DIRECT AND INDIRECT CONTRIBUTORS UNDER THE UNIVERSAL HEALTH CARE ACT

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Published — December 16, 2020 

The following post does not create a lawyer-client relationship between Alburo Alburo and Associates Law Offices (or any of its lawyers) and the reader. It is still best for you to engage the services of your own lawyer to address your legal concerns, if any.

Also, the matters contained in the following were written in accordance with the law, rules, and jurisprudence prevailing at the time of writing and posting, and do not include any future developments on the subject matter under discussion.

More on health care standards: NON-COMPLIANCE WITH OCCUPATIONAL SAFETY AND HEALTH STANDARDS

• Every Filipino citizen shall be automatically included into the National Health Insurance Program

• Direct contributors refer to those who have the capacity to pay premiums

• Indirect contributors refer to those whose premium shall be subsidized

Membership into the National Health Insurance Program (Program) is now simplified into two types, direct contributors and indirect contributors. This is to give effect to the mandate of the Universal Health Care Act that every Filipino citizen shall be automatically included in the Program.

Who are direct contributors?

The law says:

Direct contributors refer to those who have the capacity to pay premiums. They are those who are gainfully employed and bound by an employer-employee relationship, or are self-earning, professional practitioners, migrant workers, including their qualified dependents, and lifetime members. Their qualified dependents are the following:

1. Legal spouse/s who is/are not an active member of the Program;
2. Unmarried and unemployed legitimate, illegitimate children, and legally adopted or stepchildren below twenty-one (21) years of age;
3. Foster children as defined Foster Care Act of 2012; and
4. Parents who are sixty (60) years old and above, not otherwise an enrolled member.

Who are indirect contributors?

The law says:

Indirect contributors refer to those all others who are not included as direct contributors as well as their qualified dependents. Unlike the direct contributors, their premiums are shall be subsidized by the national government including those who are subsidized as a result of special laws. Examples of indirect contributors are the following:

1. Indigents as identified by the Department of Social and Welfare Development;
2. Beneficiaries of Pantawid Pamilyang Pilipino Program/Modified Conditional Cash Transfer (4Ps/MCCT);
3. Senior citizens who are not currently covered by the Program;
4. Persons with disability;
5. All Filipinos aged 21 years old and above without capacity to pay premiums;
6. Sangguniang Kabataan officials;
7. Those previously identified at point-of service (POS) or during registration members previously sponsored by Local Government Unit’s and those who are not yet in the PhilHealth database and are financially incapable to pay premiums.

Indeed, every Filipino citizen, whether or not he has the capacity to pay premiums, is automatically covered by the Program.

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Alburo Alburo and Associates Law Offices specializes in business law and labor law consulting. For inquiries, you may reach us at info@alburolaw.com, or dial us at (02)7745-4391/0917-5772207.

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