I. RATIONALE
In line with the strategic thrust to achieve universal health care or Kalusugan Pangkalahatan and pursuant to PhilHealth Board Resolution No. 1479, s. 2011 and its implementing guidelines, the poor and low-income small self-employed and underground economy workers of the informal sector including women micro-entrepreneurs may be provided coverage under the National Health Insurance Program (NHIP) through a partial subsidy scheme.
This Circular provides for the guidelines to implement the Partial Subsidy Scheme under the Sponsored Program component of the NHIP.
III. COVERAGE
This Circular covers all enrollments of poor and low-income families by local government units and/or with members of Congress, private premium sponsoig and national government agencies.
IV. GENERAL GUIDELINES
A. Qualified enrollees under this scheme are the following:
1. Those poor and low-income families, as certified by the local government unit where the enrollee resides, based on the Income Tax Returns (FUR) or Community Tax Certificate (CTC) presented by the enrollee; and
Those families assessed as non-poor under the National Household Targeting System for Poverty Reduction (NFITS-PR) of the Department of Social Welfare and Development (DSWD).
B. The local government unit and/or premium sponsors, i.e. Members of Congress, private entities, national government agencies, shall initiate the enrollment of these poor and low-income families.
C. Families proposed to be enrolled under the program are required to secure their PhilHealth Identification Number (PIN) prior to the payment of their premium contributions.
D. The annual rate of premium contribution per enrolled family under this scheme is One Thousand Two Hundred Pesos (P1, 200.00). The premium contribution may be shared between the local government unit and/or premium sponsors with the enrolled family from the following options; Provided, That the percentage share of the enrolled family shall not exceed fifty percent (50%) of the annual premium. contribution:
| Percentage Share | Amount of Contribution | ||
| LGU / Premium Sponsor | Member | LGU / Premium Sponsor | Member |
| 100% | 0% | P1,200 | P0 |
| 75% | 25% | P900 | P300 |
| 50% | 50% | P600 | P600 |
E. The PhilHealth Identification Cards (PICs) of enrolled families shall be released only upon full payment of the prescribed annual premium contribution. Membership validity that shall appear in the said card should start on the 1" day of the applicable month and continue to take effect for a period of one year.
F. Families enrolled under this scheme shall be entitled to all NHIP benefits being provided to Sponsored Program members and its qualified dependents including the "No Balance Billing" policy for selected medical cases and surgical procedures pursuant to PhilHealth Circular Nos. 011, 011-A, 011-B, s. 2011.
V. EFFECTIVITY
This Order shall take effect upon publication in any newspaper of general circulation and shall be deposited thereafter with the National Administrative Register at the University of the Philippines Law Centre. - https://www.affordablecebu.com/
