Philhealths indigent program Essay

This essay has a total of 2566 words and 20 pages.

philhealths indigent program

The Philippine Health Insurance Corporation was created by Republic Act No. 7875 to
administer the National Health Insurance Program which is designed to provide health
insurance coverage and ensure affordable, acceptable and health services for all

The Enhanced "PCSO Greater Medicare Access (GMA) Program" is a partnership forged by four
important agencies of the government: the Philippine Charity Sweepstakes Office (PCSO),
the Local Government Unit (LGU), Department of Budget and Management (DBM), the Philippine
Health Insurance Corporation (PhilHealth) and other national government agencies (NGAs)
such as DILG, DSWD, DAR, DOH.

The Enhanced PCSO GMA Program is a realization of the common goals of PCSO, PhilHealth,
DBM and the LGUs of the intention to enroll 5 million indigent families nationwide
institutionalizing an integrated health care financing and delivery mechanism that ensures
accessible, affordable and quality health care to all underprivileged Filipinos. The
Program started its enrollment on February 2004 and ended on May 2004. The validity of
this card is for a year and can be renewed through the Local Government Units (LGUs).

For the implementation of the Program, PCSO allocated P1.5 billion as assistance for the
payment of the local government unit (LGU) premium counterpart to PhilHealth for 2004,
initially utilized the P1 billion "Stand By Fund" approved by the PCSO Board. DBM, on the
other hand, assured the release of P1.5 billion to PhilHealth for the national government
(NG) premium counterpart for the would be indigent.

1. To be able to identify the qualified members
2. To be able to know the membership process
3. To be able to identify the program benefits
4. To be able know the number of indigents enrolled in Region VIII.
5. To be able to identify the number of claims from the enrolled members.
6. To determine the controversies behind the card

The study is confined only to Region VIII which composes the provinces of: Biliran,
Eastern Samar, Leyte, Northern Samar, Southern Leyte and Western Samar.

Chapter IV. Methodology
The primary data were gathered through interviews with the Membership & Marketing
Division, Finance Division, Claims Division and Management Information System of

In the secondary data, the researcher used the information from PhilHealth, news clippings
from the newspapers and the Internet.

Table I. Number of Indigents Enrolled In Eastern Samar
Municipality No. Of Indigents Enrolled Percentage

Arteche 1,142 3.27%
Balangiga 686 1.96%
Balangkayan 991 2.84%
Borongan 5,398 15.46%
Can-avid 1,909 5.47%
Dolores 3,575 10.24%
Gen. Macarthur 505 1.45%
Giporlos 1,092 3.13%
Guiuan 2,933 8.40%
Hernani 869 2.49%
Jipapad 315 0.90%
Lawaan 953 2.73%
Llorente 1,309 3.75%
Maslog 40 0.11%
Maydolong 1,154 3.31%
Mercedes 459 1.31%
Oras 3,121 8.94%
Quinapondan 1,489 4.26%
Salcedo 1,015 2.91%
San Julian 1,220 3.49%
San Policarpo 1,888 5.41%
Sulat 1,311 3.75%
Taft 1,540 4.41%
TOTAL 34,914 100.00%

In Eastern Samar, the highest number of indigents enrolled was the Municipality of
Borongan with a total of 5, 398 or 15.46% of the total enrollees which is 34, 914. The
lowest number of enrollees came from the Municipality of Maslog with only 40 enrollees and
only 0.11% of the total enrollees.

Table II. Number of Indigents Enrolled in Leyte
Municipality No. Of Indigents Enrolled Percentage

Burauen 4,314 3.61%
Calubian 2,860 2.39%
Dagami 2,625 2.20%
Leyte 2,971 2.49%
Palo 3,747 3.14%
Pastrana 1,356 1.14%
Tabontabon 634 0.53%
Abuyog 5,871 4.92%
Alang-Alang 4,094 3.43%
Babatngon 2,474 2.07%
Barugo 2,530 2.12%
Capoocan 2,572 2.15%
Tabango 2,615 2.19%
Villaba 1,713 1.43%
Carigara 3,436 2.88%
Dulag 3,755 3.14%
Jaro 2,349 1.97%
Javier 2,381 1.99%
Julita 1,198 1.00%
La Paz 1,641 1.37%
Mahaplag 3,627 3.04%
Mayorga 1,089 0.91%
Macarthur 1,761 1.47%
San Miguel 1,443 1.21%
Sta. Fe 1,653 1.38%
Tanauan 3,801 3.18%
Tolosa 1,057 0.89%
Tunga 622 0.52%

Municipality No. Of Indigents Enrolled Percentage
Tacloban 12,456 10.43%
Albuera 2,820 2.36%
Baybay 6,801 5.70%
Isabel 1,572 1.32%
Kananga 3,977 3.33%
Matag-ob 1,317 1.10%
Merida 2,398 2.01%
Ormoc 11,889 9.96%
Palompon 3,162 2.65%
San Isidro 2,838 2.38%
TOTAL 119,419 100.00%

In the Province of Leyte, the highest number of indigents enrolled was the Municipality of
Tacloban with a total of 12, 456 or 10.43% of the total enrollees of 119, 419. The lowest
number of enrollees came from the Municipality of Tunga with only 622 enrollees and only
0.52% of the total enrollees.

Table III. Number of Indigents Enrolled in Northern Samar
Municipality No. Of Indigents Enrolled Percentage

San Antonio 450 1.07%
San Isidro 2,319 5.53%
San Jose 2,633 6.28%
San Roque 1,719 4.10%
San Vicente 500 1.19%
Silvino Lobos 207 0.49%
Victoria 952 2.27%
Allen 696 1.66%
Biri 627 1.49%
Bobon 2,531 6.03%
Capul 740 1.76%
Catarman 5,238 12.49%
Catubig 1,856 4.43%
Gamay 1,794 4.28%
Lao-ang 4,672 11.14%
Lapinig 1,157 2.76%
Las Navas 3,229 7.70%
Lavezares 2,018 4.81%
Lope de Vega 690 1.65%
Mapanas 1,128 2.69%
Mondragon 2,011 4.79%
Palapag 1,785 4.26%
Pambujan 2,380 5.67%
Rosario 611 1.46%
TOTAL 41,943 100.00%

In the Province of Northern Samar, the highest number of indigents enrolled was the
Municipality of Catarman with a total of 5, 238 or 12.49% of the total enrollees of
41,943. The lowest number of enrollees came from the Municipality of Silvino Lobos with
only 207 enrollees and only 0.49% of the total enrollees.

Table IV. Number of Indigents Enrolled in Southern Leyte
Municipality No. Of Indigents Enrolled Percentage

Bato 2,885 7.37%
Hilongos 3,416 8.73%
Hindang 1,380 3.53%
Inopacan 1,563 4.00%
Matalom 3,599 9.20%
Anahawan 945 2.42%
Bontoc 1,695 4.33%
Hinunangan 2,719 6.95%
Libagon 919 2.35%
Hinundayan 1,294 3.31%
Liloan 2,006 5.13%
Limasawa 313 0.80%
Macrohon 1,053 2.69%
Maasin 2,929 7.49%
Malitbog 1,189 3.04%
Padre Burgos 858 2.19%
Pintuyan 1,067 2.73%
San Francisco 1,884 4.82%
San Juan 886 2.26%
San Ricardo 614 1.57%
Sogod 1,354 3.46%
St. Bernard 2,205 5.64%
Tomas Oppus 1,463 3.74%
Silago 885 2.26%
TOTAL 39,121 100.00%

Southern Leyte's largest enrollees among its municipalities was Matalom with 3, 599
enrollees or 9.29% of the province's total enrollees. The Municipality of Limasawa had the
smallest enrollees with only 313 or .80%.

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