Ian Alfredo Magno ONE practice Filipinos need to break is the notorious “mañana habit.”  Apparently, there seems to be no strict definition for the phrase although it has always been so closely linked with the term procrastination. To procrastinate, according to Merriam-Webster, is to keep putting off something that needs to be done. What needs to be done? An obligation, a task, assignment, beating a deadline, target or compliance with a certain requirement. Meanwhile, one basic requirement for availing Philhealth benefits is the payment of premiums. Among Philhealth’s thick clientele base is the informal sector (or individually paying members), which is comprised of self-employed or self-earning individuals who are mostly practicing professionals and business owners or entrepreneurs or skilled folks who offer their services as a form of livelihood. Unlike employed Philhealth members whose premiums are withheld and remitted by their employers, individually paying members have to pay their premiums as a matter of personal effort or obligation – either monthly, quarterly, semi annually or annually. At what rate? Philhealth Circular No. 24, series of 2013 (re: Premium Rate for the Individually Paying Program effective CY 2014) provides:
  1. PREMIUM CONTRIBUTION
  2. The annual premium contribution rate for Individually Paying Program effective January 1, 2014 shall be TWO THOUSAND FOUR HUNDRED PESOS (P2,400.00) and shall apply to Individually Paying Members with monthly income of TWENTY FIVE THOUSAND PESOS (P25,000.00) and below.
  3. Individually Paying Members with monthly income above TWENTY FIVE THOUSAND PESOS (P25,000.00) shall remain paying the annual premium rate of THREE THOUSAND SIX HUNDRED PESOS (P3,600.00).”
The idea is simple. Those with paid premiums get to avail of hospitalization benefits. Those with unpaid premiums could not avail of the benefits (at least for the time being). Unfortunately, upon hospitalization, some individually paying members find themselves ineligible to avail of Philhealth benefits due to lack of premium contributions. That’s when things get complicated. The net effect: they would have to dig deep in their wallets and pay huge hospital bills in its entirety. Couldn’t they pay retroactively? Well, retroactive payment of premiums for the informal sector is rather the exception to the rule. Nevertheless, to be allowed retroactive payment, stringent conditions must first be satisfied.  Item 4, Part III of Philhealth Circular 25, series of 2016 provides: “Retroactive payment of missed/unpaid monthly contribution/s shall be allowed within the applicable quarter.  A member with a gap of one or two months within the current quarter shall be given a grace period of until the last day of the said quarter to settle the premium amount due...” It must be carefully noted that the gap or unpaid premiums must only be good for two months, at the maximum.  In addition, such two-month gap or unpaid premiums must necessarily be within the current quarter only.  Furthermore, settlement thereof must be made not later than the last day of such current quarter. Unpaid premiums corresponding to previous quarters could no longer be remedied with retroactive payment.  That’s about it, and they have to settle the entire hospital expense out of pocket. Therefore as a new premium calendar begins, break the bad habit. Pay your Philhealth contributions ahead of time.  And avoid the burdensome and expensive effects of the mañana habit.   (Lawyer Ian Alfredo T. Magno is an associate at Atty. Francis U. Ku & Associates, and is deputy legal officer at Philhealth. E-mail: ianalfredom@gmail.com)