Legarda: Reward long-term PhilHealth members

Metro Manila, Philippines - Senator Loren Legarda has filed a bill mandating the Philippine Health Insurance Corporation (PhilHealth) to establish a reward system for its long-term members, in a bid to address complaints that members receive little in return for their premium contributions.

“Many of our workers, from factory employees to small business owners, have faithfully contributed to PhilHealth for years, hoping for comprehensive support during times of need. Yet, they often feel that their contributions don’t translate into meaningful benefits,” Legarda said in a statement on Saturday, Feb. 1.

“This bill seeks to right that wrong by acknowledging their loyalty and ensuring they feel valued within the system,” she added.

Senate Bill No. 2964, which seeks to amend the National Health Insurance Act, proposes the creation of the PhilHealth Member Recognition Program.

Under the proposal, PhilHealth members will earn points for “sustained premium contributions” which they can redeem for the following benefits:

+ Coverage of out-of-pocket expenses not included in case rate coverage

+ Enhanced medical accommodations in public and private facilities

+ Other healthcare-related expenses

+ Preventive healthcare incentives

Legarda proposed that additional points be awarded to members who avail themselves of preventive services such as annual check-ups, vaccinations, and screenings.

She also emphasized the need for a dedicated digital platform, such as a mobile app or website, allowing PhilHealth members to track their contributions and points, and redeem their rewards.

All contributing PhilHealth members will be eligible for the points-based reward system, provided they have no outstanding penalties or violations under the National Health Insurance Program.

“Retroactive recognition shall consider the member’s paid contributions within the ten (10) years preceding the effectivity of the act or the commencement of their membership, whichever is shorter,” according to the bill.

PhilHealth is directed to craft the implementing guidelines, including defining the period for sustained and consistent premium payments, within six months after the enactment of the measure.

The benefit fund will be sourced from regular contributions, PhilHealth’s reserve fund, donations, grants, and other identified sources, along with earnings from investments.

“To ensure financial stability, the corporation shall implement controls such as redemption caps, expiry periods, and tiered benefits,” the bill states, along with periodic actuarial evaluations to adjust program guidelines.

A comprehensive review will be conducted five years after the program’s implementation, with PhilHealth coordinating with the Health and Finance departments. They will assess the program’s financial stability and explore the possibility of extending benefits to indirect contributors—non-contributing members recognized under the Universal Health Care Act.