Dernière mise à jour: 29/2/2024

Informations de base

Groupe de population
Poor households

Détails du programme

Objectifs du programme

Ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risks.

Composantes du programme
NHIP presents different membership modalities: members in the formal economy; members in the informal economy; indigent members; sponsored members; citizens living abroad; senior citizens; and lifetime members.
Références
PhilHealth. n.d. Members. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/members/>. Accessed 16 May 2018>.
Date de début
1995
Références
PhilHealth. 2013. The Revised Implementing Rules and Regulations of the National Health Insurance Act of 2013 (RA 7875 as amended by RA 9241 and 10606). Manila: Philippine Health Insurance Corporation. <https://www.philhealth.gov.ph/about_us/IRR_NHIAct_2013.pdf>. Accessed 16 May 2018.
Couverture
All Filipinos are automatically covered. The program covers the premium of a range of individuals who cannot pay the premium. In 2021, the total number of 'indirect contributors' accounts for 36,355,966 individuals, including 23,809,743 indigents, 11,077,579 senior citizens, and 1,468,644 under sponsored programme.
Références
(i) Department of Health, Philippines. (2021). Philippines Health Insurance Corporation Annual Report: Malasakit at Pag-asa sa Panahon ng Pandemya. Available at: https://www.philhealth.gov.ph/about_us/annual_report/AR2021.pdf. Accessed on 20 September 2023 (ii) Department of Health, Philippines. (2018). Implementing Rules and Regulations of the Universal Health Care Act (Republic Act No. 11223). Available at: https://www.philhealth.gov.ph/about_us/UHC-IRR_Signed.pdf. Accessed on 20 September 2023
Dépenses du programme
USD3.95 billion for UHC financing in 2021
Références
Asian Development Bank. (2021). Build Universal Health Care Program (Subprogram 1): Report and Recommendation of the President. Retrieved from https://www.adb.org/sites/default/files/project-documents/55105/55105-001-rrp-en.pdf. Accessed on 20 September 2023

Ciblage et éligibilité

Groupes cibles
Poor and near-poor populations.
Critère d'éligibilité
All Filipinos including poor and near-poor populations. Beneficiaries for the indigent modality have been identified via the National Household Targeting System for Poverty Reduction (NHTSPR) since 2010. They comprise the poorest 25 per cent of the population.
Références
(i) PIDS. 2017. “Who benefits from the government health insurance subsidy for the poor?” Policy Notes, No. 2017-05. . Accessed 16 May 2018. (ii) PhilHealth. n.d. Indigent Members. Philippine Health Insurance Corporation website. . Accessed 18 May 2018. (iii) Philhealth. (2021). Strategic Plan for 2021-2023: Changing Gears: Moving Philhealth on High Speed. Available online at https://www.philhealth.gov.ph/about_us/transparency/PhilHealthStratplan2021-23.pdf. Accessed on 20 September 2023

Couverture et autres informations

Montant des bénéfices
Health insurance coverage for primary care, catastrophic procedures, and even emerging diseases are all covered under this plan. Access to both inpatient and outpatient services at PhilHealth-accredited facilities. The plan also includes special packages like Z benefits, which contribute towards the costs of specific health issues such as acute types of cancer. Additionally, there is an SDG-related package that offers a variety of benefits for cases such as Malaria, Outpatient HIV-AIDS Package, and Animal Bite Treatment Package.
Références
Philhealth., (2023): Benefits. Available online at https://www.philhealth.gov.ph/benefits/., Accessed on 20 September 2023
Bénéficiaires de prestations
Beneficiaries themselves and their dependents.
Références
PhilHealth. 2013. The Revised Implementing Rules and Regulations of the National Health Insurance Act of 2013 (RA 7875 as amended by RA 9241 and 10606). Manila: Philippine Health Insurance Corporation. <https://www.philhealth.gov.ph/about_us/IRR_NHIAct_2013.pdf>. Accessed 16 May 2018.
Durée minimale et maximale des prestations (le cas échéant)
Programme guidelines state that in case of death of a household member, their dependents should continue to benefit from the programme for the remaining coverage period or until the end of the current year, whichever comes first.
Références
PhilHealth. 2013. The Revised Implementing Rules and Regulations of the National Health Insurance Act of 2013 (RA 7875 as amended by RA 9241 and 10606). Manila: Philippine Health Insurance Corporation. <https://www.philhealth.gov.ph/about_us/IRR_NHIAct_2013.pdf>. Accessed 16 May 2018.
Mécanismes et fréquence de suivi et évaluation
PhilHealth produces annual reports and semestral status updates on the programme as well as annual procurement plan reports.
Références
PhilHealth. n.d. About us. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/about_us/>. Accessed 18 May 2018.
Legal Framework
REPUBLIC ACT No. 7875, known as National Health Insurance Act of 1995
Références
REPUBLIC ACT No. 7875, Congress of Philippines, 1995, https://www.philhealth.gov.ph/about_us/ra7875.pdf Accessed on 20 September 2023