BACOLOD City — The Sangguniang Panlungsod (SP) here is urging the Philippine Health Insurance Corporation (PhilHealth) to review and liberalize its benefit eligibility policies to better protect long-time contributors who die or become critically ill shortly after hospital admission.
The SP recently approved a resolution calling on PhilHealth to amend its policies covering members whose confinement lasts less than 24 hours before death or the onset of a critical medical condition.
The measure, principally authored by Councilor Caesar Distrito and co-authored by Councilor Celia Flor, was prompted by reports that some long-time PhilHealth members were unable to avail themselves of certain benefits despite years or even decades of regular contributions because their hospitalization failed to meet existing confinement requirements.
Distrito said the situation raises concerns over whether current policies sufficiently recognize the loyalty and financial sacrifices of members who have consistently contributed to the national health insurance program.
“Many Filipinos have faithfully paid their PhilHealth contributions for decades with the expectation that they and their families will receive assistance during their most difficult moments,” Distrito said.
He added: “It is only fair that benefit policies recognize not just the duration of confinement but also the totality of a member’s contributions and circumstances.”
The resolution cited growing public concern that families of long-time contributors may be deprived of meaningful financial assistance when a loved one dies or becomes critically ill shortly after hospital admission.
To address the issue, the SP urged PhilHealth to study the creation of a Special Protection Benefit Package for members with substantial contribution histories.
The proposed package would provide additional benefits for emergency hospitalizations, catastrophic illnesses, critical medical conditions, or deaths occurring soon after admission.
Flor said the proposal is anchored on fairness and compassion for members who have consistently fulfilled their obligations to the national health insurance system.
“This is about fairness and compassion,” she said. “Long-time contributors should not be deprived of meaningful benefits merely because a medical emergency or death occurred within a short period after hospital admission.”
The resolution noted that social health insurance is founded on the principles of solidarity and shared responsibility. It added that providing enhanced protection for long-time contributors could strengthen public confidence in PhilHealth and reinforce its mandate of providing financial risk protection during times of illness.
The SP expressed hope that the proposal would contribute to broader healthcare reform discussions and encourage PhilHealth to adopt policies that better reflect the years of commitment and contributions made by millions of Filipino members./PN
