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2017 PhilHealth Update

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I get a lot of questions about healthcare coverage in the Philippines.  The majority of questions that I get are related to PhilHealth, the Philippine Government Healthcare Insurance plan.  Today, I thought that I would update a few things about some changes coming in PhilHealth, and other information that has been around for a while, but still present constant questions that arrive in my inbox!

Changes in PhilHealth?

Yes, changes are coming to PhilHealth, and not good ones for most readers of this site.  The vast majority of readers here are foreigners who plan to visit or live in the Philippines.  The changes that are coming with PhilHealth are directly pointed at foreigners.

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All foreigners can get PhilHealth

Starting a number of years ago, as I recall it was around 2010 or shortly after that, it became possible for all foreigners to get a policy for PhilHealth.  That is still in effect, and whether you plan to come to the Philippines for 2 weeks, 2 years, 2 decades or any other length of time, you can get covered by PhilHealth.  Frankly, if you are coming for a short vacation, like the 2 weeks that I mentioned, though, you would be better to get a travel insurance policy that will cover health care expenses.  For those staying longer in the Philippines, though, and particularly for long term residents, PhilHealth is a good value.  Even though pricing is going to be changing, it will still remain a good value.

No matter if you are married to a Philippine Citizen or not, even if you are single and visiting the Philippines for the first time, you qualify to sign up for PhilHealth.  All you need to do is go visit any PhilHealth office and fill out an application for coverage, and pay your fees.  There is no medical exam or anything like that.  Sign up, pay, and you are covered.

Price going up?

As I mentioned previously, the premium cost of PhilHealth is going to be increasing for foreigners. In the past, the cost of PhilHealth has been P200 per month (P2400 per year) to cover the entire family.  Imagine that, $48 per year to cover an entire family for healthcare?  That is dirt cheap.  But, nothing lasts forever, or so I have been told.  When the coming PhilHealth changes roll out (I have been told it is June 1, 2017), foreigners will no longer be eligible to be covered as a dependent on their spouse’s policy.  Instead, foreigners will need to sign up for their own policy and the premium will be P18,000 per year.

Complaining

I have gotten a lot of complaints from other expats who already heard about the coming changes. I understand their disappointment, and why they are upset.  However, if you step back and look at things from a distance, you can realize that P18,000 is equivalent to US$360 at today’s exchange rate.  Paying $360 for a full year of healthcare coverage is still dirt cheap.  Yeah, it is not as good as paying $48, but it is still a good value.  Personally, I will pay the new rate without complaint.

No more Z Package

Z Package from PhilHealth

The Z Package is something that is relatively new with PhilHealth.  Last year, the Z Package saved my life when I had a problem with my heart.  I needed a quadruple bypass operation to save my life. That operation costs about P2 Million in private hospitals in the Philippines.  That is about US$40,000.  However, we learned about something called the “Z Package” that is offered by PhilHealth.  Under this Z Package, they offer care for very serious and expensive medical conditions.  Things like Cancer, Organ transplants, Heart Surgery, etc.  My experience is with with the Heart Z Package, and under that plan, each patient has the option of paying:

  • P350,000 for the surgery and will be staying in a private suite in the hospital.
  • P250,000 for the surgery and will be staying in a smaller private room in the hospital.
  • P100,000 for the surgery and will be staying in a ward with multiple patients.
  • Free for the surgery and will be staying in the ward.

I selected the P250k package, as I did not care about having a suite, and treatment is the same under all options.  I was very happy with the Z Package and all of the care that I received under the package.  It saved me P1.75 Million in medical costs, and frankly saved my life.

Unfortunately, under the new PhilHealth regulations, foreigners will no longer be eligible for Z Package benefits.  This does upset me, really it saddens me.  I am alive from the Z Package, and I feel that if we pay the premium we should be eligible for the same coverage that all other premium payers are getting.  Especially when we are paying a MUCH higher premium.  As it stands right now, we will be paying a hugely larger premium, but getting less services than others.  I feel that is not right.

The bright side

I feel it is unlikely that I will need the Z Package again, but you just never know.

My first reaction when I heard this news was that the Z Package would be going away for foreigners is that I started thinking of possibly moving back to the USA.  After my serious health problems that I experienced in 2016, health has become a very big concern for me.  I spend a lot of time trying to improve my health (I even have a new blog called 430 To Fit which is all about health).  However, after I stepped back and considered the entire picture, I decided that I was over-reacting.  I feel that many expats who know about this are also over-reacting.  Yeah, it is not good, and is not right that we will be getting less benefits for a lot more money, but the value is still good.

The fact is that I lived here for about 16 years before I even knew of the Z Package, and many of those years there was not even such a thing as the Z Package.  So, why would I consider moving because the package will no longer be available to me?  Truth is that I am just very thankful that it was available to me when I badly needed it.

Other options

For foreigners, no matter where you are from, there are other options available to us in the event of a catastrophic health event.  I know, because I considered a lot of options last year before settling on having surgery here in the Philippines.  You can even stay in the Philippines for care, and get a Blue Cross Philippines healthcare policy.  It is not cheap, but you can do it.

For Americans, we can go back to the USA and sign up for Obamacare (ACA) – although with the new President changes will be coming, and we don’t know what will be happening for sure.  If you are an expat who has been exempt from ACA, you can go to the USA and sign up anytime, you do not have to wait for the enrollment times.  You can get off the plane, sign up, and go have your medical procedure taken care of.  Since pre-existing conditions are not a worry under current US healthcare policy, even if you had a heart condition like I had, you could still sign up and get it taken care of.

For other nationalities who live in the Philippines, you would need to look at your own country’s healthcare system to see what options would be available to you.

Get PhilHealth

I want to encourage every person who will be spending considerable time in the Philippines to sign up for PhilHealth.  Even with the higher premium it is still inexpensive when compared to other parts of the world.

A lot of foreigners complain that Philippine Hospitals will not treat you unless you put up money in advance.  Truth is, though, if you have PhilHealth coverage, that is your ticket to getting treated.  If the hospital accepts PhilHealth (they all do now), they must treat you as long as you have PhilHealth coverage.  Say it is a holiday and you have no access to the money in the bank (ATM is not working), if you have a serious health condition suddenly, you can get treatment if you have PhilHealth!  That peace of mind is worth the P18,000 per year that it will cost for the coverage.

How much does PhilHealth Pay?

There is really now way to give a hard and fast answer.  The amount that they pay varies depending on your condition.  They have a schedule of how much is paid depending on what the diagnosis is.  Generally, if you are hospitalized, you can expect that about 50% of your bill will be paid by PhilHealth.  But, it varies.  I have also had some medical treatment that was paid 100% by PhilHealth.  Additionally, I have had treatments that were paid as low as about 25%.  If the money is an issue, talk to your doctor and make sure that he knows how PhilHealth works.  He can admit you into the hospital with the diagnosis that pays the most.  In other words, there are multiple diagnoses that can cover the problem that you have, and they may pay different amounts.  This is very common.

For example, a few years ago I was in the hospital with a very bad infection.  If my doctor listed my diagnosis as “infection” the PhilHealth would have paid one amount, but by putting my diagnosis as “Infection related to Diabetes” (which was true), the amount paid was much higher.

Hospitalization

PhilHealth is generally for medical treatment that requires hospitalization.  It does not cover things like visits to your doctor’s office.  I have had some outpatient treatments, though, that PhilHealth covered, and they are expanding what is covered, so always check.  If you will be hospitalized, though, and you are a PhilHealth member, you can be certain that there will be some coverage.

I have heard complaints from some about the fact that PhilHealth does not cover visits to the doctor’s office.  Why complain or worry?  Most doctors charge about P500 or so for an office visit, that is only $10, so it should not cramp your budget much.

So, these changes are coming!  Be ready.  I know some of this will be shocking to some foreigners.  I have already heard from many people who are outraged by it.  But, if you step back and look at the big picture, I think you will agree that although it is not right, it is still cheap.

Good luck!

Posted in

Bob Martin

Bob Martin is the Publisher & Editor in Chief of the Live in the Philippines Web Magazine. Bob is an Internet Entrepreneur. Bob is an American who lived in Mindanao from 2000 until 2019. Bob has now relocated back to the USA.

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Tim Kempton
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Tim Kempton

Bob can a foreigner get Private (non-government) insurance in the Philippines? What are the costs and will it cover you for major medical event like yours?

Bob - Expat Answer Man
Guest

Hi Tim, yes, as I said in the article you can get private coverage through Blue Cross Philippines. I don’t know the exact price, and it also would depend on your conditions, your health test, everything just like the US to price would vary. I will tell you though that it is quite expensive.

Frankelis Claeys
Guest
Frankelis Claeys

calling Pacific Cross now Bob and i have that and for 7000 pesos i donr have to pay anything at the Hospital so i stop with Philhealth just keep pating for my asawa 🙂 its only 2400 volontary

Bob - Expat Answer Man
Guest

Very interesting! I will have to look into that! Thanks for the tip.

Frankelis Claeys
Guest
Frankelis Claeys

no problem off course it depends on youre age the fees you have to pay but the only insurance that is covering you till you die sry for that and more expensive the older you get but at 65 dollar plan for around 1600 dollar and 1 500 000 pesos covered

Marlou Bocago
Guest
Marlou Bocago

Hi Bob! I’m Marlou, a senior Account Executive of Pacific Cross Philippines, formerly Blue Cross Philippines. First of all, I would like to thank you for promoting our products and services. I just want to know if I could be of any help to you or to anyone from your site and your subscribers in providing necessary information about Pacific Cross. You may contact me thru my email marlou_bocago@pacificcross.com.ph I’ll be glad to assist you. Thanks

John Coldwell
Guest

Thanks Bob.

Bob Martin
Guest

You’re welcome John.

John Coldwell
Guest
ouel
Guest
ouel

Bob, the premium change (for foreigners) doesn’t surprise me. Sounds similar to the official government policy of not allowing foreigners to have a “Senior ID” simply because they are foreigners. I’m not aware of any other country that treats foreigners like this. We live here, pay house taxes, house/car insurance, VAT, etc and should be treated the same as locals. But this is the PI and after 48 years of living/visiting here I understand that’s the way it is and it often doesn’t do any good to complain. Glad I’m retired military and have Tricare — it works great here.… Read more »

Bob - Expat Answer Man
Guest

I agree with you totally. It is not right for foreigners to be treated like that. I have been on PhilHealth for 17 years, paying premiums all this time, same premium as everybody else, now they are cutting benefits for me, and increasing my price. Not much I can do, though… I wish that I had Tri-Care like you…. comment image

ouel
Guest
ouel

It’s the “skin tax” that comes with living here.

Jonni Jon
Guest
Jonni Jon

And when you think of how many millions we put into the economy here.

Luke Tynan
Guest

Thank you for the heads up and information. I looked into private insurance a while back and what I found for my age group was very expensive ( not worth the cost) instead of a few hundred per year they wanted several thousand per year. So I will stay with the Philhealth

Bob Martin
Guest

I am also staying with PhilHealth. I may look for other coverage to supplement what PhilHealth offers, though.

John Miele
Guest

Me too…. P1500 per month is a small price to pay

Bob Martin
Guest

I totally agree John, there’s no place you can get that coverage for that price other than philhealth.

Bob New York
Guest
Bob New York

As a visitor for only a few weeks at a time I always buy travelers insurance which covers many things including temporary health insurance. From what I have learned of Philhealth over the past decade, even with the increases it still appears to be a bargain compared to medical insurance costs in the USA.

Bob - Expat Answer Man
Guest

I agree that it will still be a bargain, and I have no intention of dropping the coverage. However, there’s also the fact that it is very unfair to single out people, make them pay more, and get less coverage. I have been a subscriber to philhealth for over 16 years now, always paid my premiums comma and have even promoted them on this website. I just don’t think it’s right the way that they are doing, but like I said, I will still keep the coverage.

Steve
Guest
Steve

Am I correct Sir Bob that I will have to get an ARC to apply for Philhealth? Also, the new discriminatory rules do seem unfair and at odds with a country which would benefit from having foreign money here. More worrying is the trend towards ever-increasing restrictions on foreigners when a bit of relaxation would be more helpful to BOTH SIDES. Foreigners here should start researching the options for returning home should things get too bad – live the present but prepare for the future.

Bob - Expat Answer Man
Guest

Hi Steve, I really don’t know what an ARC is, I’ve never heard of that. I suspect that you’re asking about an ACR I card. If my suspicion is correct then no, you do not need to get one. As I said in the article anybody can get philhealth, even if you’re just a tourist here for a couple weeks. All you needed to go fill out an application and pay the money. I hope this helps.

Steve
Guest
Steve

Just checking you are ‘on your toes’ Sir Bob’ with my (uhmmm) deliberate mistake! I will ask about the need for ACR and let you know if I have problems. Thanks.

dontworrybhappy
Guest
dontworrybhappy

Bob, even now today you are required to show your ACR card.

Steve
Guest
Steve

Missed the ‘know’ as in “I will know …… “

Wally Barr
Guest

I got a quote from CIGNA it was about $900 a month and would include 3 months a year in the states for me and my family. If I had similar coverage in the states the cost is $1400 with no deductible and 100% coverage… I wonder if you can get PhilHealth and some kind of gap. Insurance that a covers the rest?

Bob Martin
Guest

Hi Wally, I would imagine policies like that are available, I would certainly be something to look into.

hgb
Guest
hgb

Wally you said, “That includes 3 months a year in the States?” Who pays for the 3 months? Who pays for the airfare?

Jason Silverman
Guest

In other forums it seems like 1,500 a month will break the budgets of some expats.

Bob Martin
Guest

I have heard a lot of that, Jason. If somebody can’t afford 1500 per month for healthcare, they probably need to look for some solutions to that. It’s still very cheap compared to what they would be paying in their own countries. That’s the way I see it anyway.

Wally Barr
Guest

1500 pesos a month? My co-pay equals that with my Blue Cross policy in the states and i have a $750 deductible, and a 2k family deductible and that is considered a premium policy

Donald John Lecraw
Guest

Bob, I disagree with your analysis and conclusions regarding the fairness of the upcoming increase in PhilHealth payments for foreigners. Most forreigners are not like you. We come here when we are 60 plus, just the age when our health care costs start to escalate. Then we marry, our wife delivers babies (expensive), our children go through childhood illnesses and accidents (expensive), and then they often go to our home countries for university and work – just when health costs are low for 20 – 60 year olds. Only our wife is low cost to the system. Yes, PhilHealth is… Read more »

Bob Martin
Guest

I can’t figure out what we disagree on? I specifically said many times in the article that I am happy to pay the cost of they are asking. So where do we disagree?

Donald John Lecraw
Guest

You also say several time that it is unfair to charge foreigners more. It’s not.

Wally Barr
Guest

Foreigners should not be charged more in the states that is discrimination and any company that engages in it can expect a class action lawsuit. If someone needs to pay more because of health factors that is reasonable not because they have white skin and some filipino thinks they poop money.

Bob Martin
Guest

That is how I feel Wally Barr. I don’t have a problem paying the price that they’re asking, but, on the other hand, if the United States announced a policy that all Filipinos could no longer get Social Security, or medical care would be triple for all Filipinos, that would certainly be met with an uproar. It’s basically the same thing that’s going on here, we’re being charged much more, and our benefits are slashed. Sure, the amount after is not too much to pay, it’s actually still cheap, but it is unequal.

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