MEMBERS

Who can be members of PhilHealth?
All Filipino citizens are mandated to enrol into the National Health Insurance Program.
What are the different membership types at PhilHealth?
There are currently five membership types/programs under the NHIP. These are:
1. Sponsored Program
2. Individually Paying Program
3. Employed Sector Program
4. Overseas Workers‟ Program
5. Lifetime Member Program

Who can enrol under these different programs?
As a general rule, remember that each Filipino is entitled to become part of the National Health Insurance
Program. Your type of membership depends primarily on two things: 1) capacity to pay and 2) employment.
Those who are below 21 are generally considered as dependents, rather than primary members.
Sponsored Program
Under the Sponsored Program, indigents belonging to the lowest 40% (Quintiles 1 and 2) of the Philippine
population in terms of income may enrol, including:
1. Families listed under the National Household Targeting System for Poverty Reduction (NHTS – PR) of
the Department of Social Welfare and Development (DSWD)
2. Families identified poor by the sponsoring Local Government Units (LGUs).

Individuals are encouraged to check whether they belong to the DSWD/LGU lists. Identified members and their dependents shall be considered part of the NHIP.

Individually Paying Program
Under the Individually Paying Program, the following may enroll:
1. Self-employed individuals. These are individuals who work for him/herself and are therefore both the
employer and employee of their businesses. These include but are not limited to the following:
a. Self-earning professionals (ex. doctors and lawyers)
b. Business partners and single proprietors/proprietresses
c. Freelancers, actors, actresses, directors, scriptwriters and news reporters who are not under an
employer-employee relationship
d. Professional athletes, coaches, trainers and jockeys
e. Farmers and fisherfolk
f. Workers in the informal sector (ex. ambulant vendors, watch-your-car boys, hospitality girls, tricycle
drivers, etc.)
2. Separated from employment. These are individuals who were previously formally-employed (with employeremployee
relationship) and are separated from employment.
3. Employees of international organizations and foreign governments based in the Philippines without agreement with
PhilHealth for the coverage of their Filipino employees in the program.
4. All other individuals not covered under the previous categories mentioned, including but are not limited
to the following:
a. Parents who are not qualified as legal dependents, indigents or retirees/pensioners
b. Retirees who did not meet the minimum of 120 monthly premium contributions to qualify as nonpaying
members
c. Children who are not qualified as legal dependents
d. Unemployed individuals who are not qualified as indigents

Employed Sector Program
Under the Employed Sector Program, the following may enroll:
1. Government Sector. Employees of the government, whether regular, casual or contractual, who renders
services in any government branches, military or police force, political subdivisions, agencies, or
instrumentalities, including government-owned and controlled corporations, financial institutions with
original charter, constitutional commissions, and is occupying either an elective or appointive position,
regardless of status of appointment.

2. Private Sector. Employees who render services in any of the following:
a. Corporations, partnerships, or single proprietorships, non-government organizations, cooperatives,
non-profit organizations, social, civic, or professional or charitable institutions, organized and based
in the Philippines
b. Foreign corporations, business organizations, non-government organizations based in the Philippines
c. Foreign governments or international organizations with quasi-state status based in the Philippines
which entered into an agreement with PhilHealth to cover their Filipino employees
d. Foreign business organizations based abroad with agreement with PhilHealth to cover their Filipino
employees
e. Sea-based OFWs
f. Household employees

Overseas Workers Program
Under the Overseas Workers Program, the following may enrol:
1. Active land-based OFWs who underwent the normal process of registration as an OFW at POEA
Offices
2. OFWs who are currently abroad but are not yet registered with PhilHealth.

Lifetime Member Program
Under the Lifetime Member Program, the following may enrol:
1. Old-age retirees and pensioners of the GSIS, including uniformed and non-uniformed personnel of the
AFP, PNP, BJMP and BFP who have reached the compulsory age of retirement before June 24, 1997,
and retirees under Presidential Decree 408
2. GSIS disability pensioners prior to March 4, 1995
3. SSS pensioners prior to March 4, 1995
4. SSS permanent total disability pensioners
5. SSS death/survivorship pensioners
6. SSS old-age retirees/pensioners
7. Uniformed members of the AFP, PNP, BFP and BJMP who have reached the compulsory age of
retirement on or after June 24, 1997, being the effectivity date of RA 8291 which excluded them in the
compulsory membership to the GSIS
8. Retirees and pensioners who are members of the judiciary
9. Retirees who are members of Constitutional Commissions and other constitutional offices
10. Former employees of the government and/or private sectors who have accumulated/paid at least 120
monthly premium contributions as provided for by law but separated from employment before reaching
the age of 60 years old and thereafter have reached 60 years old
11. Former employees of the government and/or private sectors who were separated from employment
without completing 120 monthly premium contributions but continued to pay their premiums as
Individually Paying Members until completion of the required 120 monthly premium contributions and
have reached 60 years old as provided for by law
12. Individually Paying Members, including SSS self-employed and voluntary members, who continued
paying premiums to PhilHealth, have reached 60 years old and have met the required 120 monthly
premiums as provided for by law
13. Retired underground mine workers who have reached the age of retirement as provided for by law and have met the required premium contributions.

What are the fundamental processes that each member should know?
Each member ought to be familiar with the following fundamental processes:
1. Enrolling or registering into the NHIP
2. Updating their records regularly
3. Paying for their premiums on-time
4. Getting their claims from PhilHealth
5. Knowing their benefits

What is my proof that I am already a registered member?
After registering, each member should receive the following important documents:
1. PhilHealth ID – contains the member‟s PIN (PhilHealth Identification Number), name, picture, and
signature. Remember that each member should have only one PIN.
2. Member Data Record (MDR) – contains the member‟s name, address and legal dependents listed in the
PhilHealth database.