Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

Citystate Centre, 709 Shaw Boulevard, Pasig City
Premium
Call Center: (02) 8441-7442 Trunkline: (02) 8441-7444 Year Monthly Basic Salary Monthly Premium
www.philhealth.gov.ph Rate
₱10,000.00 ₱275.00

2019 ₱10,000.01 to ₱49,999.99 2.75% ₱275.00 to ₱1,375.00

₱50,000.00 ₱1,375.00
PHILHEALTH CIRCULAR
₱10,000.00 ₱300.00
No. 2019-0009
2020 ₱10,000.01 to ₱59,999.99 3.00% ₱300.00 to ₱1,800.00
TO : ALL DIRECT CONTRIBUTOR MEMBERS ₱60,000.00 ₱1,800.00
OF THE NATIONAL HEALTH INSURANCE ₱10,000.00 ₱350.00
PROGRAM AND ALL OTHERS CONCERNED
2021 ₱10,000.01 to ₱69,999.99 3.50% ₱350.00 to ₱2,450.00
SUBJECT :
Premium Contribution Schedule in the ₱70,000.00 ₱2,450.00
National Health Insurance Program (NHIP) ₱10,000.00 ₱400.00
Pursuant to R.A. No. 11223 Known as the
“Universal Health Care Act” 2022 ₱10,000.01 to ₱79,999.99 4.00% ₱400.00 to ₱3,200.00
₱80,000.00 ₱3,200.00
₱10,000.00 ₱450.00
I. RATIONALE
2023 ₱10,000.01 to ₱89,999.99 4.50% ₱450.00 to ₱4,050.00
It is the policy of the State “to adopt an integrated and
comprehensive approach to health development which shall ₱90,000.00 ₱4,050.00
endeavor to make essential goods, health and other social ₱10,000.00 ₱500.00
services available to all the people at affordable cost and to 2024
₱10,000.01 to ₱99,999.99 ₱500.00 to ₱5,000.00
to 5.00%
provide free medical care to paupers. Towards this end, the 2025
State shall provide, among others, (b) A health care model ₱100,000.00 ₱5,000.00
that provides all Filipinos access to a comprehensive set of
B. The premium of Employed members in the government and
quality and cost-effective, promotive, preventive, curative,
private sector, including household help and sea based OFWs,
rehabilitative and palliative health services without causing
shall be computed straight based on the monthly basic salary
financial hardship, and prioritizes the needs of the population
of the employee to be equally shared between the employee
who cannot afford such services [Section 11, Article XVIII
and employer.
on Social Justice and Human Rights of the Constitution and
typified in Article 1 of Republic Act (R.A.) No. 7875, as C. For those whose basic monthly salary is below the income
amended by R.A. No. 10606, and R.A. No. 11223 otherwise floor, the premium contribution shall be computed based on
known as the Universal Health Care (UHC) Act of 2019]. the income floor, while those whose basic monthly income
is above the income ceiling, the premium contribution shall
Among the general objectives of the UHC Act is to progressively
be computed based on the income ceiling in accordance with
realize universal health care in the country through a systemic
the DBM Circular No. 2019-8 (Re: Employer (Government)
approach and clear delineation of roles of key agencies and
Share in the Health Insurance Premium Contributions to the
stakeholders towards better performance in the health system;
Philippine Health Insurance Corporation Effective FY 2019).
and to ensure that all Filipinos are guaranteed equitable access
to quality and affordable health care goods and services, and D. The employers shall ensure that the premium contribution of
protected against financial risk. women who are on maternity leave shall be regularly remitted
to PhilHealth pursuant to the Department Advisory No. 01 s.
To accomplish these objectives, Section 7 of the UHC Act
2019 of the Department of Labor and Employment (DOLE)
provides for an “Individual-based health services” that shall
re: “Guidelines on the Computation of Salary Differential
be financed primarily through prepayment mechanisms such
of Female Workers During Her Maternity Leave and Its
as social health insurance, private health insurance, and HMO
Criteria for Exemption Pursuant to Republic Act 11210 and its
plans to ensure predictability of health expenditures.” Under
Implementing Rules and Regulations.”
Section 8 of the UHC Act, the program membership in the
NHIP is simplified into two (2) types, namely Direct and E. For Self-Earning Individuals, Professional Practitioners,
Indirect Contributors. Land-based Migrant Workers and all other Direct Contributors
with no employer-employee relationship, their monthly
As such, the National Health Insurance Program (NHIP)
premium shall be computed straight based on their monthly
under R.A. No. 7875 was engaged with the same purpose of
income to be paid wholly and individually by the member in
providing health insurance coverage and ensuring affordable,
accordance with the terms of payments and corresponding due
acceptable, available and accessible health care services for
dates as prescribed by the Corporation. A separate Corporate
all citizens of the Philippines, in accordance with the policies
implementing guidelines will be issued for this purpose.
and specific provisions of the Act. This social health insurance
program serves as the means for the healthy to help pay for the Individually paying members including Land-based Migrant
care of the sick and for those who can afford medical care to Workers shall be required to provide a proof of income, such
subsidize those who cannot (Section 5, Article III of R.A. No. as financial books/records, latest BIR-received income tax
7875, as amended). return or a duly-notarized affidavit of income declaration and
overseas employment contract.
II. OBJECTIVE F. Lifetime and Senior Citizen members who obtain a regular
To operationalize the “Individual-based health services” for all source of income from employment, practice of profession
Direct Contributors of the NHIP by providing set of rules and and other means of income shall resume paying the required
guidelines on the payment mechanism pursuant to R.A. No. 7875, monthly premium contribution corresponding to membership
as amended by the UHC Act. type under the direct contributors.
G. In accordance with R.A. No. 10361, the premium
III. SCOPE contributions of the Kasambahay (or Domestic Worker) shall
This Circular covers all Direct Contributors as defined under the be shouldered solely by the household employer. However, if
UHC Act, including their qualified dependents. the Kasambahay is receiving a monthly salary of five thousand
pesos (₱5,000.00) or above, the Kasambahay shall pay his/her
IV. DEFINITION OF TERMS proportionate share.
A. Dependent - the legitimate spouse/s who is not an active H. R.A. No. 11228 decrees the mandatory PhilHealth coverage
member, unmarried and unemployed legitimate, legitimated, of all persons with disability (PWDs). Premium contributions
acknowledged, illegitimate children and legally adopted or for all PWDs shall be paid by the National Government.
stepchildren twenty-one (21) years of age and below, foster For employed PWD members, the premium shall be shared
child as defined in R.A. No. 10165 otherwise known as the equally by their employers and the National Government
Foster Care Act of 2012 and parents who are sixty (60) years (employee share).
old and above, not otherwise an enrolled member. I. The monthly premium contribution of all members shall be
B. Direct Contributors – refer to those who have the capacity remitted and reported on or before the schedule as prescribed
to pay premiums, are gainfully employed and are bound by by the Corporation. Failure to pay premiums shall not prevent
an employer-employee relationship, or are self-earning, the member from enjoyment of any Program benefits.
professional practitioners, overseas Filipino workers, as Provided, that the direct contributors shall be required to
defined in R.A. No. 10022 (Migrant Workers Act) and R.A. pay all missed contributions with interest, compounded
No. 10801 (OWWA Act), including their qualified dependents, monthly, of at least three percent (3%) for employers of
and lifetime members. private and government sector, sea-based migrant workers,
and kasambahays; and not exceeding one and one-half percent
C. Indirect contributors – refer to all others not included as
(1.5%) for self-earning individuals, professional practitioners,
direct contributors, as well as their qualified dependents,
land-based migrant workers, Filipinos living abroad, and
whose premium are subsidized by the national government
Filipinos with dual citizenship. Provided further, that in the
including those who are subsidized as a result of special laws.
case of direct contributors like self-earning individuals,
D. Member – all Filipino citizens as defined under the 1987 professional practitioners, land based migrant workers,
Philippine Constitution. Filipinos living abroad, and Filipinos with dual citizenship,
E. Professional Practitioners - refer to all practitioners required non-compliance to issued final demand letter for past due
to pass government licensure examinations in order to practice premiums including incurred interests shall result in the
their professions. The term “professional” also refers to one temporary discontinuance of succeeding benefit availments
who pursues an art and makes his living therefrom such as and may constitute an administrative offense sanctioned under
artists, athletes and others similarly situated. Section 38 of the UHC Act. Provided finally, that in the case
F. Monthly Basic Salary (MBS) - the fixed basic rate of an of employed member, the failure of the employer to remit the
employee which shall not include sales commission, overtime required contribution and to submit the required remittance list
pay, allowances, thirteenth month pay, bonuses or other shall constitute an offense as provided for under Section 38 of
gratuity payments. Further to this, those deductions to the the UHC Act.
employee’s pay occasioned by his/her under time, tardiness,
leave(s) without pay, absences, or other similar circumstances VI. SEPARABILITY CLAUSE
shall also be excluded in this computation. For the monthly- In the event that a part of the provision of this Circular is declared
paid and daily-paid employees, the MBS shall be computed unconstitutional or rendered invalid by any Court of Law or
based on the estimated Equivalent Monthly Rate (EMR) competent authority, provisions not affected by such declaration
consistent with the latest edition of the Department of Labor shall remain in full force and effect.
and Employment-Bureau of Working Condition’s Handbook
on Worker’s Statutory Monetary Benefits. VII. REPEALING CLAUSE
All issuances inconsistent with this Circular are hereby repealed
G. Self-Earning Individuals – those who render services or
or modified accordingly.
sell goods as a means of livelihood outside of an employer-
employee relationship or enterprises owned and operated by
VIII. DATE OF EFFECTIVITY
employers which may employ fewer than (10) employees or
This Circular shall take effect after fifteen (15) days from its
informal sectors such as seasonal employees engaged in the
publication in a newspaper of general circulation and three (3)
production of goods and services with the primary objective of
certified true copies had been furnished the Office of National
generating employment and income for the persons concerned
Administrative Register (ONAR) of the UP Law Center.
including job order contractors and project-based contractors.

V. GENERAL GUIDELINES
A. Premium Contribution Table for Direct Contributors.
Effective the applicable month upon effectivity of the BGEN. RICARDO C. MORALES, AFP (RET) FICD
Implementing Rules and Regulations (IRR) of the UHC Act, President and Chief Executive Officer (CEO)
the monthly premium contributions shall be in accordance
with the premium rates and monthly income/basic salary floor
and ceiling prescribed in the said Act, as follows: Date Signed: October 25, 2019