Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
Cih'SLilt Cliiln; B>S: Omnlx. '09 Sljan- UM. Rjj/ G/t
Hcnlrhlinc 441-7444 wv.-w.philhcalth.gov.ph
PHILHEALTH CIRCULAR
No. feT1 s. 2012
JW,
SUBJECT: Updated Documentary Requirements for Member
Registration, Amendment and Benefit Availment
Pursuant to PhilHeulth Circular No. 29 series of 2010, all members of the National Health Insurance
Program (NHIP) registering or amending their member information shall use the Phi]Health
Member Registration Form (PMRF) attaching therein the appropriate documentary requirements for
submission to the nearest PhilHeakh Office. For amendments, the member may also use the
Member Data Record (MDR) on which to write legibly the changes in member information and
submit together with the appropriate supporting documents to the nearest PhillleaJth Office for
updating
The following are the documentary requirements for member registration, declaration of
dependents, benefits availment including the necessary requisites for amendment to be attached to
the PMRF, MDR or PliilHealth Claim Form 1:
PURPOSE REQUIREMENTS
1. Member Registration/Enrollment
Any of the following:
A.Birth Certificate; OR
B.Any vulid IDs/documents listed in Annex A
For Orphans.
A.Aftidavit ot Gusirdiiinship, it guardian is rehiuvc; OR
B.Certificflte of Foundling from Civil Registry, with DSWTD
Certification, if sponsored by iiti institution.
2. For Declaration of Dependents
2.1 Spouse Any of the following:
A.Marriage Certificate/Con tract; OR
B.Any valid IDs/documents in Annex A (2(1 or 2e),
whichever is applicable
C.For Miisbms, Athdavit of Marriage issued by the Office ot
Muslim Aftairs that passed through the Shau'a Court must
be registered/authenticated in the NSO.
D.For Indigenous Peoples, Certiticate ol Tribal Members!lip
issued by or 13iirangay Gi phi in AND Certificate of
Confirmation on the Authenticity of the Marriage issued by
the Regional NCIP.
Cliildren
2.2.1 Legitimate or
illegitimate below 21
Vi J old
Ally of the following:
A.Birth Certificate; OR
B.Any valid IDs/documents in Annex A(1.2) AND in A(2)
2.2.2 Adopted, below 21
yr_s. old
A. Court Decree/Resolution of Adoption; ANDPURPOSE REQUIREMENTS
B. Any of the following:
1.Birth Certificate of adopted child; OR
2.Any r\vo (2) v;ibd IDs/documents in Annex A:
n. One from 1.2 AND
b. One troni 2
2.2.3 Stepchild/ren below 21
yrs. old
A.Mil mage Certificate he twee n natural parent and
stepmother/steptathcr; AND
B.Any of the following:
1.Birth Cenificale of adopted child: OR
2.Any two (2) valid IDs/documents m Annex A:
a. One from 1.2 AND
h. One from 2
2.2.4 Mentitlly or physiciilly
disabled, 21 yrs. Old
nnd above
A.Medical Ccrtiticate trom attending physician stating and
describing extent of disability; AND
B.Any of the following:
1.Birth Certificate of adopted child; OR
2.Any two (2) valid IDs/documents in Annex A:
ii. One from 1.2 AND
b. One from 2
1.3 Parenrs
2.3.1 60yrs. old and above
Any of the following:
A.Birth Certificate of both registrant and parent; OR
B.Any valid documents listed in Annex A (2) of BOTH
registrant and parent
13.2 Stepparents 60 yra.
old and ;ibovt
ALL of the following:
A.Marriage Certificate/Contract between biological parent
and stepparent; AND
B.Birch Certificate of stepparent or Annex A (1.1); AND
C.Birth Certificate of member or ANY documenr listed in
Annex A (2) proving relationship oi member and
biological parent
:.3.j Adoptive parents, 60
yi"s. old and ;ibove
A.Court Dcciec/Rcsoluuon of Adoption ol member; AND
B.Any of the following:
1.Birth Certificate of Adoptive parent"; OR
2.Any valid ID/document of adoptive parent listed ui
Annex A (1.1)____
3. For Amendment
3.1 Name and Dnte of Birth of
Member nnd/or dependent/*
Ajiy of rhe following:
A.Birth Certificate; OR
B.Any v-.\]id ID/document listed in Annex A
Any of rhe following:
A.M am age Certificate/Contract;
B.Court Decision;
C.Death Certificate; OR
D.Any valid document listed in Ajinex A (2d) or Annex A
(2e)
'4 Nl
vpW f a r / -, i ( (TPURPOSE REQUIREMENTS
4. For Benefit Availment
Member A.Appropriate PliilHcaUh Chum Form 1; AND
B.Any of the following:
1.PliilHealth Identification Card (PIC);
2.PliilHealth Number Card (PNQ together with any
viilid ID/document listed in Ajincx A; OR
3.Pantawid Pamilya Pilipino Program ID
4.2 Dependent A.Appropriate PlulHeakh Cl;um Form i; AND
B.PNC, or Any photo bearing valid ID; AND
C.Any of the following:
1.Member Data Record (MDR) reflecting name of
dependent psirient: OR
2.Ajiv valid document listed in Annex A (2)
4.3 Acceptable proof of
contributions
Overseas Workers Program Members;
Any of die tallowing:
A.Validated Remittance Forms of banks and remittance
centers;
B.Official Receipt issued by recognized remittance centers:
OR
C.Validated Payment Slip
Employed Members:
A.Duly signed PhilHe.ilth Claim Form 1 (CFl); OR
B.Employer Certification
Individually Paying Member:
Any of the following:
A.PhiiHenlth Official Receipt (POR);
B.PhilHealth Agent's Receipt (PAR);
C.Printed proof of payment from PhilHeiikh website;
D.Certificate of Premium Payment (CPP);
E.Validated Buy ad Center Payment Form;
F.Validated Payment Receipt of ACAs;
G.Validated Acknowledgement Receipt of ACA.s
II. Sendoul Form trom MLhuiller ( for online transaction),
I. Sendoiu lorm Remote Transaction from MLhuillier (tor
offline transaction);
j. Validated Payment Slip; OR
K. Validated PhilHealth Premium Order Slip (PPOS) and
Point-of-Sale Generated Receipt (POS-GR)
All concerned ins Damons shall require from transacting individuals/members only those
applicable documents mentioned in the foregoing enumeration.
F'.IA. TalESffA. CJUIAG!
a!e:__ W>J MjjV@ |Annex A
LIST OF OTHER VALID IDENTIFICATION CARDS AND DOCUMENTS
&1.-4 7Ja."icf:c;s/\a.iouiao:t j
Lc:"
:;-:i-.r, te/ <
ilY.. ;
PURPOSE
1.PiootofIdL-ndcvandAge
1.1For18yrsoldandnbove
1.2Forminorsbelow18yrs.old
;1.
b.
c.
d.
e.
f.
gh.
i.
ik.
1.
m.
n.
o.
Pq-
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S.
ta.
b.
c.
d
e.
f.
gh.
i.
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k.
REQUIREMENTS
BaptismalCertificate.
GSIS/SSSMembers'ID
Passport
Driver'sLicense
ProfessionalRegulatoryCommission(PRC)ID
NationalBureauotInvestigation(NBI)Clearance
PoliceClearance
Voter'sID
PostalID
SeniorCitizen'sCard
OverseasWorkersWelfareAdministration(OVWVA)ID
OverseasFilipinoWorker(OFW)ID
AlienCertificationofRegistration/ImmigrantCertilicauon
ofRegistration
IdentificationCardsIssuedbyRecognizedGovernment
Institutions/Agencies/Corporations
CertificatefromtheNationalCouncilfortheWelfareof
DisabledPersons(NCWDP)
DepartmentofSocialWelfareandDevelopment(DSWD)
orLocnlSocialWelfareDevelopmentOfficer(LSWDO)'
Certification
IntegraiedBin:ofthePliilippmesIdenciGcation("aid
CompanyIDsissuedbyprivateentitiesorinstitutions
registeredwjlhorsupervisedorregulatedbytheBangko
SentralngPiljpinas(BSP),SecuoncsandHxchange
Commission(SEC)orInsuranceCommi.ssion(1C)
BnrangayCertification,subjectfor\'alidauon
Affidavitfrom(-\vo(2)DisinrcicstcdPersons,subjectfor
validation
Certificateoflivebirth(newboms)
BaptismalCertificate
SchoolID
Passport
PoliceClearance
AlienCertificationofRegistration/fmrnigrsintCcrtificanon
otRegistration
CertificatefromtheNationalCouncilfortheWelfareof
DisabledPersons(NCWDP)
DepartmentofSocialWeltareandDevelopment(DSWD)
orLocalSocialWelfareDevelopmentOfficer(LSWDO)
Certifiesuon
IntegratedBarofthePliiiippines[cL-ntjficationCaid
BarangayCertification,subjectforvalidation
Affidavitfromrwo(2)DisinterestedPersons,subjecttor
validationNOTE:
Affidavits administered by the following officials authorized to administer oath, as provided in
Administrative Code of 1987, as amended (Republic Act 6733, Section 41), shall be accepted as valid
supporting documents:
1.Members and Secretaries of both houses of the Legislative Body
2.Members of the Judiciary
3.Department Secretaries
4.Governors and Vice Governors
5.City/Municipal Mayors
6.Bureau/Regional Directors
7.Clerks of Court
8.Register of Deeds
9.Other Civilian Officers in the Public Sendee of the Philippine government whose
appointments are vested upon the President and are subject to confirmation by the
Commission on Appointments
10.All other Constitutional Officers
11.Public Notaries
i '@@./$@'$ MA. IErt''-:SAA. O/JIAQIT_,
PURPOSE
2.ProotofRelationship
REQUIREMENTS
ii.Certificateotlivebirth(torncwboi'ns)
b.BaptismalCcrtihcaie
c.DepartmentofSocialWelfareandDevelopment(DSWD)
orLoralSocialWelfareDevelopmentOfficer(LSWDO)
Certification
d.BarangayCertification,subjectforvalidation
e.Affidavitfromtwo(2)DisinterestedPersons,subjectfor
validation