MANILA — A senior administration lawmaker on Wednesday revealed that single parents will now be entitled to free coverage of the state-run Philippine Health Insurance Corp. (PhilHealth) as provided under the law expanding the economic benefits for single fathers and mothers.
Camarines Sur 2nd District Representative LRay Villafuerte declared the provision of complimentary healthcare services subsequent to a report from the National Council for Solo Parents Inc. The report indicated that PhilHealth is currently formulating the protocols for executing the complimentary healthcare services for single parents.
“Alongside a monthly cash subsidy for solo parents earning the minimum wage or below and the 10-percent discount plus exemption from the 12-percent value-added tax (VAT) on certain essential purchases, single dads and moms are now entitled to free PhilHealth coverage,” Villafuerte said.
The Bicol lawmaker spearheads the House of Representatives’ efforts concerning Republic Act 11861, which broadened the scope and benefits for single parents and their families outlined in the longstanding “Solo Parents Welfare Act of 2000” or RA 8972.
Under this legislation, PhilHealth coverage is automatic and encompasses both employed and unemployed single parents.
RA 11861 extends the age limit of eligible dependents for the benefits outlined in the law from 18 to 22 years. Moreover, it expands the coverage of spouses to not only include legally married partners but also those in common-law relationships, as defined by the Family Code.
In addition to PhilHealth benefits, solo parents can avail themselves of a 10% discount and VAT exemption on essential purchases such as baby formula, diapers, and prescribed medications for children aged six years and below.
Furthermore, solo parents are entitled to a seven-day paid parental leave, regardless of their employment status, and are given priority for participation in telecommuting programs at their workplaces, as stipulated by the Telecommuting Act of 2018, which the lawmaker also co-authored.
Included in the definition of solo parents are individuals whose spouses have been medically certified as physically or mentally incapacitated, those who have been separated from their spouses for a minimum of six months and have assumed sole responsibility for the care and support of their children, those whose marriages have been nullified or annulled and who have been entrusted with sole parental care, those abandoned by their spouses for a minimum of six months, and those whose spouses have been incarcerated due to criminal conviction.
Additionally, individuals considered solo parents under RA 11861 include unmarried fathers or mothers, rape victims who chose to raise their children, and the spouses or family members of overseas Filipino workers who have been absent for 12 months.
Moreover, grandparents, other family members, or qualified guardians who assume sole responsibility for eligible children, as well as individuals whose spouses have been detained for a minimum of three months due to criminal conviction, are covered under the law.
P50 billion settled
In the latest hearing of the House committee on health regarding the review of the state insurer’s charter, PhilHealth president Emmanuel Ledesma disclosed that over the last five months of 2023, PhilHealth had successfully processed approximately P50 billion in payments owed to hospitals and doctors.
Ledesma highlighted that this achievement fulfills the commitment made to the panel in September of the previous year to settle outstanding dues to healthcare providers.
“I made a promise during the September hearing, and we committed to pay 100 percent to close to 100 percent within 90 days. We backtracked, and for August to December (2023), PhilHealth has paid P50 billion. It is in line with our promise and we complied with it,” he told the panel.
Ledesma emphasized PhilHealth’s commitment to resolving its outstanding obligations to guarantee the uninterrupted provision of services to its members and their beneficiaries.
“We feel that we have a lot of room for improvement with regard to payment of claims. In the next few months, we expect to have much less complaints, if not zero, because we are perfecting the system,” he said.
Primary care
To enhance the execution of its extended primary care benefit package, PhilHealth disbursed more than P257 million as the initial installment of capitation payments to primary care provider networks (PCPNs).
“This initial wave of releases will definitely hasten enlistment of members under the networks’ catchment areas and facilitate patients being seen by the providers that they have chosen,” Ledesma said in a statement.
“This is an investment in the general welfare of the Filipino people. We are ready to invest in Konsulta so that many people can avoid contracting diseases or illnesses and these are addressed early on to avoid them getting worse,” he added.
The allocated funds will aid accredited Konsulta facilities within partner networks in preparing to cater to patients seeking Konsulta services, including consultations, health screening and assessment, dispensing essential drugs and medicines, and conducting laboratory procedures, as stated by the PhilHealth chief.
He highlighted that among the initial seven PCPNs operating under a sandbox setting, four have already received their capitation funds from the state health insurer. These include Quezon province with P72.9 million, South Cotabato with P53.9 million, Bataan with P114.7 million, and Baguio City with P15.9 million.
“These funds were frontloaded, meaning we have advanced the funding even before they render the services. This way, these networks can mobilize these to augment health resources and even ground personnel so that they can serve patients adequately, especially those underserved communities and the vulnerable segments,” Ledesma explained.
In June of the previous year, PhilHealth initiated the PCPN sandbox sites, marking the start of a partnership aimed at enhancing primary care services, digitalizing patient records, and streamlining claims processes within specific regions.
This year, the agency has earmarked P30 billion to bolster the rollout of Konsulta across additional participating networks, extending coverage to more regions, particularly in geographically isolated and economically depressed areas.
