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Medical Costs & PhilHealth

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As readers know, last week I was hospitalized. I’d been sick for about five weeks, with infections in my arms and hands, very serious infections. I needed to go into the hospital so I could have intravenous antibiotics, as oral antibiotics were not strong enough to eliminate the infections.

Anytime you are hospitalized, of course, cost is always a concern. Health Care is much cheaper here in the Philippines than it is in the United States, but still how much will it cost is always in your mind. In this article, I’d like to talk about the cost that was involved in my hospitalization, and also about PhilHealth, the National Health Care Insurance in the Philippines.

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Our family signed up for PhilHealth about two years ago. The premiums are very inexpensive, 2400 pesos per year for the entire family. However, you hear so many stories about PhilHealth, we just were not sure how much they would really pay. From the stories you hear, they may pay nothing, or they may pay as much as about half of your costs. For the cost of the premiums though, if they pay anything, you’re money ahead.

PhilHealth Card

PhilHealth Card

My doctor practices at three different hospitals in town. I got to choose between which of the three hospitals I wished to go to. I chose the least expensive of the three. I made this decision based on the fact that I was only going in for something very simple, needing to have an IV. I mean, if I had a heart attack or some other very serious condition I would have definitely made a different choice, and though I had a serious infection, it had been cleared to the point where I only needed intravenous antibiotics, something not difficult to administer. So, based on this, I chose to go to Davao Adventist Hospital.

At the hospital, I had a choice of different types of rooms. The best room available was a suite. Below that, they offered private rooms, semi private rooms, and a ward with many patients. I chose to have a private room. I had heard that PhilHealth will not pay anything on a private room, but given that the cost was low, it was not really a big concern for me. The private room was 1350 pesos per night. The room was quite nice, and large. I had no complaints about it.

Now, let’s talk about costs.

My stay in the hospital lasted for four days. My total hospital bill, which consists of room and board, admittance fee, laboratory, medication, and professional fees for two different doctors came to a total of 25,024 pesos, that is about $560. Four days in the hospital for $560? That’s already very cheap. There were some additional costs involved for medication. Some of the medication did not come through the hospital but we went and got it for an outside online pharmacy. So, of course, those costs were not included on hospital bill. The antibiotics that I was taking were very expensive. About 1300 pesos three times per day, so nearly $100 a day just in antibiotics. Some of those antibiotics were gotten from the hospital pharmacy, and were included on the hospital bill. However, at times the hospital pharmacy was out of stock, and we had to go to a different online pharmacy, for which costs were not shown on the bill.

What did PhilHealth Pay?

Of the costs, let me break down what PhilHealth paid in each category on a percentage basis.

  1. Room and board. Total cost for room and board was 5400 peso. PhilHealth paid 52% of this cost. I had always heard that PhilHealth would pay nothing on a private room, but this turned out to be untrue.
  2. Admittance Fee. This was only 300 pesos, of which PhilHealth payed nothing.
  3. Laboratory fees. This came to about 4000 pesos. PhilHealth paid 75% of the cost, 3000 pesos.
  4. Medicines. 4670 pesos at the hospital, PhilHealth paid 64% of this, 3000 pesos. PhilHealth also paid a large percentage on the medicines that we had to procure from outside the hospital.
  5. Professional fees for the doctors. Total was 10,708 pesos. PhilHealth paid nearly 4000 pesos, a little under 40%.

There were few other minor costs on different things which are not even worth getting into. The total, though, was 25,000 pesos more or less. Of this amount, PhilHealth paid 12,600 pesos. Our personal payment was 12,424 pesos, almost exactly 50% for each of us. Considering that our total premium is only 2400 pesos per year, and that covers the entire family, having them pay out over 12,000 pesos for a single event is very impressive in my view.

As I said earlier, I basically chose this hospital because it was the least expensive. However, I have to say the care was great. The people were wonderful, friendly, competent – just all around good. Based on my experience, I would definitely go back to Davao Adventist Hospital again, and even for more serious conditions than I had thought.

If you read online forums and other such things, you will see a lot of negative things about PhilHealth. To be honest though, I was very, very impressed with them. Another thing which was great, was that the amount was just deducted from our bill. I had been under the impression previously that it could take months to get reimbursed after paying out of pocket for the hospital bill. This was simply untrue. I would strongly advise that if you live in the Philippines, getting PhilHealth is a wise choice. It’s very inexpensive, my experience is that they pay about half of your bill, and it is handled very efficiently in my experience as well. I don’t see how you can possibly go wrong by purchasing PhilHealth.

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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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Rudolf Van Oldenbarneveld

Very good article Bob, I always pay out of pocket, did not know about Phil health,

MindanaoBob
7 years ago

I highly recommend that you get the PhilHealth, Rudolf, it is really great.

john rey
john rey
7 years ago

Thats good bob but you have to be married to get that i have been told i am living here on a tourist visa and i have been told i cant get it i am in my 70s

MindanaoBob
7 years ago
Reply to  john rey

Hi John, the information you have been given is incorrect. It was accurate up until a couple years ago, but ends changed a couple years back. Under current PhilHealth rules you are eligible, even being single and on a tourist visa.

Mike
Mike
5 years ago
Reply to  john rey

I am living here on a 9a tourist Visa and just arrived back from applying and being accepted for Philhealth and I am not married. After reading this I am really glad I have it now.

MindanaoBob
5 years ago
Reply to  Mike

Hi Mike, yep, Philhealth is great to have and everybody is eligible!

Ann Manguilimotan
7 years ago

I forgot what’s the retirement age in there Bob, but my mom was 73 and had Senior citizen’s discount of 10 (or 20%?) on top of what Philihealth covered when she was hospitalized. The discount extended to the dr’s fees even. It might be something that you can look into when you get older.:) Anyway, happy for you that you’re well now.

MindanaoBob
7 years ago

Foreigners do not qualify for Sr. Citizen discounts.

John Power
John Power
7 years ago
Reply to  MindanaoBob

I always get senior citizen’s discount here, and I have no SS card. I just show my drivers licence, which has my date of birth on it. I also know a few foreigners here who do have SS cards!

MindanaoBob
7 years ago
Reply to  John Power

For a foreigner to avail of a Senior Citizen Discount is a deportable offense. It is strictly written in the law that it is only for Philippine Citizens.

Ronald McCarthy
Ronald McCarthy
7 years ago
Reply to  MindanaoBob

It is quite true that a foreigner may NOT avail of a Senior Citizen Card for discounts. However, that does not prevent vendors from offering a foreigner a discount, a different matter entirely.

Glad to hear that you’re on the mend!.

MindanaoBob
7 years ago

That ka, Ron. Yes, of course you are correct about the discount.

Bob
Bob
5 years ago
Reply to  MindanaoBob

Let me get this straight. I’m an American here on a tourist Visa and I’m 64 years old. I can get their health care here for free and go to any government hospital in the Philippines just because I am a senior citizen?

MindanaoBob
5 years ago
Reply to  Bob

You are correct, except about the cost. It is not free for you, it is P2400 per year, only about $50 for the entire year.

Sven
Sven
5 years ago
Reply to  MindanaoBob

Hello, I am 43, from Germany and I live since 3 years here in the Philippines with Tourist Visa/ACR and of course want stay here. I have a long term lesee contract for a house. But I am no permanent resident (because tourist status). Is it possible to avail for PhilHealth? I heard from some sides yes and from other sides no, because no permanent resident. But I have a lesee contract for 2 years, autorenew.

MindanaoBob
5 years ago
Reply to  Sven

Hello Sven. Tourists are eligible for PhilHealth. They changed that law a few years back. All you have to do is go register and pay your fee.

Good luck!

Paul Thompson
7 years ago

Bob; Even though I have TriCare, I’d never let go of PhilHealth, it is just that good of a deal. I agree with you that they pay quickly and so far it has been a bargain. (A bit of paperwork, but I’m not complaining. Any foreigner (Married to a Filipina/o) should sign up the first week they are here, as you wait 90 days before you can use it. But after 6 years on the plan I’m still ahead of what they have paid vice what I have paid. Oh, and if you pay 3 years at a time it’s… Read more »

MindanaoBob
7 years ago
Reply to  Paul Thompson

I fully agree with you Paul.

Fred
Fred
5 years ago
Reply to  Paul Thompson

Hello Paul,
I too have Tricare but I understand it don’t cover me if I live in the Philippines.
I plan to move there in a few months with my Filipina wife and health care is of great concern to me.
Can you tell me how Tricare works for you there?
Thanks in advance
Freddy
fastfreddygk@yahoo.com

RT Cunningham
7 years ago

I’ll be using PhilHealth when I return later this year. Tricare for US military retirees and dependents is a huge waste of money unless you have a catastrophic illness and probably even then. I won’t even go into detail about the time it takes to get reimbursed for anything at all at an “approved” facility.

I’m glad it worked out for you and it just gives me confidence for if and when I need to check into a hospital myself.

Paul Thompson
7 years ago
Reply to  RT Cunningham

RT
I’m in no way defending TriCare but what reimbursement are you waiting for? I just was treated for Hyper-Tension at an “APPROVED” hospital and after paying my yearly deductible and co-pay TriCare paid the rest, the hospital seemed happy about their relationship with TriCare so would you please explain what you mean?

RT Cunningham
7 years ago
Reply to  Paul Thompson

Paul, you’re an exception to the rule. I had trouble with TriCare BEFORE I left the states. Perhaps they do things differently now, but I’m not one to test the waters.

How much is the deductible for an individual and how much for a family now? I spent less $1000 over the course of six years “out of pocket” in Olongapo. That didn’t include me or my wife because neither of us have been sick or injured enough to warrant a hospital visit – it was for nieces, nephews and childbirth for in-laws.

RandyL
7 years ago
Reply to  RT Cunningham

You can learn more than you want to know about problems with TRICARE in the Philippines at …
https://www.facebook.com/pages/TRICARE-Overseas-The-Wall-of-Shame/113467078703149

MindanaoBob
7 years ago
Reply to  RT Cunningham

Hi RT, It was both easy to avail of and also very efficient, I recommend it highly.

RT Cunningham
7 years ago
Reply to  MindanaoBob

I paid the Philhealth premiums for in-laws and I didn’t know I could use it myself until recently. It’s a good deal.

MindanaoBob
7 years ago
Reply to  RT Cunningham

It was only a couple years ago that foreigners were allowed to join the system.

Frank
Frank
7 years ago
Reply to  MindanaoBob

Not true. I moved here in 2006, married and was immediately included on my wife’ PhilHealth.

Many PhilHealth payments are dependent on how long you’ve been a paying member. My wife had a major operation at Doctors Hospital in Cebu City., just over one year ago. The total cost was over 150,000PHP. PhilHealth paid approximately 75% of that.

Some one mentioned that he knew foreigners with SSS cards….not possible unless they are dual citizens.

As many have agreed; Senior discounts are illegal to avail of but, a vendor can choose to give a discount gratuitously.

MindanaoBob
7 years ago
Reply to  Frank

Yes, I have actually been on PhilHealth since 2000, but didn’t know it until a couple years ago. An accountant of one of our businesses signed us up without our knowledge.

What I was saying in the previous comment, though (which you said was untrue, but it is not) is that it was only a couple years ago that foreigners who do not have a Philippine spouse were allowed to sign up. That is an absolute fact.

RandyL
7 years ago
Reply to  Frank

Actually, Senior Discounts can be availed by foreigners in the Philippines. A qualified senior citizen is one that is determined eligible by the Office for Senior Citizen Affairs (OSCA). The following are excerpts from the law and seem to be consistent with the same interpretation in our local office. Republic Act 7432 AN ACT TO MAXIMIZE THE CONTRIBUTION OF SENIOR CITIZENS TO NATION BUILDING, GRANT BENEFITS AND SPECIAL PRIVILEGES AND FOR OTHER PURPOSES. “Contributions of Senior Citizens to the Community. Any qualified senior citizen as determined by the OSCA may render his/her services to the community, which shall consist of….”… Read more »

MindanaoBob
7 years ago
Reply to  RandyL

The wording of the law specifically says that “resident citizens” are the only only people eligible. Since foreigners are, by definition, non-citizens, they are not eligible. Enforcement and implementation varies from one locale to another, but under the law, foreigners are not eligible.

John Power
John Power
7 years ago
Reply to  RandyL

Randy, I don’t know how other ex pats live here, but my income is only just above 60,000, and I can live VERY well here. I live in a quiet exclusive subdivision in Metro Manila, and I eat and drink well. Even back in the UK, plenty of pensioners live on less than that.

MindanaoBob
7 years ago
Reply to  John Power

But the information Randy posted was 60,000 pesos per YEAR. I doubt your income is less than that. That is only p5k per month.

John Power
John Power
7 years ago
Reply to  MindanaoBob

Sorry Bob. I didn’t read it properly. Just a senior moment!

MindanaoBob
7 years ago
Reply to  John Power

No problem, I figured you just mis-read it!

Alan Cline
Alan Cline
7 years ago

Have had Philhealth for a number of years and have never understood failure of some not to have . Only time i needed they paid about 25 % – 30% which also included private room and higher % when two kids had Dengue . It did come to my attention recently that coverage stops at age 70 which of course will affect many expat spouses if true .

MindanaoBob
7 years ago
Reply to  Alan Cline

I agree, Alan, I don’t understand those who don’t get it, the cost is so low, it’s a no-lose situation in my opinion.

John Power
John Power
7 years ago

Bob, that’s THE most useful article I’v read on here. I just didn’t know about it! However, can anyone confirm what Alan said, about the age limit. I’m already 71, but even then my wife is younger, so I will still get it for her.

MindanaoBob
7 years ago
Reply to  John Power

I’m glad you found the article useful, John. There is no age limit on PhilHealth, as far as I am aware. I will have to look into that further.

Heinz Schirmaier
Heinz Schirmaier
7 years ago
Reply to  MindanaoBob

Thanks for the info Bob, going to have Shirl sign up for her, the 3 kids and her mom next week. Glad to hear also that I can be included when I finally move there.
Thanks again my friend and I’m glad you’re ok now!

MindanaoBob
7 years ago

Hello Heinz – Probably they will need two policies to cover those who you listed. I am sure that Shirl must be over 21, and if so a different policy would be needed for her and her mother, but still we are talking about very little money.

Rudolf Van Oldenbarneveld

A lot of places do not give you a discount if you are not Philipino.

MindanaoBob
7 years ago

Senior Citizen discounts are not allowed for foreigners.

Rudolf Van Oldenbarneveld

So Bob would not be able to get that.

Ann Manguilimotan
7 years ago

I’m sorry Rudolp & Bob, if you don’t qualify, but your significant others may still qualify. I am not well versed of the requirements but it sure helped to have those discount when hospital bills pile up. Not many filipinos know or take advantage of this privilege.

Leuterio Violet
7 years ago

I can not tell

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