Where to get Health Insurance Plans in the Philippines

In today’s modern lifestyle where everything is fast paced and amplified by a lot of stress, a person’s health is often put on the line.

Today’s pundits continue to promote a slew of lifestyle options towards a general feeling of wellness in the belief that a preventive approach could prevent excessive medical costs.

While an ounce of prevention is definitely worth a pound of cure, could there be a ton of protection that could cover oneself from seemingly insurmountable medical costs when illness does happen?

This is when a health insurance plan can provide the providential ton of protection from unforeseen medical costs brought about by an illness.

But a sound health insurance plan does not stop at just covering medical costs like hospitalization when treating an illness.

What makes a good health insurance plan?

  • A good health insurance plan should be able to provide access to highly reputable health care from the best doctors and medical facilities for the insured within the best possible scenarios, pre and post illness or injury.
  • The best health insurance plans can provide maximal protection from unforeseen financial costs brought about by medical care and treatment of illness or injury not only for the insured but also extended to his or her nominated beneficiaries or dependents.

1. Philhealth

In the Philippines, the primary health insurance provider is the Philippine Health Insurance Corporation, or Philhealth.

Philhealth is the administrative arm of the National Health Insurance Program, whose mandate is “to provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines”.

Premium Payments

Premium payments are identified according to membership categories that range from government and private employees, business owners, household help and family drivers, professionals, migrant workers, naturalized Filipino citizens, Filipinos with dual citizenship, indigents, and lifetime members, to name a few.



Coverage ranges from Inpatient Benefits, Outpatient Benefits, Z Benefits for “catastrophic” conditions that require prolonged and expensive medical treatment and care like cancer, coronary artery by-pass surgeries and lower limb prostheses, and Millennial Development Goal health conditions like treatment and cure of TB, malaria, HIV-AIDS, to name a few.

Philhealth pays out claims of its members to Health Care Institutions on an identified case-rate system covering over 4,600 medical and surgical cases. Click here to read more about Philhealth Benefits.


2. Health Maintenance Organizations (HMO)

Beyond Philhealth, a growing number of the Filipino workforce is covered by Health Maintenance Organizations, or HMOs.

HMOs are private institutions that package a cluster of identified health care services for a group like corporations and small business enterprises.  HMOs liaise with an identified network of health care providers that span a set of pre-identified hospitals, doctors, clinics and laboratories.

Premiums and Coverage

Premiums and coverage provided by HMOs depend upon the scale that the group would like to subscribe to.

HMOs are widely popular among the working sector because they provide access to major Health Care Institutions as well as medical, surgical and dental practitioners.

In the Philippines, HMO coverage is often used as an added benefit or “perk” optionally offered by business owners who care enough to look after the health and well being of their employees.

Click here to see the List of Health Maintenance Organizations (HMOs) with Certificates of Authority Issued by the Insurance Commission for License Year 2016 . This is as of November 29, 2016.

3. Other Health Insurance Plan Options

If one does not belong to a corporation, or is a self-earning individual, or is a retiree, or is an individual who wants to ensure ample health coverage without dipping unnecessarily into personal savings, there is the option to take out a personal health insurance plan from private health insurance providers.

Features and benefits vary from the different health insurance providers.  Here are some key items to take note of or inquire about when considering a health insurance plan:

  • Amount of coverage including details of hospital, doctors and other medical fees covered
  • Range of illnesses covered
  • Age limitations of plan coverage
  • Cost of premium vis-à-vis duration of plan coverage
  • Claims procedure

There are a number of insurance providers who piggyback a health insurance feature with a life insurance policy like Insular Life, Philam Life, and Sun Life.

While there are insurance providers that offer health insurance plans that offer purely medical insurance protection like Pacific Cross (formerly Blue Cross).

Sometimes, the choice of what health insurance plan to invest in is determined by the stage in life one is in.  If one is still active in the workforce, one can opt for a health insurance feature within a life insurance policy to augment Philhealth and HMO coverages.

Or if one is caring for a senior family member, a health insurance plan that offers protection from possible medical costs might be a wise investment.

Click here to see the List of Insurance Companies whose Certificates of Authority were Renewed for License Year 2016-2018. This is as of April 10, 2017.

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