Author MRTC

REVENUE MEMORANDUM ORDER (RMO) NO. 043-2025

BACKGROUND

This RMO was issued to provide guidelines on the medical allowance granted to the employees of the BIR. Section 7 of Executive Order (EO) No, 64-2024 authorized the grant of a medical allowance not exceeding ₱7,000 per annum starting FY 2025 to each qualified government civilian personnel as a subsidy to avail of Health Maintenance Organization (HMO)-type benefits subject to the conditions set forth by the Department of Budget and Management (DBM).

This RMO aims to establish guidelines and procedures, and also to identify the roles and responsibility of offices-in-charge and eligible personnel of medical allowance.

SCOPE AND EXCLUSIONS

The grant of medical allowance in the BIR applies to all officials and employees regardless of appointment status, excluding individuals hired without employer-employee relationship such as contract of service and outsourced personnel among others.

DEFINITION OF TERMS

  1. Geographically Isolated and Disadvantaged Areas (GIDAs) – areas that were disadvantaged due to the presence of both physical and socio-economic factors.
  2. Administrative Action Personnel (AAP) – BIR personnel in charge or assigned with administrative matters per division/office/service/group.
  3. “Six (6) Month of Service” – 6 months shall be reckoned in accordance with Section 31, Chapter 8, Book I of the administrative Code of 1987. As a general rule, a month of 30 days; however, where service refers to a specific calendar month, the actual number of days in that month shall apply.

CONDITIONS AND GUIDELINES FOR THE GRANT OF MEDICAL ALLOWANCE

  1. In government and rendered services for a total of 6 months in a particular fiscal year, which includes leave with pay and services rendered under any of the alternative work arrangements.
  2. Newly hired personnel may qualify if they have rendered 6 months of service.
  3. Transferred to BIR within the year and was not granted Medical Allowance by their former agency upon submission of certificate and those transferred their place of assignment within the BIR through Revenue Travel Assignment Order (RTAO) upon securing of Certificate of Non-Payment from previous office.
  4. Medical allowance of those who are assigned to another government agency will be granted by their parent agency, while secondment will be granted by the recipient agency.
  5. For compulsory retirees, whose services have been extended, may be granted if they completed 6 months of service within the same.
  6. For compulsory retirees, whose services have been extended, may qualify if they have completed 6 months of service within the same year, subject to submission of required documents.

    In case of death, the entitlement applied if the 6 months service requirement and if the employee has enrolled in a Health Maintenance Organization (HMO), with eligible medical expenses incurred.   Reimbursement may be claimed by legal heirs, but no cash equivalent will be provided for non-valid expenses or HMO coverage.
  7. Those who are charged with administrative and/or criminal cases, which are still pending for resolution are still eligible to medical allowance until final conviction is made.
  8. Those who are on leave or on study/training/scholarship grant, whether locally or abroad shall be entitled to the grant of allowance for the year if they render at least 6 months of service.
FORMS AND OTHER DETAILS OF MEDICAL ALLOWANCE
Forms of Medical Allowancea. Group Arrangement (HMO Coverage) – HMO-type product availed through BIR.
b. Individual Arrangement in cash through  Disbursement Voucher – For personnel who:
– Avail a new HMO-type benefit; or
– Paid for existing/renewed HMO-type benefits; or
– Paid eligible medical expenses (hospitalization, emergency care, diagnostics, medicines) due to difficulty in acquiring an HMO product, in view of the following:
-Locality is classified as GIDA (certified by CIR/Regional Director);
– No licensed HMO branch/office in locality (certified by   CIR/Regional Director); or
– HMO application was denied.
Coverage for Continuing HMO PlansMedical allowance covers the fiscal year—partially or fully—when the allowance is granted.
Other HMO EnrollmentPersonnel enrolled in other HMOs, whether as dependent of their spouse, parent(s) or child/children must provide proof of enrollment subject for verification of the head office
FORMS AND OTHER DETAILS OF MEDICAL ALLOWANCE
Benefits for HMO ProductsThe HMO must include at least one of the following:
In-Patient Benefit
Out-Patient Benefit
Emergency Care
Annual Physical Exam
Executive Check-up
Dental Benefit
Maternity Benefit
HMO Coverage PeriodCoverage must be valid for 12 months from the effectivity date.
HMO Cost vs. Allowance AmountIf the HMO premium is below ₱7,000, the personnel still receive ₱7,000.
If the premium is above ₱7,000, excess cost is shouldered by the personnel.
Medical Allowance AvailmentAvailment for both group and individual arrangements must not begin earlier than July 1 of the fiscal year.

PROCEDURES IN AVAILING AND PAYMENT OF MEDICAL ALLOWANCE

  1. A Medical Allowance committee (MAC) is created to handle matters on grant of the medical allowance in the National and Regional Offices. Enumerated below are the roles and responsibility of MAC:
    1. Screen HMO products/plans accredited by the Insurance Commission.
    2. Coordinate with HMO providers to determine suitable plans equivalent to the Medical Allowance amount.
    3. Facilitate presentations of HMO plans to BIR personnel.
    4. Conduct surveys to support provider selection and recommend the most beneficial plan.
    5. Review policies and HMO contracts related to the medical allowance.
    6. Assess localities classified as GIDA or lacking adequate HMO access.
    7. Safekeep documents related to the program.
    8. Perform other related duties as necessary.
  2. The BIR personnel shall fill-out the Medical Allowance Availment Form (MAAF) “Annex A”, select their form of availment (group/individual arrangement) and submit to their AAP.
    1. For group arrangement, the BIR shall secure the availment of their HMO plan.
    2. For individual arrangement, the personnel must attach the following to the MAAF:
    3. Those who availed their own HMO plan or paid their existing or renewed their existing HMO-type benefit must submit proof of enrollment with an HMO provider duly licensed by IC such as but not limited to:
      1. Certified copy of the HMO agreement or valid identification card issued by the HMO provider; and
      2. Membership Certification issued by the HMO provider; or
      3. Original invoice/certification for the payment of membership fee for the HMO product acquired.
    4. Those who paid their medical expenses due to difficulty acquiring HMO product are required to submit the following documents to their office AAP for consolidation:
      1. Certification of GIDA or Certification of no adequate HMO branch or office of a licensed HMO company or proof of denial from any HMO company duly licensed by IC; and
      2. Invoices for the medical services undertaken (e.g. hospitalization, emergency care, diagnostic tests, and prescribed medicines).
  3. AAP verifies eligibility and completeness of the MAAF and supporting documents.
  4. AAP classifies MAAFs by arrangement type and submits them as follows:
    1. Group Arrangement: Forward MAAFs for preparation of Medical Allowance Payroll (Annex B).
    2. Individual Arrangement: Submit Payroll (Annex C) certified by head office with complete documentation, including:
      1. o Accomplished MAAFs and attachments
      2. o List of personnel with pending/decided cases
      3. o Study/training contracts (if applicable)
      4. o Certificates of non-payment and clearances for transferees
      5. o ORS (Box A) and DV (Box A) signed by PD

        Regional AHRMD shall furnish Annexes B and C to Finance Division and submit the same to Budget Division (BD) for issuance of Sub Allotment Advice (SAA).
  5. Individual Arrangement
    1. PD/AHRMD signs the payroll and ORS (Box A).
    2. BD/FD signs ORS (Box B); FD processes and signs DV (Box C) for regional offices.
  6. Group Arrangement
    1. PD/AHRMD consolidates group MAAFs
    2. MAC evaluates HMO plans and selects a provider in accordance with budgeting, accounting, and auditing rules.
    3. Contract is prepared and signed by authorized officials (CIR/RD).
    4. HMO provides the signed contract and health cards.
    5. PD/AHRMD prepares ORS and DV with supporting documents.
    6. Only personnel employed as of December 31 of the preceding fiscal year may join the group arrangement; those hired on or after January 1 shall receive the allowance individually after completing six months of service.
  7. For those who are still to complete the 6 months of government service for the concerned fiscal year and those eligible personnel who opted the individual arrangement but were not able to provide the attachments of the MAAF at the time of submission of AAPs too PD/HRMD, may still avail medical allowance provided that they have completed the length of government service and documentations required.
  8. The AAP shall safekeep a copy of documentary requirements submitted by all personnel who availed Medical Allowance on their respective office.

SUBMISSION OF ANNUAL REPORT

The annual report on the grant of medical allowance using the prescribed template shall be submitted:

PERSONNEL/OFFICE CONCERNEDFORMTODEADLINE
AAPs in the National OfficeAnnex DPDEvery 10th day of January of the following year
AAPs in the Regional OfficesAHRMD
AHRMD (consolidation of report from AAPs of regional offices)Annex EFDEvery 12th day of January of the following year
PD (consolidation of report from AAPs in the National Office)BD  Every 15th day of January of the following year
FD (review Annex E submitted by AHRMD)–
BD (review and consolidation of reports from National and regional officesAnnex A (DBM BC 2024-6FSEvery 21st day of January of the following year
FS/BDDBMNot later than 31st day of January of the following year
ROLES AND RESPONSIBILITY
Commissioner of Internal Revenue/Regional DirectorsIssuance of policies and guidelines in relation to the grant of Medical Allowance; andApprove Certification of communities identified as GIDA and communities with no adequate HMO branch or office.
All officials and employeesSubmit documents for medical allowances and make use of medical allowances for his/her wellness.
AAPsValidate and certify the MAAFs and its supporting documents;Prepare documentary requirements for Medical Allowances;Prepare reports for PD/AHRMD submission; andSafekeeping of documents.
Head of OfficesEnsures compliance;Approving documentary requirements for medical allowance availment; andSign the Medical Allowance Payroll.
Personnel Division/Administrative and Human Resource Management DivisionPrepare and certify medical allowance and other documentary requirement;Certify the correctness of Medical Allowance payroll; andPrepare and submit report to BD/FD.
Budget/Finance DivisionFacilitate and monitors the allocation/utilization of medical allowance;Certification of funds availability; andPrepare necessary report required by DBM.
Accounting/Finance DivisionProcess the payment to HMO provider and to eligible BIR personnel; andCertify funds availability and propriety of supporting documents.
Finance Division/Assistant Regional DirectorApproves payment of Medical Allowance; andEnsures timely submission of reports.

FUND SOURCES

The amount required for the grant of medical allowance shall be charged against the available Personnel Services (PS) allotment of the BIR or may charge against the Miscellaneous Personnel Benefits Funds and any other available appropriations under the annual GAA, subject to Budgeting, accounting and auditing rules and regulations.