Getting health insurance in the Philippines: A complete guide

The Philippines is a popular destination for overseas travellers. The country’s healthcare is considered good by international standards, and government reforms in the past 2 decades are pushing the country closer to universal healthcare. Foreigners qualify for this coverage, and this might be a great reason to consider the Philippines for long-term visit or a permanent relocation.

This guide should help give you a better overview of the healthcare system and insurance options in the Philippines, and how to get healthcare coverage when you get there.

What kind of healthcare system does the Philippines have?

The government offers affordable public health insurance through the Philippine Health Insurance Corp (PhilHealth)ACR I-Card)

The annual premium contribution rate for foreign retirees is P15,000.00, while that of other foreign citizens is P17,000.00. They may pay for their premium contributions either quarterly, semi-annually or annually.¹

Health Management Organisation (HMO) is a system that delivers healthcare, Most employees are entitled to this as part of the benefit package they receive from their employer. You can also use your HMO membership along with your PhilHealth plan. If you need care, PhilHealth will cover 15-30% of the cost, and your HMO plan should cover the rest.²

Who needs to be covered by health insurance, by how much, and what’s actually covered?

The Philippine government is making progress towards universalising healthcare. That means, theoretically, everyone will be covered for almost every type of medical procedure. This health insurance scheme is government-run and funded through subsidies as well as contributions from employers and employees.

How long can I go without health insurance?

In order to benefit under PhilHealth, there are certain minimum terms of contribution that you must meet. This means that it may be best to register your eligibility for the scheme as early as possible. For full information see the PhilHealth website.³ If you’re working in the Philippines and you’re unsure about HMO, then you’ll need to speak to your employee before or when you first arrive in the country. When travelling to the Philippines for travel, not to work or reside, then you should organise travel insurance that covers medical expenses before you arrive.

Private or Public health insurance, which should I choose?

Private insurance

Private health insurance gives those insured access to private healthcare networks. In the Philippines, private insurance is usually bought by self-employed or freelance workers, or companies that provide private options to their employees. Immediate family members can also be on the plan, but this may come at an additional cost. Private insurers offer many benefits and features. Their facilities will probably meet high international standards.

Benefits likely include:

• Inpatient/outpatient services.
• Hospitalisation and surgical assistance.
• Cash assistance for loss of income due to accident/illness.
• Other ancillary services such as laboratory tests and medication.

Public insurance

PhilHealth provides various plan options, depending on personal factors like income and age. It was set up in 1995 to provide universal coverage at affordable rates.⁴

The PhilHealth network consists of both public and private facilities. Coverage administered by PhilHealth includes comprehensive medical benefits such as:

• Inpatient/outpatient services.
• Catastrophic coverage.
• Surgery.
• Maternity benefits.
• Other ancillary services such as laboratory tests and medication.

HMOs

There are several HMO options in the Philippines. HMOs are like private providers, except they give you access to certain doctors within a certain network. Plans are usually comprehensive and customisable and run on a reimbursement basis. HMOs administer programs such as:

• Inpatient/outpatient services.
• Surgery.
• Other ancillary services such as laboratory tests and medication.

Temporary Insurance

Some tourists or expats may choose to have temporary travel insurance that covers medical care and assistance. Depending on your situation and how long you intend to stay in the Philippines, this type of insurance might be the best option for you.⁵

What’s the average cost of health insurance?

The cost of health insurance in the Philippines will depend upon what option you choose, and your status - for example there is a different rate for those who are retired. For full details refer to the PhilHealth website, or speak to your employer.

You may need to think ahead to ensure your medical needs are met when you’re overseas. This could mean paying for your health insurance ahead of time. Wise can help you reduce costs when transferring money abroad. Wise’s Borderless account can help you hold and manage your money between multiple currencies so you have it ready when you need it the most. Which means if you are surprised with hospital bills or a monthly health insurance payment, you can send your money to the Philippines just when you need it the most.

Who’s covered by public health insurance? And in what scenarios?

All citizens of the Philippines and expats alike have access to PhilHealth. You can learn more on PhilHealth’s website about the plans you qualify for. If you have a private plan, your provider will be able to discuss the specific plans and what scenarios you are covered under.

How do I sign up for medical insurance?

To sign up for PhilHealth:

• Visit a local health insurance office or PhilHealth Express outlet.
• Fill out two copies of the registration form.
• Submit the registration form to the office or outlet.
• After you’re approved, your Member Data Record and PhilHealth ID card will arrive in the mail.
• Pay your premium contribution using your PhilHealth ID number.⁶

For full details, you’ll need to see the PhilHealth website directly. If you’re getting private health insurance, you should check with your specific provider about enrollment details.

The health card

If you use PhilHealth you’ll be issued a PhilHealth ID card. This is a government-issued ID and you can also use it to apply for other services in the country, such as opening a bank account. You can use your PhilHealth ID number to pay for your insurance premium contributions.

If you’re going the private health insurance route, you’ll need to check with your specific provider about the details of a health card and how to get it.⁷

The quality and affordable healthcare in the Philippines is just another reason to consider this country for your home away from home. Follow this guide to ensure your insurance meets your overseas healthcare needs.

Sources used:

Sources checked on 08-November 2019.