PhilHealth, pay for the time you been overseas or not, to continue?

[Mike J]

This publication would indicate you are covered unless I am reading it wrong or things have changed.

https://dumaguete.com/philhealth-health-insurance-foreigners-philippines/#:~:text=Foreign nationals are required to,have made 120 monthly contributions.

[OnMyWay]

11 hours ago, jimeve said:

Booked in to have cataract surgery, been told they have put it back a month, Not a bigger but they said I can't use my wife's Phil-health account as I'm a foreigner

We explained to her that I was on my wife's account before the change in 2016, but they would not have it so I told them to cancel my opp and stormed out of the building.

So back to square 1. 

It is not clear who is telling you this.  Is it the doctor, the hospital or Philhealth?

It sounds like you are the same as me as I have been on my wife's Philhealth since about 2013.  They covered me when I had shoulder surgery in 2019.

[OnMyWay]

3 minutes ago, Mike J said:

This publication would indicate you are covered unless I am reading it wrong or things have changed.

He is on his wife's plan.  He should be grandfathered.  That appears to be for if he is paying the premium himself under the new plan.

[Mike J]

Here is a circular from 2017 when the changes were made.  It clearly matches the earlier post that I made.  PDF format so I will only show the URL.

https://www.philhealth.gov.ph/circulars/2017/circ2017-0003.pdf

Edited January 9, 2023 by Mike J

[Dave Hounddriver]

Maybe he just has to get the Philhealth Cataract Pre-Approval form?  Here is a link to a 2012 version but better to find a current one.

https://www.philhealth.gov.ph/circulars/2012/circ59_2012.pdf

 

[OnMyWay]

2 hours ago, Mike J said:

Here is a circular from 2017 when the changes were made.  It clearly matches the earlier post that I made.  PDF format so I will only show the URL.

https://www.philhealth.gov.ph/circulars/2017/circ2017-0003.pdf

Yes, and we discussed this back then.  It seemed clear that foreign spouses would not be covered under their wife's plan:

"Foreign nationals are required to enroll as member and shall not be covered as dependent by their Filipino Spouse."

However, over the next few years, myself and others were covered under our wife's plan.  I never saw anything official about that. but it appeared that we were grandfathered.  In 2019 when I had my shoulder surgery, Medical City Clark Philhealth never blinked and paid for some of my costs.

Could that have changed?  Certainly.  Following.

[jimeve]

2 hours ago, Mike J said:

That just doesn't sound correct.  Have you tried contacting other places that do cataracts?   I ask because I, and I am sure many other expats, are on the wife's Philhealth plan and should be grandfathered. 

Not yet Mike, Going back to the other hospital and see what happens.

 

[jimeve]

2 hours ago, OnMyWay said:

It is not clear who is telling you this.  Is it the doctor, the hospital or Philhealth?

It sounds like you are the same as me as I have been on my wife's Philhealth since about 2013.  They covered me when I had shoulder surgery in 2019.

It was the secretory of the clinic, she said go to Phil-health and find out.

I had dengue and in hospital for two nights Phil-health covered me too.

[jimeve]

1 hour ago, Dave Hounddriver said:

Maybe he just has to get the Philhealth Cataract Pre-Approval form?  Here is a link to a 2012 version but better to find a current one.

https://www.philhealth.gov.ph/circulars/2012/circ59_2012.pdf

 

Dave, The doctor said they are a credited Phil-health clinic and said I could avail of Phil-health on my wife's account. That was the first visit.

I think you know the place. ACE next to hyper mart.

[Mike J]

26 minutes ago, jimeve said:

Not yet Mike, Going back to the other hospital and see what happens.

 

Please keep us informed as to what you find out.  This thread is of interest to me as I have was told several years back that I have the beginning of cataract in one eye.