Center for Health Market Innovations (CHMI)

Programs

Social Insurance of Paracelis, Mountain Province

last updated Sep 27, 2011

Overview

Implementing organization: 
Paracelis, Mountain Province
Legal Status: 
State/government
Year Launched: 
2003
Stage: 
Existing/expansion stage
Income Level of Target Population: 
20-60% (lower to lower-middle), 60-90% (middle to upper-middle)
Summary: 

Social Insurance of Paracelis is a local government-driven social health insurance model initiated and administered through the Municipal Health Office (MHO) utilizing government financial management systems.

Key program components: 

It is a local government-driven social health insurance model initiated and administered through the Municipal Health Office (MHO) utilizing government financial management systems.

It aims to make health care affordable, accessible and equitable with minimal contributions from members. Contributions are pooled and then used by members when ill or during wellness checkup anytime within the year of membership. To make it more responsive, only out-patient (OPD) services are provided to complement PhilHealth’s benefits.

It has 2 schemes, each with corresponding membership and benefit packages. Charged against the fund, members are entitled to free services and goods availed of within the municipality only. There are 2,421 active members, 68% of which are schoolers. Overall, renewal rate of 12% is currently; low but is expected to increase when the schools renew membership. Bulk of fund (88 %) is reimbursement to partner-cooperatives and village dispensaries for medicines bought by members.

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