UHC

Section 4: Definition of Terms Primary care - Refers to initial-contact, accessible, continuous, comprehensive and coordinated care that is available at the time of need, including a range of services for all presenting conditions, and the ability to coordinate referrals to other healthcare providers in the healthcare delivery system, when necessary. Healthcare provider - Refers to any of the following:

  1. Community-based healthcare organizations
  2. Health Promotion and Education Centers (HPECs) - promote health and prevent disease through health education, information dissemination, and community-based activities.
  3. Non-government Organizations (NGOs) - independent organizations that work to improve the health and well-being of communities through various health-related programs and services (e.g., Philippine Red Cross, World Vision Philippines, Operation Smile).
  4. Local Government Unit (LGU) Health Offices - local government-run health offices responsible for the implementation of health programs and services in their respective municipalities or cities. Primary care provider - A healthcare provider who is responsible for providing primary care services. Primary care practice - The exercise of duties and responsibilities of a multidisciplinary team of health workers in a primary care facility. Primary care facility - An institution that delivers primary care services, licensed or registered by the Department of Health (DOH). Primary care worker - A healthcare worker, who may be a health professional or community health worker/volunteer, certified by DOH to provide primary care services.

Section 5: Population Coverage Coordination of PhilHealth with other agencies for the inclusion of all Filipinos in its databases at no cost.

Section 6: Service Coverage Includes outpatient drug benefits and emergency medical services. Services of healthcare professionals, laboratory, dental and other medical services, personal preventive services, prescription drugs, and biologicals.

Section 7: Financial Coverage Financed by the national government through the Department of Health (DOH); free of charge for all (population-based). Individual-based health services will be financed through social health insurance, health insurance, and HMO plans.

Section 8: Program Membership Registration of Filipinos to Primary Care Provider Networks. Legal spouse/s who is/are not an active member. Unmarried and unemployed legitimate, illegitimate children, and legally adopted or stepchildren below twenty-one (21) years of age. Foster children as defined in RA 10165 (Foster Care Act of 2012). Parents who are sixty (60) years old and above, not otherwise an enrolled member. LGUs with DOH and Philhealth will register their constituents to a primary care provider within their jurisdiction. DOH with the national government shall support LGUs in financing (population-based). DOH shall issue guidelines for primary care provider guidelines, coordination with Philhealth shall promulgate guidelines of registration to a primary care provider processes, procedures, guidelines, data management.