Objectifs du programme

To achieve universal health coverage nationwide.

Références
PIDS. 2017. “Who benefits from the government health insurance subsidy for the poor?” Policy Notes, No. 2017-05. <https://dirp4.pids.gov.ph/websitecms/CDN/PUBLICATIONS/pidspn1705.pdf> . Accessed 16 May 2018.
Previous programme name (if any)
 
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.
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>.
Conditionalities (if any)
 
Contribution type and amount
 
Méthodes de ciblage
Proxy Means Test
Régions ciblées
Nationwide
Groupes cibles
Poor households
Critère d'éligibilité
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
PIDS. 2017. “Who benefits from the government health insurance subsidy for the poor?” Policy Notes, No. 2017-05. <https://dirp4.pids.gov.ph/websitecms/CDN/PUBLICATIONS/pidspn1705.pdf> . Accessed 16 May 2018. PhilHealth. n.d. Indigent Members. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/members/indigent/member.html>. Accessed 18 May 2018.
Eligibility reassessment (if any)
 
Type de bénéfices
Health insurance.
Montant des bénéfices
Members of the Philippine Health Insurance Corporation (PhilHealth) and their dependents have access to inpatient and outpatient services in PhilHealth-accredited facilities. Special packages for institutional deliveries, screening of newborns, and treatment of various illnesses (e.g.: tuberculosis, SARS, avian flu) are also included. Qualified dependents share a coverage of up to 45 days per calendar year.
Références
PIDS. 2017. “Who benefits from the government health insurance subsidy for the poor?” Policy Notes, No. 2017-05. <https://dirp4.pids.gov.ph/websitecms/CDN/PUBLICATIONS/pidspn1705.pdf> . Accessed 16 May 2018. PhilHealth. n.d. Sponsored Members. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/members/sponsored/dependent.html>. Accessed 18 May 2018.
Payment/delivery frequency
 
Mécanisme de versement des bénéfices
Members of the Philippine Health Insurance Corporation (PhilHealth) and their dependents have access to inpatient and outpatient services in PhilHealth-accredited facilities. Special packages for institutional deliveries, screening of newborns, and treatment of various illnesses (e.g.: tuberculosis, SARS, avian flu) are also included. Qualified dependents share a coverage of up to 45 days per calendar year.
Références
PIDS. 2017. “Who benefits from the government health insurance subsidy for the poor?” Policy Notes, No. 2017-05. <https://dirp4.pids.gov.ph/websitecms/CDN/PUBLICATIONS/pidspn1705.pdf> . Accessed 16 May 2018. PhilHealth. n.d. Sponsored Members. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/members/sponsored/dependent.html>. Accessed 18 May 2018.
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.
Couverture
14,641,685 indigent members with 28,844,119 dependents amounting to 43,485,804 people under the Indigent Programme (2016).
Références
PhilHealth. 2016. Annual Report 2016. Manila: Philippine Health Insurance Corporation. <https://www.philhealth.gov.ph/about_us/annual_report/ar2016.pdf>. Accessed 18 May 2018).
Dépenses du programme
PHP19,209.46 million in benefit payments to indigent members (2016).
Références
PhilHealth. 2016. Annual Report 2016. Manila: Philippine Health Insurance Corporation. <https://www.philhealth.gov.ph/about_us/annual_report/ar2016.pdf>. Accessed 18 May 2018).
Institutions et organismes impliqués
Government of Philippines (through PhilHealth).
Références
PhilHealth. n.d. About us. Philippine Health Insurance Corporation website. <https://www.philhealth.gov.ph/about_us/>. Accessed 18 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
 
MIS
 
Stakeholder
Population Group