Legarda files bill to reward years of loyalty among PhilHealth members with enhanced benefits

Manila, Philippines — Senator Loren Legarda has filed a groundbreaking bill seeking to recognize and reward the loyalty of long-term PhilHealth contributors, aiming to address long-standing grievances about inequities in the national health insurance system. The proposed measure establishes the PhilHealth Member Recognition Program (PMRP), a points-based system designed to reward members for consistent and sustained contributions, offering additional tangible benefits beyond the standard package.

Under the bill, members who have consistently paid premiums will receive retroactive recognition for their past contributions, covering up to ten (10) years prior to the program’s implementation or from the start of their membership, whichever is shorter. This means that members who have been diligently paying for years will be rewarded with points that can be redeemed for additional healthcare benefits, payment for out-of-pocket expenses, improved accommodations, enhanced preventive care services, or even non-medical health-related services.

“Many of our workers, from factory employees to small business owners, have faithfully contributed to PhilHealth for years, hoping for comprehensive support during times of need. Yet, they often feel that their contributions don’t translate into meaningful benefits,” Legarda said. “This bill seeks to right that wrong by acknowledging their loyalty and ensuring they feel valued within the system.”

For example, a long-time contributor who has been paying premiums for 10 years will not only accumulate points moving forward but also receive retroactive points based on their past payments. The bill also proposes loyalty bonuses for members who have consistently paid for five, ten, or twenty years without interruptions.

“This is our way of saying thank you to those who have stayed committed to the program,” Legarda explained. “Their contributions have sustained the system, and it’s time we acknowledge their sacrifices.”

While the National Health Insurance Program (NHIP) was designed to function as a traditional insurance program, the evolving demands of members and the competitive advancements in the private sector highlight the need for PhilHealth to innovate. The private sector has already developed various financial innovations, such as loyalty rewards and flexible spending accounts, which enhance customer satisfaction and retention in regular medical and health insurance programs. The bill aims to ensure PhilHealth remains relevant and responsive to its members by encouraging the adoption of emerging trends and reimagining its approach.

Addressing Inequities in PhilHealth

The bill seeks to address one of the most common criticisms of PhilHealth: the perception that contributors receive little in return for their years of financial support. Many members have complained that despite regular payments, their benefits barely cover medical expenses, often leaving them with significant out-of-pocket costs. Employers striving to support their employees are often compelled to secure private medical insurance to fill the gaps left by PhilHealth. Furthermore, many direct contributors, particularly employees or those on minimum wage, are forced to turn to other government programs, relying on the discretion and goodwill of those responsible for approving their applications.

By introducing a rewards system that recognizes loyalty, the bill aims to rebuild trust and strengthen the bond between members and PhilHealth. It also provides flexibility, allowing members to transfer accumulated points to family members for use during emergencies.

Preventive Healthcare and Digital Integration

Another key feature of the bill is its focus on preventive healthcare. Members can earn additional points by availing themselves of preventive services such as vaccinations, annual check-ups, and health screenings. This approach also benefits PhilHealth, as maximizing preventive healthcare helps reduce the occurrence of emergency situations and costly medical procedures, ultimately lowering expenses for both the program and its members.

To ensure transparency and ease of use, the bill mandates the creation of a digital platform where members can track their points, redeem benefits, and nominate beneficiaries for transferable points.

Safeguarding Sustainability

The bill also includes strict safeguards to ensure the program’s sustainability. Redemption caps, point expiration policies, and periodic actuarial reviews will be implemented to prevent financial strain on the National Health Insurance Fund (NHIF).

“Financial sustainability is a priority. We’ve designed the PMRP to strike a balance between rewarding loyalty and maintaining the stability of the fund,” Legarda emphasized.

“We owe it to our long-term members to make them feel their contributions matter. This is not just about insurance; it’s about fairness, recognition, and building trust in a system meant to serve all Filipinos,” Legarda concluded.

After the implementation of the program, PhilHealth will conduct a comprehensive review to assess its financial impact, particularly its sustainability and strain on the National Health Insurance Fund (NHIF). This evaluation will include a study of whether the program can be expanded to include indirect contributors, such as indigents and sponsored members, without compromising the corporation’s financial health.

“We just need data based on actual implementation to determine if the program can be extended to include indirect contributors in the future,” Legarda stated.

Legarda’s proposed bill not only seeks to reward loyalty but also aims to rebuild trust and ensure a more equitable and sustainable health insurance system for all Filipinos. (30)