PhilHealth allows retroactive payment of premium contribution but subject to certain rules declared by PhilHealth Circular No. 24, series of 2003.
The Circular establishes that any employed member who is terminated from employment or indigent or OFW member whose membership coverage expired and who failed to immediately pay his/her premium as an Individually Paying Member shall be allowed to retroactively settle his/her premium.
The member shall be given a grace period of one (1) calendar quarter immediately after the unpaid quarterly period to retroactively settle his obligation, without complying to the sufficient regularity rule.
The Sufficient Regularity Rule of Premium Contribution refers to the payment of premium contribution of at least nine (9) months within the twelve-month period immediately prior to the month of availment.
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|Furthermore, an Individually Paying Program (IPP)
member who has missed/unpaid premium contribution and has established
sufficient regularity of premium payment shall be allowed to retroactively
pay within one (1) month immediately following the missed period. Meanwhile,
newly-enrolled IPP members whose membership to PhilHealth covers less
than nine (9) months from the initial date of enrollment may be allowed
to pay retroactive premium payments within one (1) month immediately following
the missed period even without fulfilling the requirement of sufficient
regularity to be able to avail of PhilHealth benefits.
Their entitlement to pregnancy-related benefits (benefits availed of during the course of pregnancy, including Normal Spontaneous Delivery [NSD] package, Breech Delivery, and Caesarian Section), however, shall follow the sufficient regularity rule.