Health Insurance in the Philippines

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The Philippines has a totally pay-as-you-go health care system. Your first stop at the hospital (as it is in the US) will be the cashier’s office. You must have money to pay for health care, otherwise you will not get care, will not be admitted to a hospital no matter how dire your situation. A very few hospitals will accept foreign medical insurance cards, but most will not. Larger hospitals accept credit cards (St. Paul’s does) but many do not.

Do not come to the Philippines unless you have the resources to pay for medical care. Even if you are admitted to the hospital, security guards will probably prevent you from leaving the hospital until your bill is settled.  See the story of Thomas Hunt for a horrifying example.

Routine health care expenses in the Philippines can be very inexpensive.  Your total cost for routine health care may be less than you’ll pay for deductibles and co-payments in the U.S.  Still, care for a serious illness (coronary bypass surgery, cancer treatment for example) can run in to the many tens or thousands of dollars.

The US medical insurance program for the elderly, Medicare, does not cover care in the Philippines.  Some US veterans can receive care through VA clinics.  Some retiree medical insurance programs will reimburse you for care paid for in the Philippines.  A very limited number of Philippine hospitals accept US Blue Cross Insurance.  One is Asian Hospital in Alabang, a southerly suburb of Manila.  If you’re well enough and are covered by Medicare, you can return to the US for treatment.

Sorry, but I’m not familar with how or if European, Canadian or Australian national health insurance programs work (if at all) in the Philippines.  Please add any information you can share in the comment box below.

Private heath insurance is available such as Blue Cross Philippines.  I’ve had mixed reports about it.  Some have had satisfactory experiences, others are very unhappy.  Pre-existing conditions will be excluded.

Definitely sign up for the Philippine government program, PhilHealth. Benefits for inpatient treatment are not comprehensive, but very worthwhile. With major surgery you may save tens of thousands of pesos.  The cost is P100 per month and the insurance covers the whole family including the foreign spouse can be covered.  If you are your spouse are going to be responsible for all or part of the medical needs of the extended family, make sure they are all signed up.

Here is what the PhilHealth web site says about a foreigner signing up on his or her own.  “…the Implementing Rules and Regulations of RA 7875, as amended by RA 9241, provides for the inclusion to the National Health Insurance Program the citizens of other countries residing and/or working in the Philippines. If the foreign national is employed, he/she shall be registered under the Employed Sector Program. Meanwhile, if he/she is self-employed or merely residing in the country, he/she may enroll as an Individually Paying Member. He/she only needs to accomplish and submit to any PhilHealth office, the PhilHealth Member Registration Form (PMRF) and a photocopy of his/her Alien Certificate of Registration (ACR) issued by the Bureau of Immigration (BI) to prove his/her residency in the country.”

The Iloilo City PhilHealth office is well-run and signing up a fairly painless process. You can pay annually.  We pay through our bank each December for the upcoming year.  In our case the bank does not have the payment form (why is that?) so that we have to go to the (nearby) PhilHealth office to get the form and then pay the bank.  Ask for several payment forms so that they can be used in subsequent years.  It’s essential that you obtain and retain the official receipt for your PhilHealth payment.  You’ll need to have it when you file a claim.

Our experience with PhilHealth was good when Carol was hospitalized in Manila.  Due to mis-communication I had to visit the incredibly busy PhilHeath office on Taft Avenue in Ermita, Manila.  Although the office and the harried staff were so busy, the office was well run, most everyone was patient, and was not the nightmare I feared.   On the first trip there, I obtained the Member Data Record (MDR), but I had to go back and get a record of our premium payments on the second visit.  Once you have those documents, the hospital cashier’s office will take over.  Your PhilHealth benefits will be calculated and deducted from the hospital and physician fees you owe.

Comments (10) Write a comment

  1. Thank you for your website. It’s really informative. I’m a Filipina-American, and my husband & I are considering leaving the US to move to the Philippines. I have a few questions about the healthcare system and the pay-as-you-go system you described:
    1. Your article was written in 2011, and was wondering if the system is the same or has changed? Is it still “pay upfront before you get any care”?
    2. What if you have a terrible accident and are in critical condition (unconscious) upon arriving to the ER, and you don’t have enough cash on you (or the hospital doesn’t accept credit cards). I read in another article “Payment upfront is required — even when you are involved in an accident, sent to the ER and incoherent. They will wait for your family to arrive with cash or a credit card regardless of your condition.” Is that really true? This just sounds unbelievably unethical considering the Hippocratic Oath required by doctors.
    3. In the example above, if the hospital only accepts cash, and the banks are closed, thus your spouse can’t withdraw the cash needed to pay upfront, will the hospital not admit you or provide you care, regardless of the dire situation?
    4. If you do have health insurance (i.e. whether private ins. or PhilHealth ins.), is it a completely different situation? Meaning, you will get the care needed upon arrival to the hospital (using the ER example above) without having to prepay for services since you have an insurance card to prove you are covered?
    5. How does the insurance coverage work in the Philippines? In the US, basically when you go to the doctor/hospital, upon arrival you simply pay a co-pay fee (i.e. $35 for doctor visit or $100 for ER visit). You get the care you need. Then the doctor/hospital submits the bill to your insurance company. The insurance company pays the doctor/hospital the full bill, the insurance co. calculates what’s covered by your ins. plan, then they later bill you the amount you owe for the portion not covered. In the Phil., do you pay the full bill to the doctor/hospital before you leave the doctor/hospital facility, then YOU must submit a claim to your insurance co. and wait for your reimbursement? If so, how long does it take to receive your reimbursement from the ins. co?

    We wouldn’t live in Manila but are looking at a smaller coastal town/city. Thank you in advance for answering our questions. And thank you again for this website! 🙂

    Reply

    • It’s very hard to generalize. In the worst case, such as you arrive in the private hospital emergency department alone and unconscious you will probably receive a basic level of care. Being alone is a very unusual situation in the Philippines. You might not receive more expensive care, say an MRI or surgery or expensive clot-busting drugs until payment is arranged. It will be an advantage if you are a foreigner because foreigners are thought to have money. Perhaps others will share experiences. An increasing number of hospitals accept credit cards. There are private insurance programs here. Having coverage would help. When you regain consciousness you will be presented with a bill. Pay it and the hospital will feel better about additional care. This scenario is not unique to the Philippines. It would be true in many developing countries. PhilHealth would help a little, but of course the hospital will have to know you have it which defies your scenario. I am not familiar with the ins and outs of the private medical insurance programs in the Philippines, as we self-insure. Expect existing conditions to be excluded. Hope this helps.

      Reply

  2. Author : J. J. Reyes (IP: 98.155.230.185 , cpe-98-155-230-185.hawaii.res.rr.com)
    E-mail : americaninstitutes@gmail.com
    URL : http://www.overseasretirementcare.com
    Whois : http://whois.arin.net/rest/ip/98.155.230.185
    Comment:
    Hi Arnoldo,

    If you are military retired, there is a Medical City satellite hospital at the former Clark Air Base that is an approved service provider for TriCare insurance. They can answer your questions regarding medication and insurance reimbursement.

    Aloha – J.J. Reyes

    Reply

  3. You have an excellent, informative website! I use your site as my first choice for information. My question is whether PhilHealth will be available to me if I move to the Philippines. I am 63 years old, single, retired, will get an SRRV visa, have no health insurance, and have a pre-existing medical condition. I read the Implementation Rule you cited, but I’m not sure if I will have to be self-employed in the Philippines (which I will not be). Thank you very much, Rick in Florida

    Reply

    • Rick,

      Yes, here is what the PhilHealth website says, Question – can a foreign national enroll in PhilHealth. Answer – “YES, the Implementing Rules and Regulations of RA 7875, as amended by RA 9241, provides for the inclusion to the National Health Insurance Program the citizens of other countries residing and/or working in the Philippines. If the foreign national is employed, he/she shall be registered under the Employed Sector Program. Meanwhile, if he/she is self-employed or merely residing in the country, he/she may enroll as an Individually Paying Member. He/she only needs to accomplish and submit to any PhilHealth office, the PhilHealth Member Registration Form (PMRF) and a photocopy of his/her Alien Certificate of Registration (ACR) issued by the Bureau of Immigration (BI) to prove his/her residency in the country.”

      Your SRRV ID card will serve as your ACR although some PhilHealth employees may not be up to speed on the SRRV. The PRA should be able to help if you run into a problem.

      Just keep in mind that PhilHealth benefits (like its premiums) are quite limited. PhilHealth helps but is not a full replacement for U.S. Medicare. You can see our account of Carol’s surgery for a concrete example of the degree of help from PhilHealth. In short, “Total : P149,955.17. Of this, the Philippine Heath Insurance Corporation (PhilHealth) paid P11,200 to Dr. Toral, perhaps P5,000 to Dr. Songo and P10,255.17 to Manila Doctors Hospital, so PhilHeath paid a total of P26,455. reducing our out-of-pocket expense to P123,500. Since our annual PhilHealth premium is P1,200, PhilHealth is a bargain.”

      PhilHealth website: http://www.philhealth.gov.ph/

      Reply

  4. Pingback: A Sobering View Of Health Care Costs In The Philippines « Expat In Davao

  5. The VA will provide any care that it can in its small clinic. It will o nly send you to an outside hospital or provider for you service related condition.

    Reply

  6. how good is VA coverage in the philippines. i know there is a clinic but will the VA cover hospital stays ?

    Reply

  7. I live in Canada and our health care will cover up to $5,000 Canadian. I called them and asked. Also you are allowed to be out of Canada for 7 months per year, after that you will not be covered any more. So you have to be living in Canada for at least 5 months out of the year to keep your health care going.

    Reply

  8. From contributor Dave Starr: Regarding TRICARE providers. While it may speed things along to use a provider from the list, a TRICARE authorized person may use _ANY_ licensed provider in the Philippines. The TRICARE benefits contractor will then investigate and, if warranted, certify the new provider … that’s how most of the doctors on the list got on the list. My own family physician is TRICARE certified and didn’t even know it. Where many retired military have a problem is in looking for a doctor/hospital who will provide service charging only the TRICARE co-pay required and then do their own billing of TRICARE for the remainder. This seldom works well and has lead to a lot of heart aches and more than a few cases of fraud. In general the best way to handle TRICARE Standard … the ‘flavor’ that we have here in the Philippines, is just go to the doctor or hospital, pay the bill and submit for reimbursement to TRICARE yourself … you can even do it virtually for free by faxing in the claims. More from Dave at http://philfaqs.com/

    Reply

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