Free PhilHealth coverage OK’d for solo parents

Free PhilHealth coverage OK’d for solo parents

MANILA, Philippines —  Single parents will now be entitled to free coverage of the state-run Philippine Health Insurance Corp. (PhilHealth) as provided under the law expanding the economic benefits for single fathers and mothers, a senior administration lawmaker disclosed yesterday.

Camarines Sur 2nd District Rep. LRay Villafuerte announced the free health services following a report from the National Council for Solo Parents Inc., which said PhilHealth is now working on the guidelines on the implementation of the free health services for single parents.

“Alongside a monthly cash subsidy for solo parents earning the minimum wage or below and the 10-percent discount plus exemption from the 12-percent value-added tax (VAT) on certain essential purchases, single dads and moms are now entitled to free PhilHealth coverage,” Villafuerte said.

The Bicol legislator is the House of Representatives’ lead author of Republic Act 11861, which expanded the coverage and benefits due single parents and their families under the two-decades-old “Solo Parents Welfare Act of 2000” or RA 8972.

The PhilHealth coverage is automatic and will apply to both working and non-working solo parents.

RA 11861 increased the age threshold of the dependents entitled to the law’s benefits from 18 to 22 years and expanded the coverage of spouses to include not only the legitimate husbands or wives, but also partners in common-law relationships, as defined by the Family Code.

Villafuerte said solo parents may also avail themselves of the 10-percent discount and VAT exemption on their purchases of essentials such as baby’s milk, diapers and doctor-prescribed medicines for their kids aged six years and below.

Solo parents are likewise entitled to a seven-day parental leave with pay, regardless of employment status, and get priority in any telecommuting program of their workplaces, according to the lawmaker, who also co-authored RA 11165 or the Telecommuting Act of 2018.

Among those included in the definition of solo parents are those whose spouses have been medically certified as physically or mentally incapacitated, those who have been separated from their spouses for at least six months and have taken on sole parental care and support of their children, those whose marriages have been nullified or annulled and have been entrusted with solo parental care, those who have been abandoned by their spouses for at least six months and those whose spouses have been jailed for criminal conviction.

Aside from parents whose spouses passed away, unmarried fathers or mothers and rape victims who opted to keep their children, those legally considered as “solo parents” under RA 11861 include the spouses or family members of overseas Filipino workers who have been away for 12 months.

Grandparents and other family members or qualified guardians who bear sole responsibility over the qualified children and those whose spouses have been detained for at least three months for a criminal conviction are also covered.

P50 billion settled

Meanwhile, PhilHealth had already settled some P50 billion worth of payments being claimed by hospitals and doctors during the last five months of 2023, PhilHealth president Emmanuel Ledesma reported during yesterday’s hearing of the House committee on health on the review of the state insurers’ charter.

Ledesma said he has already fulfilled his promise to the panel in September last year to pay the hospitals and doctors.

“I made a promise during the September hearing, and we committed to pay 100 percent to close to 100 percent within 90 days. We backtracked, and for August to December (2023), PhilHealth has paid P50 billion. It is in line with our promise and we complied with it,” he told the panel.

Ledesma noted that PhilHealth is keen on settling its unpaid obligations to ensure the smooth delivery of services to its members and their beneficiaries.

“We feel that we have a lot of room for improvement with regard to payment of claims. In the next few months, we expect to have much less complaints, if not zero, because we are perfecting the system,” he said.

Primary care

To boost the implementation of its expanded primary care benefit package, PhilHealth released over P257 million as its first tranche of capitation payments to primary care provider networks (PCPNs)

“This initial wave of releases will definitely hasten enlistment of members under the networks’ catchment areas and facilitate patients being seen by the providers that they have chosen,” Ledesma said in a statement.

“This is an investment in the general welfare of the Filipino people. We are ready to invest in Konsulta so that many people can avoid contracting diseases or illnesses and these are addressed early on to avoid them getting worse,” he added.

The fund will help accredited Konsulta facilities under the partner networks to ensure readiness to serve patients availing themselves of Konsulta services from consultations to health screening and assessment, to the dispensing of essential drugs and medicines and laboratory procedures, according to the PhilHealth chief.

He noted that four out of the first seven PCPNs under a sandbox setting have received their capitation funds from the state health insurer – Quezon province with P72.9 million; South Cotabato, P53.9 million; Bataan, P114.7 million and Baguio City, P15.9 million.

“These funds were frontloaded, meaning we have advanced the funding even before they render the services. This way, these networks can mobilize these to augment health resources and even ground personnel so that they can serve patients adequately, especially those underserved communities and the vulnerable segments,” Ledesma explained.

In June last year, PhilHealth launched the PCPN sandbox sites. The partnership aims to strengthen primary care services, digitize patient records and streamline claims processes within select areas.

The agency has allotted P30 billion this year to intensify the implementation of Konsulta in more participating networks to cover more regions, especially in geographically isolated and depressed areas. – Mayen Jaymalin