SSS and PhilHealth for OFWs

Insurance was one of the things that I talked about on Day Two of Project Be's Financial Literacy Workshop. I explained the concept of insurance and how it may address the risk of monumental future losses and expenses, especially when savings are insufficient. When I asked the participants who among them had insurance, less than 10 of 50 raised their hands. But when I asked who had SSS (i.e., Social Security System) and/or PhilHealth (i.e., Philippine Health Insurance Corporation) coverage, almost all of them raised their hands.

While it was good to know that most domestic workers in Hong Kong, as represented by the workshop participants, are active members of SSS and PhilHealth, that they don't consider these government instruments as insurance is a bit disconcerting. As a matter of fact, these two instruments are types of social insurance--ways that the government manages risk for its citizens: SSS offers a specific flavor of cash value life insurance while PhilHealth provides basic health insurance coverage. It's also worrying that SSS and PhilHealth benefits are sometimes ignored and mostly left unused in the Philippines, perhaps because SSS and PhilHealth memberships are compulsory for those who are employed and some people consider premiums immaterial compared to their wages. But even as SSS and PhilHealth remain misunderstood and unappreciated, for a vast majority of Filipino workers living abroad--particularly those who have limited income and act as breadwinners for family members back in the Philippines--these two government-backed insurance instruments serve as their families' first line and cheapest source of protection against risk. In this post, I will briefly present some of the benefits of SSS and PhilHealth coverage and how OFWs all over the world can avail of these benefits.

SSS OFW Coverage Program

Who are covered under this program? New and previous OFW members not over 60 years old; coverage of takes effect upon payment of the first monthly contribution.

What are the benefits of an OFW member? For a maximum monthly premium of 1,560 pesos, OFWs are entitled to various benefits and loan privileges, provided qualifying conditions are met. In general, the greater the accumulated contributions, the greater the value of the benefits. Some of these benefits include:

• Sickness allowance of up to 54,000 pesos
• Maternity benefit of up to 39,000 pesos for a maximum of 4 deliveries/miscarriages
• Funeral benefit of 20,000 pesos
• Retirement/disability/death monthly pension of up to 2,400 pesos per month, paid in perpetuity, or a lump sum payment of total contributions plus interest
• Access to salary loan of up to 24,000 pesos, housing loan of up to 2 million pesos, and house repair and improvement loan of up to 1 million pesos

One advantage of SSS over comparable policies offered by private insurance companies is that failing to make a contribution--a real possibility since OFWs make voluntary (and not mandatory) contributions--does not invalidate the coverage, which is what happens if you miss payment for private insurance. It must be said, though, that missing an SSS contribution will temporarily make you ineligible for some benefits, although you can always make up for it in the future.

OFWs can avail of/apply for all benefits except housing and house improvement loans through 13 SSS international offices in Asia, the Middle East, and Europe.

For more information, please visit the SSS website, or contact the Foreign Branch Expansion and Monitoring Department of the SSS Head Office at 924 7844, 435 9814, or ofw@sss.gov.ph.

PhilHealth Overseas Workers Program

Who are qualified members? Active land-based (as opposed to "sea-based") OFWs who underwent the normal process of registration as an OFW at Philippine Overseas Employment Administration (POEA) Offices. OFWs who are currently abroad but are not yet registered with PhilHealth may also register under this category.

Who are qualified as dependents? As I mentioned, unlike private health insurance, dependents of PhilHealth members also enjoy benefits without additional premiums. Qualified dependents include:

• Legal spouse (non-member or whose membership is inactive)
• Child or children - legitimate, legitimated, acknowledged and illegitimate (as appearing in birth certificate) adopted or stepchild or stepchildren below 21 years of age, unmarried and unemployed.
• Child or children - 21 years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support.
• Parents (non-members or membership is inactive) who are 60 years old and above, including stepparents (biological parents already deceased) and adoptive parents (with adoption papers).

What are the benefits of membership? For an annual premium of 1,200 pesos (will be 2,400 pesos starting January 1, 2013), members and their dependents are entitled to the following benefits:

• Inpatient coverage - PhilHealth provides subsidy for room and board, drugs and medicines, laboratories, operating room and professional fees for confinements of not less than 24 hours.
• Outpatient coverage - day surgeries, dialysis and cancer treatment procedures such as chemotherapy and radiotherapy in accredited hospitals and free-standing clinics
• Special benefit packages for specific cases

For more information, please visit the PhilHealth Overseas Workers Program website.