Philhealth Membership

Enrolling in PhilHealth Coverage for Seniors

Securing reliable healthcare coverage remains vital for all Filipinos. Enrolling in the national health insurance program is essential now. Filipino senior citizens gain automatic entitlement to PhilHealth coverage. This access ensures medical and hospitalization benefits are readily available. We guide you through the necessary steps for successful registration today. Understanding the eligibility rules simplifies your entire enrollment process effectively.

Confirming Senior Citizen Eligibility

You must first determine if you qualify under the senior citizen category clearly. PhilHealth extends coverage to several groups of elderly citizens consistently.

Primary Beneficiaries:

• 
  

  Filipino citizens must be residents of the Philippines officially.

  
  


• 
  

  You must have reached the age of sixty (60) years or above already.

  
  


• 
  

  You must not currently hold coverage under any other PhilHealth membership category.

  
  

Qualified Dependents:

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  Qualified dependents of existing senior citizen members are included. These dependents must also be senior citizens themselves to qualify.

  
  


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  Qualified dependents of members belonging to other categories also qualify. They must be senior citizens themselves, with or without prior coverage.

  
  

Important Note for Workers:

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  Senior citizens who remain gainfully employed must follow a different rule.

  
  


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  Individuals with regular sources of income shall continue paying premiums. This payment continues under their existing, applicable membership categories primarily.

  
  

Becoming a Member: Registration Procedures

PhilHealth offers two convenient options for seniors to enroll easily. You can choose the method that best suits your location and accessibility needs immediately.

Option 1: Enrollment Through OSCA

The Office for the Senior Citizens Affairs (OSCA) provides a straightforward enrollment channel.

1. 
   

   Fill Out the PMRF: Complete two clean copies of the official PhilHealth Member Registration Form (PMRF). Fill out the forms accurately and completely now.

   
   


2. 
   

   Submit to OSCA: Submit the duly accomplished PMRF to the local OSCA office directly. Use the OSCA office located in the city or municipality where you reside permanently.

   
   


3. 
   

   Await Documents: You must then await the issuance of your final documents patiently. PhilHealth will issue the Member Data Record and Identification Card. This information will be delivered to you directly through the OSCA office promptly.

   
   

Option 2: Enrollment Through LHIO

You may also enroll directly at a PhilHealth Local Health Insurance Office (LHIO).

1. 
   

   Fill Out the PMRF: Complete two clean copies of the official PhilHealth Member Registration Form (PMRF) accurately.

   
   


2. 
   

   Attach Photo: Attach one clear 1-inch by 1-inch photo to the form immediately. This picture must have been taken within the last six months for validity.

   
   


3. 
   

   Present ID: You need to present your official Senior Citizen’s Identification Card. This must have been issued by the OSCA in your city or municipality specifically. Alternatively, you can present any valid government-issued ID for verification easily.

   
   


4. 
   

   Submit PMRF: Submit the fully accomplished PMRF and attached documents to the LHIO officer.

   
   


5. 
   

   Await Documents: Wait for your official Member Data Record and PhilHealth Identification Card.

   
   

Premium Contributions and Funding

Seniors enrolled under this category enjoy a critical benefit immediately. The government covers their premium contributions entirely. The funds for these premiums are securely sourced from national legislation primarily. This funding comes from the proceeds of Republic Act No. 10351 successfully. This law is commonly and widely known as the Sin Tax Law. This government funding ensures access to healthcare remains financially viable for all seniors.

Claiming Benefits During Hospitalization

Availing benefits during a hospital stay is now a smoother process than before. Hospitals with the PhilHealth HCI Portal installed simplify the claim process significantly.

1. 
   

   Present ID: Senior citizens only need to present their Senior Citizen Card upon admission. Alternatively, use your Member Data Record or any proof of identity and age readily.

   
   


2. 
   

   Eligibility Check: The Hospital staff will print a PhilHealth Benefit Eligibility Form (PBEF) quickly. A PBEF that clearly says “YES” confirms benefit entitlement immediately. This confirmation serves as the basis for automatic benefit deduction successfully.

   
   

What if the PBEF says “NO” or the system is unavailable?

If the hospital lacks the HCI portal or the PBEF denies coverage, action is still possible. If you were unable to enroll before discharge, you must follow an alternative claim process. Attach the following documents to the usual claim forms consistently:

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  A duly accomplished PhilHealth Member Registration Form (PMRF).

  
  


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  An acceptable proof of your status as a senior citizen. This proof must include, but is not limited to, the official Senior Citizens’ Identification Card.

  
  

Timely enrollment ensures easy benefit availment when it matters most actively. Secure your PhilHealth coverage today for future peace of mind.

In case the hospital has no HCI portal installed, or the PBEF says “NO”, or the senior citizen was not able to enroll before discharge, the following should be attached to the usual claim documents:

a. duly accomplished PhilHealth Member Registration Form (PMRF); and
b. an acceptable proof of status as a senior citizen, including but not limited to the Senior Citizens’ Identification Card.