: Last working day of the first quarter of the applicable semester (e.g., the deadline for payments covering July to December is September 30).
- Annually: Last working day of the first quarter of the year (e.g., the deadline for payments covering January to December 2019 is March 31, 2019).
If you miss a payment deadline, PhilHealth permits retroactive contributions or payments for missed premiums under certain conditions. Specifically, you must:
- Have paid nine consecutive contributions leading up to the missed payments.
- Make the retroactive payment within one month of the missed payments.
For example, if you missed payments for July to September, you can make up for those payments in October, but only if you’ve paid your premiums consistently from October of the previous year until June.
If you manage to make up for your missed contributions before the first day of hospitalization, those payments will be counted as part of your qualifying contributions, which are necessary to access PhilHealth hospitalization benefits. Qualifying contributions consist of three monthly payments within the six months preceding the first day of hospitalization.
For instance, if you missed payments from July to September but made up for them in October, you can benefit from PhilHealth coverage if you get hospitalized in November. However, if you paid during or after your hospitalization, those payments won’t be considered, and you won’t be eligible for benefits.
Note: If you can’t make up for missed payments, you’ll still receive PhilHealth coverage if needed, but you’ll be billed for unpaid premiums with compounded monthly interest. Therefore, it’s advisable to pay contributions in advance to prevent interruptions in your PhilHealth coverage. When paying in advance, make sure you are paying for the correct months or time period to ensure your payment record with PhilHealth is accurate.
How long do I need to continue paying PhilHealth contributions?
You are entitled to PhilHealth benefits as long as you remain an active member by paying qualifying contributions. However, you will automatically become a lifetime member upon reaching the retirement age of 60, provided you have paid a minimum of 120 monthly contributions. Once you achieve lifetime member status, you won’t be required to pay premiums anymore.
Nonetheless, there are senior citizen members who are over 60 years old and may opt to continue paying PhilHealth contributions if they are still employed or have a regular income. More information about senior citizen membership can be found here.
Do you need help with paying for your PhilHealth contributions? Ask an accountant from one of our Partner Firms, today.