Health Insurance in the Philippines

Sincerely, health care should always be the topmost priority of a people. This is because, as it is rightfully said, a healthy person is one who remembers to work.

Again, a country that thrives in everything is a country that takes its people’s health care seriously. The government of the Philippines got to understand these sayings and set up a health care system for its people.

We believe that part of what prompted the upgrading of the health insurance system in the Philippines came as a result of having so many visitors in the Philippines.

Overview of health insurance in the Philippines

For people to come into the Philippines and live, they want to make sure their health can be covered. So, health care insurance in the Philippines has some level of good standard to it now.

As such, the World Health Organization (WHO) ranked the health care system in Philippines 60th in the whole world.

It still did not stop there, the government of the Philippines keeps making the health care system better each passing year.

For better understanding, it is very important we explain health care insurance in simpler terms. Firstly, health insurance is a type of contract that pays for the hospital bills and drugs of an individual in full or in part. It is either the insurance company pay the hospital bills themselves or give out cash to their clients to pay.

More so, health insurance also covers prescription drugs, doctor’s visits, vision, and dental expenses.

This means that once an individual who has health insurance gets sick or any kind of health emergency, the health insurance company that they use helps cover their medical bills. However, the coverage has to do with the plan the insured bought.

Types of health insurance in Philippines

Firstly, in the Philippines, there are three types of health care insurance systems available to Filipinos.

The government-run health insurance system has been made very affordable to Filipinos. The private health insurance companies, and the Health Maintenance Organizations (HMOs). Of course, you can choose from either of them because the end goal is to get your health and your family insured.

However, private health insurance companies have their perks and all but they can be quite expensive for low-income earners to access. Also, HMOs have people it serves better. So, instead of going without having your health insured, it is better you check out the three and go with the one that suits your need.

Again, the expatriates in the country have a plan called the evacuation plan. This plan is also offered by private health insurance companies.

Government health care insurance in Philippines

Government health insurance in Philippines has been made available for all citizens. It was done in a bid to curb the unnecessary diseases and illnesses that come with a lack of proper health care in the country.

In 2019, the Filipino government set up a health care system called the Philippine Health Insurance Corporation, PhilHealth for short.

The program provides an affordable health care system for the citizens that can not afford the private and expensive health insurance companies. The beauty of PhilHealth is that it does not collect deductibles or allow co-pays for the users.

Furthermore, the PhilHealth program is funded by the government and provides various health plans for the people that are enrolled in it.

These programs have different plans for different sets of people according to your age or income like:

Lifetime Members plan: This plan is for the old and retired government workers who are from sixty years and above.

This set of people has paid the slated amount for health care regularly for a long period of time. Therefore, they are placed on a totally free health care insurance plan.

Formal sector plan: The government automatically provides a coverage plan for the government workers In the Philippines.

Senior Citizen plan: The senior citizen plan covers the old Filipinos that have never bought a coverage plan before. That is, an elderly Filipino that is sixty and above but did not previously insure falls into this plan.

Informal Economy plan: The plan is for immigrants that are working in the Philippines, and also the self-employed. However, this plan does not cover tourists in the country.

Sponsored members plan: Some local governments in the states subsidize some of these health care plans to accommodate their people. The sponsored member’s plan is for those people that their local governments subsidize.

It is important to note that, if you are not a citizen of the Philippines, you are not entitled to any government health insurance coverage. Also, if you are married to a citizen, you will be covered as a dependent.

As it stands, there are benefits that come with government health care insurance. Aside from being very affordable to the poor and retired citizen, the extra benefits include:

  • Maternity care
  • Laboratory tests
  • Out and Inpatients services
  • Surgeries
  • Catastrophic services

Health Maintenance Organization (HMO)

These HMOs are made up of a network of private organizations that come together to provide health insurance for their members.

It works for health emergencies. Just visit any accredited HMO hospital or clinic, show your card and get your needed medical attention.

Also, some private companies provide their workers with HMOs. Besides, If you are enrolled in this type of plan, you can only access health care plans from the health care providers in the network.

Furthermore, there are two popular Health Maintenance Organizations in the Philippines. The MediCard and the Maxicare.

Maxicare

The Maxicare health care corporation is among the top Health Maintenance Organizations. Basically, a group of doctors and businessmen came together in 1987 and formed Maxicare. Just for the sole purpose of providing great health care opportunities for the people.

Currently, Maxicare boasts of about twenty-four thousand networks of doctors and specialists, about one thousand, four hundred hospitals and clinics.

Not only that, but Maxicare also has about one thousand dental services and it serves about 1.6 million people in the country. 

MediCard

This Health Maintenance Organization has a network of about forty-three thousand accredited doctors and about over one thousand hospitals and clinics in the Philippines.

MediCard opened its doors for business for close to three decades now and hey are still strongly in business till now.

In furtherance, they offer lots of health care plans to their clients which are:

MediCard Family Individual plans: These plans are ready for families or individuals that want to get coverage for preventive health care, outpatients, hospitalization, health emergencies, or dental care.

MediCard VIP Plans: This particular health care plan can cover you even if you had an emergency outside the country. However, it still covers out-patients, dental coverage, preventive health care.

The MediCard RxER: RXER is another better form of MediCard package that allows people of any age to join. The coverage offers ranges from trauma cases, out-patients, emergency cases, or preventive care.

MediCard HealthPlus: This plan covers Free-Standing Clinics for one full year, outpatient, and preventive coverage.

MediCard Kabayan: The overseas sponsors created this plan but still provides good health coverage for their beneficiaries in the country.

The MediCard Select: It gives room for the return of funds that were not used. It is another plan that provides varieties of coverage for its beneficiaries.

MediCared Health Check: The plan remains valid for a full year. This great plan gives you the opportunity to constant medical check-ups as often as you desire. Also, a discount on lab tests, and physical exams for once. You only get to pay P500.

My MediCard: This plan offers you medical check-ups with the MediCard doctors. It also comes with one-time oral prophylaxis and lasts for one year. This plan goes for just P3,600.

Benefits of Health Maintenance Organizations (HMOs)

  • Surgeries
  • Hospitalizations
  • Lab tests
  • Medications
  • Dental services
  • Outpatient services

Private health care insurance in Philippines

Private health insurance in Philippines is for the well-to-do in the country. However, they live up to their standards in the services they provide for their clients.

A little over 30% of the country makes use of private health care insurance companies. This includes the visitors like the tourists and the Expats.

Moving forward, the private health care insurance companies offer wider and more convenient plans. But as explained earlier, it costs a lot, especially if you do not earn much.

Still, private health insurance in Philippines still serves a great purpose for non-citizens in the country and it is better we speak about them in case a traveler wants to use their services. 

KanMend by FWD

If you are diagnosed with any of these critical illnesses and more, KanMend made it their duty to have them covered. That is if you are a member.

  • Major burns
  • Bacterial Meningitis
  • Heart and blood illnesses
  • Major organ failure
  • Occupationally acquired HIV/AIDS
  • Neuro-Muscular illnesses

Other benefits offered by KanMend include

  • Six months free konsultaMD telemedicine access
  • Covers up to forty-two critical illnesses
  • Critical illness starter plans

Sun Life Health care Insurance

The Sun Life health care insurance company is among the few private health care companies in the country.

In addition, they are among the best too by all standards. With Sun Life, there is a package for every member of your family, regardless of age. Some of their packages include:

SUN Fit and Well:

  • Coverage until an individual clocks hundred.
  • Life insurance coverage
  • Wellness benefits

SUN Senior Care:

  • Health and Wellness benefits
  • Covers 17 Advance-Aged Critical illnesses
  • Benefit for Specific Covered Surgeries/Conditions
  • Life Insurance

SUN Cancer Care:

  • Coverage until hundred years
  • Specialized health solutions
  • Life insurance coverage
  • Wellness benefits

SUN LifeAssure:

  • Coverage until seventy years
  • Covers thirty-six critical illnesses
  • Life insurance protection

SUN Healthier Life:

  • Covers until age seventy
  • Life insurance coverage
  • Simplified issue offer

SUN First Aid:

  • Covers for ten years
  • Hospitalization benefits
  • Life insurance cover
  • Money-back feature

SUN Maiden and SUN Maiden PLUS:

  • Covers till sixty-five
  • Female C.I benefits
  • Life insurance coverage
  • Maternity benefit option

SUN ICU Protect:

  • Covers till hundred years
  • Severity-based health insurance plan with ICU and major C.I benefits
  • Wellness benefits
  • Life insurance 

Manulife health care insurance

First and foremost, the company is also called Manulife Philippines. Mainly it has its headquarters in Canada from where it spreads its wings. Manulife has a good reputation even outside the Philippines. They offer health care packages in bundles known as HealthFlex bundles.

Additionally, you can customize this package and pay for only where you need coverage. It has some benefits that include:

  • Protection at any age but up to 100
  • Waiver of premiums
  • Additional health coverage in cases of heart attack, stroke, or cancer with assistance while you get better
  • Dividends that you can withdraw anytime

Caritas Health Shield

This health insurance company offers diverse health care coverage for its members. They have plans called MAX Health Care Program, Supreme Health Care Program, Kiddie Health Care program, Ultra Health Care Program, AND Enhanced Core 6 and 10 Health Care program.

PRU Life U.K

This health insurance company provides a health coverage plan called the PRUWellness. This coverage gives you daily cash benefits, bulk money when needed to cover your hospitalization costs.

The company will add the extra cash will also be added if you require surgery or ICU services.

Other features include;

  • Long-term hospitalization benefits
  • Daily hospital income benefit
  • Surgical expense refunds
  • ICU benefits   

Evacuation coverage plan

In the Philippines, private health insurance companies offer evacuation plans. This is mostly for the expatriates in the country.

The evacuation plan helps you to be evacuated to the places like Singapore in case of medical emergencies.

Besides, this plan can be a package on its own or part of a private insurance package. Since non-citizens can only access private health care insurance facilities, it is important for short-term visitors without their travel health coverage to buy this.

Private health care insurance benefits

  • Life insurance
  • Compensations
  • Lab tests
  • Prescription drugs
  • Financial assistance during the loss of income
  • Critical illness benefits

Finally, health insurance in Philippines is now within the reach of everyone. That is, from the rich to the low-income earners, down to the expats and the tourists.

Also, any age can now comfortably access any of the health care facilities available in the country. Undoubtedly, the Filipino government is doing right by the country in making sure health care coverage can be accessible to both the citizens and the visitors.

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