In Order to facilitate the processing of claims for reimbursement of Medicare benefits of OFWs and their dependents and to ensure that only qualified members are entitled to Medicare benefits, the following additional guidelines are hereby prescribed for guidance observance of all concerned.

Payment of Claims:

1. In cases where the OFW has an existing private health insurance coverage provided by the employer, and his entire hospital expenses are shouldered by either the employer or the Health Management Organization (HMO), no reimbursement shall be paid out.  Out-of-pocket expenses not covered by the employer or the HMO may be reimbursed by OWWA Medicare to the extent allowed under the rules.
   
   
2. However, where the employer shoulder the hospital expenses, but deducted the amount from the OFW ™s salary, the OFW shall be entitled to reimbursement.  In addition to the documents required under MOI No. 014-B, series of 1995, proof that hospital expenses were deducted from the OFWs salary, such as pay slip or certification from employer, is required.
   
   For immediate compliance.

Adopted: 19 Apr. 2001

(SGD.) WILHELM D. SORIANO
Administrator