Updated Documentary Requirements for Member Registration, Amendment and Benefit Availment

October 10, 2012

PHILHEALTH CIRCULAR NO. 050-12

 

Pursuant to PhilHealth Circular No. 29 series of 2010, all members of the National Health Insurance Program (NHIP) registering or amending their member information shall use the PhilHealth Member Registration Form (PMRF) attaching therein the appropriate documentary requirements for submission to the nearest PhilHealth Office. For amendments, the member may also use the Member Data Record (MDR) on which to write legibly the changes in member information and submit together with the appropriate supporting documents to the nearest PhilHealth Office for updating.

The following are the documentary requirements for member registration, declaration of dependents, benefits availment including the necessary requisites for amendment to be attached to the PMRF, MDR or PhilHealth Claim Form 1:

 

Purpose	Requirements
1.	Member Registration/Enrollment
				Any of the following:
					A.	Birth Certificate; OR
					B.	Any valid IDs/documents listed in Annex A
				For Orphans:
					A.	Affidavit of Guardianship, if guardian is
						relative; OR
					B.	Certificate of Foundling from Civil Registry,
						with DSWD Certification, if sponsored by
						an institution.
2.	For Declaration of Dependents
	2.1	Spouse	Any of the following:
					A.	Marriage Certificate/Contract; OR
					B.	Any valid IDs/documents in Annex A
						(2d or 2e), whichever is applicable
					C.	For Muslims, Affidavit of Marriage issued
						by the Office of Muslim Affairs that passed
						through the Shari'a Court must be
						registered/authenticated in the NSO.
					D.	For Indigenous Peoples, Certificate of Tribal
						Membership issued by or Barangay Captain
						AND Certificate of Confirmation on the
						Authenticity of the Marriage issued by
						the Regional NCIP.
	2.2	Children	Any of the following:
		2.2.1	Legitimate or		A.	Birth Certificate; OR
			illegitimate below 21
			yrs. old		B.	Any valid IDs/documents in Annex A
						(1.2) AND in A (2)
		2.2.2	Adopted, below 21		A.	Court Decree/Resolution of Adoption; AND
			yrs. old
					B.	Any of the following:
						1.	Birth Certificate of adopted child; OR
						2.	Any two (2) valid IDs/documents in
							Annex A:
							a.	One from 1.2 AND
							b.	One from 2
		2.2.3	Stepchild/ren below		A.	Marriage Certificate between natural parent
			21 yrs. old			and stepmother/stepfather; AND
					B.	Any of the following:
						1.	Birth Certificate of adopted child; OR
						2.	Any two (2) valid IDs/documents in
							Annex A:
							a.	One from 1.2 AND
							b.	One from 2
		2.2.4	Mentally or physically		A.	Medical Certificate from attending physician
			disabled, 21 yrs. Old			stating and describing extent of disability;
			and above			AND
					B.	Any of the following:
						1.	Birth Certificate of adopted child; OR
						2.	Any two (2) valid IDs/documents in
							Annex A:
							a.	One from 1.2 AND
							b.	One from 2
	2.3	Parents	Any of the following:
		2.3.1	60 yrs. old and above		A.	Birth Certificate of both registrant and
						parent; OR
					B.	Any valid documents listed in Annex A (2)
						of BOTH registrant and parent
		2.3.2	Stepparents 60 yrs.	ALL of the following:
			old and above		A.	Marriage Certificate/Contract between
						biological parent and stepparent; AND
					B.	Birth Certificate of stepparent or Annex A
						(1.1); AND
					C.	Birth Certificate of member or ANY
						document listed in Annex A (2) proving
						relationship of member and biological parent
		2.3.3	Adoptive parents, 60		A.	Court Decree/Resolution of Adoption of
			yrs. old and above			member; AND
					B.	Any of the following:
						1.	Birth Certificate of Adoptive parent; OR
						2.	Any valid ID/document of adoptive parent
							listed in Annex A (1.1)
3.	For Amendment
	3.1	Name and Date of Birth of	Any of the following:
		Member and/or dependent/s		A.	Birth Certificate; OR
					B.	Any valid ID/document listed in Annex A
	3.2	Civil Status	Any of the following:
					A.	Marriage Certificate/Contract;
					B.	Court Decision;
					C.	Death Certificate; OR
					D.	Any valid document listed in Annex A (2d)
						or Annex A (2e)
4.	For Benefit Availment
	4.1	Member		A.	Appropriate PhilHealth Claim Form 1; AND
					B.	Any of the following:
						1.	PhilHealth Identification Card (PIC);
						2.	PhilHealth Number Card (PNC) together
							with any valid ID/document listed in
							Annex A; OR
						3.	Pantawid Pamilya Pilipino Program ID
	4.2	Dependent		A.	Appropriate PhilHealth Claim Form 1; AND
					B.	PNC, or Any photo bearing valid ID; AND
					C.	Any of the following:
						1.	Member Data Record (MDR) reflecting
							name of dependent patient; OR
						2.	Any valid document listed in Annex A (2)
	4.3	Acceptable proof of	Overseas Workers Program Members:
		contributions	Any of the following:
					A.	Validated Remittance Forms of banks and
						remittance centers;
					B.	Official Receipt issued by recognized
						remittance centers; OR
					C.	Validated Payment Slip
				Employed Members:
					A.	Duly signed PhilHealth Claim Form 1
						(CF1); OR
					B.	Employer Certification
				Individually Paying Member:
				Any of the following:
					A.	PhilHealth Official Receipt (POR);
					B.	PhilHealth Agent's Receipt (PAR);
					C.	Printed proof of payment from PhilHealth
						website;
					D.	Certificate of Premium Payment (CPP);
					E.	Validated Bayad Center Payment Form;
					F.	Validated Payment Receipt of ACAs;
					G.	Validated Acknowledgement Receipt of
						ACAs;
					H.	Sendout Form from MLhuillier (for online
						transaction);
					I.	Sendout Form Remote Transaction from
						MLhuillier (for offline transaction);
					J.	Validated Payment Slip; OR
					K.	Validated PhilHealth Premium Order Slip
						(PPOS) and Point-of-Sale Generated
						Receipt (POS-GR)

 

All concerned institutions shall require from transacting individuals/members only those applicable documents mentioned in the foregoing enumeration. cEaCAH

This Circular shall take effect fifteen (15) days from publication in any newspaper of general circulation and shall be deposited thereafter with the National Administrative Register at the University of the Philippines Law Center.

All other previous issuances inconsistent with this Circular are hereby amended and/or repealed accordingly.

 

(SGD.) DR. EDUARDO P. BANZONPresident and Chief Executive Officer

ANNEX A

 

List of Other Valid Identification Cards and Documents

 

Purpose	Requirements
1.	Proof of Identity and Age
	1.1	For 18 yrs. old and above	a.	Baptismal Certificate
			b.	GSIS/SSS Members' ID
			c.	Passport
			d.	Driver's License
			e.	Professional Regulation Commission (PRC) ID
			f.	National Bureau of Investigation (NBI) Clearance
			g.	Police Clearance
			h.	Voter's ID
			i.	Postal ID
			j.	Senior Citizen's Card
			k.	Overseas Workers Welfare Administration
				(OWWA) ID
			l.	Overseas Filipino Worker (OFW) ID
			m.	Alien Certification of Registration/Immigrant
				Certification of Registration
			n.	Identification Cards Issued by Recognized
				Government Institutions/Agencies/Corporations
			o.	Certificate from the National Council for the
				Welfare of Disabled Persons (NCWDP)
			p.	Department of Social Welfare and Development
				(DSWD) or Local Social Welfare Development
				Officer (LSWDO) Certification
			q.	Integrated Bar of the Philippines Identification Card
			r.	Company IDs issued by private entities or
				institutions registered with or supervised or
				regulated by the Bangko Sentral ng Pilipinas
				(BSP), Securities and Exchange Commission
				(SEC) or Insurance Commission (IC)
			s.	Barangay Certification, subject for validation
			t.	Affidavit from two (2) Disinterested Persons,
				subject for validation
	1.2	For minors below	a.	Certificate of live birth (newborns)
		18 yrs. old	b.	Baptismal Certificate
			c.	School ID
			d.	Passport
			e.	Police Clearance
			f.	Alien Certification of Registration/Immigrant
				Certification of Registration
			g.	Certificate from the National Council for the
				Welfare of Disabled Persons (NCWDP)
			h.	Department of Social Welfare and Development
				(DSWD) or Local Social Welfare Development
				Officer (LSWDO) Certification
			i.	Integrated Bar of the Philippines Identification
				Card
			j.	Barangay Certification, subject for validation
			k.	Affidavit from two (2) Disinterested Persons,
				subject for validation
2.	Proof of Relationship	a.	Certificate of live birth (for newborns)
			b.	Baptismal Certificate
			c.	Department of Social Welfare and Development
				(DSWD) or Local Social Welfare Development
				Officer (LSWDO) Certification
			d.	Barangay Certification, subject for validation
			e.	Affidavit from two (2) Disinterested Persons,
				subject for validation

 

NOTE:

Affidavits administered by the following officials authorized to administer oath, as provided in Administrative Code of 1987, as amended (Republic Act 6733, Section 41), shall be accepted as valid supporting documents:

1. Members and Secretaries of both houses of the Legislative Body

2. Members of the Judiciary

3. Department Secretaries

4. Governors and Vice Governors

5. City/Municipal Mayors

6. Bureau/Regional Directors

7. Clerks of Court

8. Register of Deeds TCacIA

9. Other Civilian Officers in the Public Service of the Philippine government whose appointments are vested upon the President and are subject to confirmation by the Commission on Appointments

10. All other Constitutional Officers

11. Public Notaries