In the Philippines, the PhilHealth Identification Number (PIN) and its physical ID card are essential for the availment of social health insurance benefits under the Universal Health Care (UHC) Act (Republic Act No. 11223). While the PhilHealth ID is not a primary national identity document, it serves as vital proof of membership required for seamless hospital discharge and claims processing.

The loss, damage, or required correction of a PhilHealth ID necessitates a formal replacement process through the Philippine Health Insurance Corporation.

Grounds for Replacement

A member may request a new PhilHealth ID card under the following circumstances:

Loss or Theft: The physical card is no longer in the member's possession.
Deterioration: The card is worn out, unreadable, or physically damaged.
Data Amendment: Changes in legal name (e.g., due to marriage or court order), correction of birth date, or updates to membership category.
Upgrading to PVC: Transitioning from the traditional paper-based ID to the digitized Member Data Record (MDR) or the newer PVC-style cards (where available).

Procedural Requirements

To secure a replacement, the member must submit specific documentation to any PhilHealth Local Health Insurance Office (LHIO) or PhilHealth Express outlet.

1. Primary Documents

PhilHealth Member Registration Form (PMRF): A duly accomplished form with the "Amendment/Replacement" box checked.
Valid Government-issued ID: To verify the identity of the claimant (e.g., Passport, Driver’s License, UMID, or PSA Birth Certificate).

2. Specific Requirements based on Ground

For Lost IDs: An Affidavit of Loss executed before a Notary Public. This legal document narrates the circumstances of the loss and is a mandatory requirement for re-issuance.
For Damaged IDs: Surrender of the old or mutilated ID card.
For Data Amendment: Supporting legal documents such as a Marriage Contract (for change of surname) or an Annotated Birth Certificate (for correction of entries).

The Step-by-Step Process

Visit a PhilHealth Office: Locate the nearest LHIO or PhilHealth Express branch. It is recommended to arrive early, as these offices often operate on a queuing system.
Submit Documentation: Present the PMRF and supporting documents to the frontline officer for evaluation.
Payment of Fees: For lost cards or requests for a PVC-type ID, a replacement fee (typically PHP 90.00) must be paid at the cashier. Note: The initial issuance for indigents and certain priority sectors may be subsidized or waived under specific PhilHealth circulars.
Verification and Processing: The officer will update the member’s digital records.
ID Issuance: Depending on the office's equipment and current stock of cards, the ID may be issued immediately or scheduled for pickup/mailing.

Legal Considerations and Electronic Alternatives

The PhilHealth Digital ID

Under the transition toward the Philippine Identification System (PhilSys), PhilHealth has moved toward digital integration. Members can now access their Member Data Record (MDR) online through the PhilHealth Member Portal. Legally, a printed MDR or a digital display of the PIN is often sufficient for healthcare providers to verify eligibility, even in the absence of a physical plastic card.

Use of the PhilID (National ID)

Per Executive Order No. 162, series of 2022, all government agencies are directed to accept the PhilID as sufficient proof of identity. Consequently, a member who has lost their PhilHealth ID may still avail of benefits by presenting their National ID, provided their PIN is linked or available in the facility’s Health Information System.

Special Categories

Indigents and Senior Citizens: Under the UHC Act, these members are considered "Automatic Members." Even without a physical card, they may avail of "Point of Service" enrollment or use other valid IDs to trigger their PhilHealth benefits at accredited facilities.
OFWs: Overseas Filipino Workers may process replacements through PhilHealth’s accredited collecting agents or through the online portal before returning to the Philippines.

Penalties for Fraud

It is important to note that declaring a card "lost" via a false Affidavit of Loss to obtain a second ID for fraudulent purposes (such as lending the ID to a non-member) is a criminal offense. Such acts are punishable under the Revised Penal Code (Perjury) and the PhilHealth Law, which carries significant fines and imprisonment for health insurance fraud.