How To Register For Healthcare In The Philippines

Following a recent overhaul, the Philippines has a two-tier health insurance system, comprised of public insurance and private cover. We will look below at your options for registering with the healthcare system.

PhilHealth, the national healthcare scheme, is funded by the government and by employer/employee national health contributions. Although everyone is technically entitled to healthcare, not all medical procedures are covered and you will have some out-of-pocket expenses. All Filipinos are covered by the national health system, but until recently, foreigners were not eligible to join the scheme. However, in 2017 PhilHealth was extended to apply to expat workers.

How to register for healthcare in the Philippines

Your employer should sign you up with PhilHealth. You will need to pay around nine months’ worth of contributions before you become eligible for coverage under the scheme, but check with your employer or PhilHealth itself if this applies to you, as the number of contributions that you need to pay may vary.

You will need to submit some documentation at your nearest PhilHealth Local Insurance Office (LHIO). Some categories of pensioner may need more documentation: check with PhilHealth beforehand what you need to take with you. As a minimum, you will need to submit the following:

  • a valid Alien Certificate of Registration Identity Card (ACR I-Card) issued by the Bureau of Immigration
  • a PhilHealth Member Registration Form (PMRF) for Foreign Nationals
  • 2 photos
  • 2 valid forms of ID, such as your passport

Once you are registered you will then be issued with a PhilHealth ID card and number, which you must take with you to medical appointments.

You can also register to make voluntary contributions into the system via your PhilHealth ID number: you need to sign up as a ‘voluntary member’ first.

You can register for your PhilHealth card online here.

You will have to co-pay some treatment costs, usually the difference between what your healthcare provider charges and the amount covered by PhilHealth. You may also want to sign up with a HMO (Health Maintenance Organisations: medical insurance groups providing health services for a fixed annual fee), as a top-up for your PhilHealth cover. Check with your employer to see if this is already part of your insurance package. However, you should note that medical costs in the Philippines remain comparatively low: if you pay upfront, a visit to the GP will cost you about ₱300 – 600 (USD$6 – 12) and a specialist will be in the region of ₱1000 (USD$20). A number of specialists also double as GPs.

jeepneys in rizal park of manila philippines

You can find a local GP (and other specialists) through word of mouth, via the phone directory, or via online listings such as FilipinoDoctors.org.

Basic dental care is covered under PhilHealth, but you may wish to opt for private dental provision or pay out-of-pocket costs: the country is a destination for medical tourism and private dental care is of a high standard.

Most hospitals in the country are private and good quality.

 

Philippines Health Insurance

How To Move To The Philippines

International relocation abroad luggage

How To Open A Bank Account In The Philippines

If you plan to move to the beautiful Philippines, you may find yourself wanting to open a bank account. Even if you maintain existing chequing or savings accounts at home, to pay certain bills or to manage your savings, you may find that you need a local account to pay local expenses and so that your salary can be deposited into it. Alternatively, you could open an international account with your current bank, if they have that option, or you could open an offshore bank account that can be accessed from wherever you are.If you have decided that you want or need a bank account in the Philippines, you should be prepared for a bureaucratic process in getting one. While the requirements are fairly straightforward, they will vary depending on the bank you choose, and the processing might not be as fast as you are used to at home.

To open a bank account in the Philippines, you will need to apply in person at a local branch of your chosen bank. You will need an Alien Certificate of Registration Identity Card (ACR I-Card), which is the officially recognised identification card for foreigners. You can apply for an ACR I-Card even on a temporary visitor’s visa, as long as you have been in the Philippines for more than 59 days.

Almost all banks require you to be a resident in the Philippines for at least six months to open a bank account in Philippine pesos, but some banks may allow you to open a dollar or other foreign currency savings account much earlier (after two months) or with less documentation.

You will usually need to have been a resident in the Philippines for at least six months to open an account in Philippine pesos

Some banks will accept other proof of identity and legal status in the country, like the Immigrant Certification of Registration, as sufficient documentation to support your application, but you will likely have to sit down with the bank manager to discuss your circumstances in order to be approved. English and Filipino are the country’s two official languages, and you should have no problem conducting bank business in English.

You will also need your passport, proof of address (usually a rental agreement or utility bills), two passport-sized photographs, and a minimum deposit. The amount the minimum deposit will be will vary depending on the bank and what currency you want the account to be in. Most banks offer accounts in Philippine pesos and US dollars, and some also offer them in Chinese yuan and other currencies. Minimum deposits in pesos can range from P3,000 to P10,000 ($60 to $200).

Once you have completed all the necessary documentation and turned in your application, your account should be available quickly—possibly within the day—but you will need to wait up to two weeks for access to your bank card.

Some banks will also require a bank reference from a former bank in your country of citizenship. They may directly make contact with your bank, or they may ask you to provide a letter of reference. Sometimes, this requirement is waived if you have been introduced to the bank by a current customer of theirs. If they ask for a reference, your application will be put on hold and not approved until they have received it. If you have a Filipino spouse, they can usually refer you and have you approved immediately.

If you are having trouble with a bank, or even with one specific branch of a bank, try others. Some are more used to working with foreigners than others and will have a better understanding of the rules, or they may have more flexible bank policies to make opening a bank account in the Philippines easier.

When signing up for an account, make sure you understand all of the applicable fees. Some Philippine banks charge extra to use a debit or credit card, or they may levy monthly account handling fees to manage your account.

Banks are typically open from 9 a.m. to 3 p.m. Monday through Friday and closed on weekends and holidays.

Some Philippine banks charge extra to use a debit or credit card

When withdrawing money, try to get a mix of higher and lower denominations, as this will make it easy to spend locally. The Philippine peso comes in denominations of 20, 50, 100, 200, 500, and 1,000, and one peso equals 100 centavos. Coins come in denominations of 1, 5, and 10 pesos, as well as 5, 10, 25, and 50 centavos. While big cities will regularly accept credit and debit cards for most transactions, you will definitely need cash if you are living in or travelling to a small town or rural area.

The most popular banks in the Philippines include Banco de Oro (BDO), Landbank, Philippine National Bank (PNB), Bank of the Philippine Islands (BPI), and Metrobank. BPI has special interest-earning chequing account options for entrepreneurs, and Metrobank allows Filipino citizens to open accounts while abroad. Keep in mind, though, that Philippine banks are only required to provide insurance for deposits up to a maximum of P500,000 (about $9,800) per individual, which is far less than in many Western countries. So, think twice before keeping large amounts of savings in onshore Philippine accounts.

International banks, such as HBSC, Citibank, Deutsche Bank, and Bank of America, are also available in the Philippines. They tend to cater to expats, particularly those with lending needs, since banks in the Philippines have strict regulations on bank lending to foreigners. International banks will have higher minimums for account deposits and monthly balances, though. They may also have fewer ATMs outside of the big city centres, which could result in high withdrawal fees.

What Quality Of Healthcare Can You Expect In The Philippines?

The quality of healthcare in the Philippines varies substantially between the public and the private sector. In the public sector, you will find a number of issues, including overcrowding and limited medical equipment. Meanwhile, some of the private clinics are much more modern, and the region is becoming a destination for medical tourism. The standard of medical personnel is generally high, but there is a personnel shortage, as doctors often choose to work abroad.Many expats choose to take out private insurance to cover their stay in the Philippines, but we will look at your options in more detail below.

Public healthcare in the Philippines

The average life expectancy in the Philippines in 2019 was 71.16 years, which was a 0.18% increase from 2018. The average life expectancy is lower for men than for women. The leading causes of death include heart disease, diseases of the vascular system, pneumonia, malignant neoplasms/cancers, all forms of tuberculosis, accidents, COPD and allied conditions, diabetes, and respiratory illnesses.

As in many nations, the disease burden in the Philippines is shifting from infectious diseases to non-communicable diseases (NCDs), such as diabetes and chronic kidney disease. Around 68% of the Filipino population die from NCDs each year. The high incidence of NCDs is related to alcohol abuse, which is a problem in the Philippines.

The population in the Philippines is ageing, which increases the strain on the healthcare system. A recent report from tax advisory firm Deloitte shows that the level of per-person healthcare spending in the Philippines is one of the lowest among Southeast Asia’s major economies. At the time the report was written, the country’s spending was projected to increase an average of 8% annually, from an estimated $12.5 billion in 2013 to $20 billion in 2018, whilst the level of funding was falling, resulting in a gap between income and expenditure on healthcare.

As mentioned above, there is a shortage of medical personnel in the Philippines. The average number of doctors in Southeast Asia overall is 0.6 per 1,000 people, but the average number is slightly higher in the Philippines, which has approximately one physician per 1,000 Filipinos.

There is a shortage of medical personnel in the Philippines

Southeast Asia, as a whole, has substantially lower rates of medical personnel than more developed nations, such as the UK or USA. Similarly, there is a shortfall of dentists and midwives. Many doctors have either retired or emigrated. Some reports suggest that the best doctors are actually working in the public sector.

The country has a number of barangay (local neighbourhood) health workers. These are people who have undergone training programmes under accredited government and non-government organisations. They volunteer in community primary healthcare services, providing assistance in areas such as first aid, maternal, neonatal, and child health, and community-based interventions, including immunisation clinics.

Public hospitals outside of Manila may only offer basic emergency care, and even in tourist resorts you may find relatively minimal provision. If you are intending to live in a rural area, therefore, you should assess how easily and quickly you can access local medical facilities.

The country has a national healthcare system, the Philippine Health Insurance Corporation (PhilHealth), and citizens are entitled to free healthcare under this. All Filipinos are covered by the national health system, but not all forms of treatment are included in it. Until recently, foreigners were not eligible to join the scheme, but in 2017 PhilHealth was extended to apply to expat workers.

There are two categories of recipients: those who are paying national insurance contributions and those who are unable to do so, such as people who are unemployed or on low incomes. If you find that you are not eligible for PhilHealth, you may need to take out private cover instead.

You will find many pharmacies in the Philippines, including 24-hour pharmacies in the major cities, a number of which are attached to hospitals.

Be aware of country-specific issues. For example, the Philippines has had occasional outbreaks of Zika virus and dengue fever.

Private healthcare in the Philippines

In the Philippines, many medical personnel in the private sector have trained in the US, and they therefore speak good English. You will find the best quality of private care in the capital, Manila. However, some expats prefer to opt for cover that includes a medical evacuation clause, so that they can seek treatment either in neighbouring countries, such as Singapore, or in their home nation.

You will find the best quality of private care in the capital, Manila

Most of the country’s hospitals are privately run and are of a high standard. The Philippines is a major exporter of medical personnel, and it is also a destination for medical tourism. Although treatment can seem expensive to many Filipinos, it is competitively priced in comparison to in some Western nations, such as the USA. Top hospitals include:

• The Alabang Medical Center
• The Asian Hospital and Medical Center
• The Makati Medical Center
• The Medical City
• St. Luke’s Medical Center – Quezon City

The Philippines is increasingly becoming a destination both for medical tourism and wellness tourism. Based on Medical Tourism Index lists, the Philippines ranks 16th in the medical tourism industry and 19th in the quality of its facilities and services. Health tourism income was around US$60 million in 2017.

Around 80,000 to 250,000 people travel to the Philippines annually to take advantage of its high standard of private treatment at competitive prices. They opt for treatments such as ophthalmology, dental care, cardiology and minimally invasive surgery. The Department of Tourism has been working with the Department of Health to create a unified Philippine Medical Tourism Programme and to turn the Philippines into a health and wellness hub.

What Cover Is Available For Sports Injuries In The Philippines?

Whether you are resident in the Philippines or simply visiting, you may wish to take advantage of the country’s beautiful coastline and beaches. The country is a major destination for diving and other water sports, and, particularly in areas such as Luzon, there are thousands of dive sites.Diving is a year-round activity with three main seasons. There are numerous places you can explore, and corals, sharks and wrecks can all feature in your diving experience.

Whichever activity you would like to do in the Philippines, it’s worth remembering that there are always some associated risks. This article will take you through what cover is available in the Philippines with regard to sports injuries.

What cover is available for residents of the Philippines?

After a revision of the national healthcare system, the Philippines is now functioning on a two tier health insurance system, made up of public insurance and private cover. However, this may have limited application to you as an expat.

Your employer may sign you up with PhilHealth, the national health insurance scheme, but this offers fairly basic access. The public sector is overcrowded, underfunded, and may, in rural areas, be very rudimentary. The benefits of PhilHealth often do not fully kick in until your second year of coverage, and the scheme does not cover all costs.

Whether or not you are covered by PhilHealth, you will be able to access the public healthcare system if you are prepared to pay out of pocket. However, be aware that although hospital costs in the Philippines are not comparable to those in the US they can still escalate quickly.

• One night hospital stay: ₱2,500/US$50
• Visit to emergency room: ₱2,500/US$50
• Visit to a doctor: ₱500/US$10
• ICU: up to ₱30,000 per day/US$600

Many expats resident in the Philippines opt for private cover, either individually or as part of group insurance offered by an employer.

The Philippines functions on a two tier health insurance system, made up of public insurance and private cover

What cover is available for visitors to the Philippines?

If you are visiting the country as a tourist and intend to undertake any sporting activities, it is advisable to have comprehensive insurance.

If you sustain an injury, you will need to contact your health insurance provider to check whether treatment will be covered under the terms of your policy. If it is, then your provider may be able to pay for your healthcare treatment directly, but check this with the hospital, as they may ask you to pay in cash and then claim the money back from your insurance company once you return to your home nation.

Note that there are time limits in place with most insurers for compensation claims. You will not be able to claim compensation for an injury suffered many years ago, for example.

If you booked your holiday through a registered travel agent, you should be covered by existing legislation, and they will be able to advise you with regard to making a claim.

Check whether your existing health insurance policy covers you for repatriation; many policies do not have a medical evacuation cause. Also check whether your policy has a clause that is dedicated to covering sports injuries, either as additional cover, or as specialist cover, such as water sports insurance.

If you opt for specialist cover, make sure that this includes the activities that you are actually planning to do. This applies whether you are a visitor to the Philippines or resident in the country. Most companies will cover sporting activities to some extent, but the levels of protection can vary. Travel insurance policies may cover snorkelling and diving, for example, but will not cover sea kayaking. Most will cover:

• Swimming
• Surfing
• Standup paddle boarding
• Snorkelling
• Water skiing
• Rowing

Check, too, that your specialised policy does not have personal liability clauses that exclude vehicles, such as jet skis. For example, most travel insurance policies either do not include the following or they have exemption clauses:

• Jet skiing – you must follow local rules relating to water safety
• Scuba diving – many policies will only cover you if you have an open water licence, are diving under the supervision of a licensed instructor, and do not dive below a specific depth limit (usually 130 feet)
• Sailing – you must stay within 10 to 12 nautical miles of the shore
• Yachting – you must be within 60 miles of a safe haven
• White water rafting – some providers will only cover grade one to three rapids; others may cover up to grade five
• Fishing – some insurance providers won’t cover deep sea fishing or spear fishing
• Paragliding – this usually only covers tandem paragliding with a licensed instructor

Most insurance companies will cover sporting activities to some extent, but the levels of protection can vary

Be aware that diving in the Philippines can have dangers that are not necessarily found in other places. For example, there are numerous venomous sea creatures, such as triggerfish, stonefish, lionfish and sea snakes. Make sure that you go diving with an experienced guide, and observe all reasonable precautions.

Doctors in the Philippines say that the most common sports injuries in the country are usually team-sport related, and they include ACL tears, ankle sprains, dislocations, and so on. Physiotherapy is in demand in the country, and there are a number of physio clinics, particularly in urban areas. Prices are competitive, with a consultation costing around US$20 and a massage often costing around US$10 to US$20 per session.

You should also be able to locate a chiropractor in your area without too much difficulty, and the country has a professional chiropractic association.

All of these clinics will be able to provide treatment for sports injuries, such as tendon, ligament and cartilage tears, repetitive stress injuries, musculoskeletal tension, back pain, and shoulder pain. Additionally, they will be able to advise you on the best course going forward, in terms of rehabilitation. Before you get treatment, you may want to get prior approval from your insurer and check that your chosen clinic will accept your policy.

Prescriptions In The Philippines: What Is Available And How To Ensure You Get The Right Level Of Care

The Philippines has a large number of pharmacies, and you should have little difficulty in accessing either prescription or over the counter medication there, particularly if you are in one of the major urban areas. However, there are some factors to be aware of, such as the prevalence of counterfeit drugs. This article will take you through what is available, how much prescriptions cost, and how to get the care you need.

What is available?

There is a wide range of drugs available in the Philippines. With the exception of opioid pain medications and benzodiazepine family drugs, such as Valium, it is possible to get most medications over the counter, without a proper prescription, so long as they are in stock. Some ADHD medications and some painkillers are subject to restrictions, so you may find it difficult to obtain these.

The Philippine Department of Health gives a list of prescription drugs, as well as their prices. You can also check the MIMS drug manual, which is available in bookshops and online. Note that generic drugs are not automatically offered, and attempts to write this into law have been unsuccessful. You may have to ask for them, and some expats have reported that pharmacies will try to sell you the more expensive brand name drugs.

Be aware that prescription drug prices can be higher in the Philippines than in the USA. It has been estimated that the cost of medication in the Philippines is the second highest in Asia, after Japan.

How much do prescriptions cost?

Prescription drugs in the Philippines can be costly. The pharmaceutical company Pfizer – which has agreements with larger pharmacy chains in the Philippines, such as Mercury – runs the Pfizer Sulit discount programme for prescription medication that is produced by Pfizer itself. It is basically a loyalty card scheme in association with over 2,000 drugstore, hospital, and medical centre redemption partners.

Prescription drugs in the Philippines can be costly

GlaxoSmithKline (GSK) has been running a ‘ValueHealth’ programme that is similar. They say that they offer discounts on antibiotics, asthma medication, and some paracetamol-based preparations, such as Calpol. GSK is in negotiations to acquire Pfizer’s global consumer healthcare business, namely over-the-counter drugs, but this has come to the attention of Filipino antitrust bodies. You may wish to keep an eye on this developing situation, in case it affects your discount card.

The government has introduced a ‘Cheaper Medicines Act’, in order to bring down the costs of some medications, but this is not as extensive as it might be. Some basic medications, such as blood pressure medication, painkillers, anti-allergy drugs and so on, will still only cost you the equivalent of a few dollars.

You will have to pay 12% VAT on your prescription medication.

How to get the care you need

The Philippine Pharmacists Association Inc. (PPhA) reports that around 50,000 licensed pharmacists are on their list, as of February 2019, although only 23,500 are active or practicing. The regulatory board says that they still need trained pharmacists and pharmacy assistants.

Some expats recommend going to the larger pharmacy chains, such as Mercury or Watsons, as they are more reliable. They sell medication that is genuine (counterfeit drugs are a problem in Southeast Asia generally) and within its expiration date. They are also usually air conditioned (fake drugs are adversely affected by the heat). Note, however, that a lot of Asian-made drugs are not tested to the standards of the FDA.

If possible, it might be worth taking your existing medication into the Philippines with you in its original packaging, so that you can avoid complications at the pharmacy. However, bear in mind that some medications may be prohibited (see above, regarding permitted drug list), and you may need to declare others (for example, anything containing codeine, such as cough medicine). Your medication may be confiscated, but you should not be fined.

It is advisable to bring a letter from your doctor with you, stating the nature of the prescription. You might find that there are limitations on how much medicine you can bring. For instance, you may only be allowed to bring in a three-month supply. If you are only visiting the Philippines for a short period, you are advised to bring sufficient medication to cover your stay. Consult your GP or your local Filipino diplomatic mission if you need further advice.

Make sure you check whether or not your medication is prohibited in the Philippines

If you are bringing in any equipment relating to your condition, check with the authorities what exactly is permitted, as you may be restricted on some items (for example, you are permitted to bring in 100 insulin needles/lancets).

E-prescriptions are now available from Filipino doctors. Prescriptions for antibiotics, anti-infectives, and antiviral preparations are only valid for one week from the date they are issued.

You can also order your medication from abroad. Expats have reported good results with regards to ordering drugs in from Canada and the UK.

Check the opening hours of your local pharmacy, and note whether there is a number for a duty pharmacy in your area, which will be open when others are shut.

It is advisable to check the health advice relating to the Philippines on your government’s country page before you travel, as there may be health issues that are specific to the area you are visiting. The Philippines is, for instance, prone to occasional outbreaks of dengue fever and Zika virus.

Maternity Care In The Philippines: What The Options Are And How To Decide On A Birth Plan

As an expat in the Philippines, you will have a number of choices when it comes to giving birth. You can choose to have your baby at home, in a public hospital, or in a private hospital.If you are covered under the Filipino national health insurance scheme, PhilHealth, then this will cover your prenatal care and the delivery. However, public healthcare is undeniably overstretched. Alarming photos in the local Filipino press show mothers having to share not only the same ward but the same bed. For this reason, many expats choose to give birth in the private sector.

Read on to learn more about your options.

How to decide on a birth plan

A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are. When writing your birth plan, you may want to consider the following questions:

• Where do you want to give birth?
• Who do you want to have with you (e.g. your partner)?
• What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
• Do you need any birthing aids?
• Do you want pain relief, and if so, what kind?
• What kind of birthing environment would you prefer?

You will likely be restricted to giving birth in hospital, as the Department of Health has been discouraging home births, in an attempt to reduce the infant and maternal mortality rate. In 2018, the infant mortality rate in the Philippines was about 22.5 deaths per 1,000 live births. In 2013, the Department of Health implemented the ‘No Home Birthing Policy’, which requires mothers to give birth in hospitals or registered birthing facilities. Fines and imprisonment of Filipino mothers have been reported. These draconian measures, which some commentators say are an infringement of women’s rights, have been introduced to address unacceptably high mortality rates and a reliance on ‘hilots’ (untrained birth personnel).

In general, expats in the Philippines choose hospitals, such as St. Luke’s and Makati Medical Centre, due to the higher levels of care.

The Department of Health has been discouraging home births in the Philippines

There is an emphasis on C-sections in Filipino hospitals (with a commensurate level of expense), so if you do not wish to give birth via this method, unless it is medically necessary, you must make this very clear. Do not let yourself be talked into having a C-section because you are a foreigner and will be expected to pay more. Some expats choose a clinic, with a hospital as a backup plan, as clinics are more amenable to conventional births.

Maternity care in the Philippines

Once it has been established that you are pregnant, your doctor will schedule a series of appointments for you, including for medical tests, such as ultrasounds and scans. As your pregnancy advances, these sessions will become more frequent.

Medical care in the country is generally of a high standard, both in the public and the private sector. Many Filipino doctors have trained in the States and speak English. However, facilities and equipment in public hospitals may not be at the level that you are used to in the West. Using a public hospital will mean that your treatment costs will be substantially less.

Some average costs in the private sector (if you don’t have insurance) are:

• Prenatal GP visit: ₱700 to ₱1250 per month (US$14 to US$25)
• Prenatal ultrasound: ₱1150 to ₱4000 (US$22 to US$78)
• Birth and delivery: ₱15,000 to ₱100,000 (US$294 to US$1960)
• C-section: ₱80,000 to ₱170,000 (US$ 1568 to US$3332)

Costs will be cheaper in the public sector. Delivery under PhilHealth can be free. Otherwise, you are likely to find yourself paying around ₱2000 to ₱24,000 (US$39 to US$470), depending on the nature of the delivery and whether there are any complications.

PhilHealth offers a Maternity Benefits Package. Whether you are eligible for this will depend on your employment status and your level of contributions. If you are, you will be entitled to ₱6,500 (US$127) if you give birth in a hospital. If you give birth in a non-hospital facility, you will receive ₱8,000 (US$157). Philhealth also gives benefits to mothers who have a C-section birth – you will receive a fixed amount of ₱19,000 (US$373). This will only apply to your first four normal birth deliveries. PhilHealth will also cover complicated vaginal delivery at ₱9,700 (US$190); breech extraction at ₱12,120 (US$238); and vaginal birth after C-section (VBAC) at ₱12,120.

You will need to bring with you:

• Hospital admission form
• OB admission slip
• Your birth certificate
• Maternity benefit form, if applicable
• Photo ID for both you and your partner
• Marriage certificate (if applicable)
• PhilHealth or HMO Claim Forms
• Your own night clothes and baby supplies

Many Filipino doctors have trained in the States and speak English

You can expect to spend one or two days in the hospital, unless you have had a C-section, in which case you will be discharged a little later.

You will then need to make a series of postnatal appointments. Ask your GP about the vaccination rota. You may be able to have your child vaccinated for free if you have a local community clinic, but otherwise you will have to pay for each vaccination.

If you are intending to claim under PhilHealth, you will need to take the following to a Philhealth office within 60 days of being discharged from the hospital:

• Latest copy of your PhilHealth Member Data Record (MDR)
• PhilHealth Claim Form 1 (CF1), filled out and signed by your employer; you can get this at Philhealth branches, the birth hospital or healthcare facility, or your employer
• Proof of premium payment; employees will need to submit the certificate of premium payments with OR numbers
• PhilHealth ID and a valid ID
• Claim Form 2 (CF2), filled out by your doctor or health care provider; the hospital usually provides this form
• Marriage certificates

Paid maternity leave is available to all working mothers and has recently been extended from 60 days to 105 days. You will have the option of extending this for 30 days without pay. Under the new law, employees who are solo parents will also be granted an additional 15 days of paid maternity leave.

Will the baby be a Filipino citizen?

Your baby will only be eligible for Filipino citizenship if either you or their other parent is a Filipino citizen.

How To Register With The Health System In The Philippines

Following a revision of the national healthcare system, the Philippines is now functioning on a two tier health insurance system, made up of public insurance and private cover. Will you be able to register with this scheme, if you are an expat? We will look below at some of the options available to you.

How does the Filipino state health insurance system work?

PhilHealth, the old system, is funded by the government and by employer/employee national health contributions. Up until now, although everyone is technically entitled to free at the point of delivery healthcare, not all medical procedures have been covered. Some out-of-pocket expenses must be made, which limits access to treatment for some low income Filipino citizens. It is hoped that the recent overhaul of Philhealth into a revised body, the Philippine Health Security Corporation (PHSC), will result in more genuinely universal coverage.

All Filipinos are covered by the national health system. Until recently, foreigners were not eligible to join the scheme, but in 2017 PhilHealth was extended to apply to expat workers. There are two categories of recipients: those who are paying national insurance contributions and those who are unable to do so, such as those who are unemployed or on low incomes. If you are in the latter category, the government will subsidise you. You may under certain circumstances be covered by PhilHealth as a foreign retiree, and, in addition, your dependants will be covered.

In 2017, PhilHealth was extended to apply to expat workers

Your employer should sign you up with PhilHealth, but check that this has been done and that they are paying their share of the contributions. You will need to pay around nine months’ worth of contributions before you become eligible for coverage under PhilHealth. However, the number of contributions that you will need to make can vary, so check with your employer or PhilHealth for clarity.

You will need to submit the following documentation to the local health insurance office:

• A valid Alien Certificate of Registration Identity Card (ACR I-Card) issued by the Bureau of Immigration
• A PhilHealth Member Registration Form (PMRF) for foreign nationals

Once you are registered, you will be sent a PhilHealth ID card and number, which you must take with you to medical appointments. You can use this for other purposes too, such as opening a bank account. You can also register to make voluntary contributions into the system via your PhilHealth ID number.

Note that the system is not entirely free at the point of delivery. You will have to co-pay some of your treatment costs, usually the difference between what your healthcare provider charges and the amount covered by PhilHealth. You may also want to sign up with a Health Maintenance Organisation (HMO). An HMO is a medical insurance group that provides health services for a fixed annual fee. It can act as a top up for your PhilHealth cover. Check with your employer to see if this is already part of your insurance package.

You will then be entitled to register with a GP and a dentist (PhilHealth covers basic dental treatment).

Your employer should sign you up with PhilHealth

Private health insurance in the Philippines

Even though you may be entitled to access the public healthcare system, you may prefer to opt for private cover. Public healthcare provision in the Philippines is erratic. It is of a high standard in the cities but is often limited and difficult to access in rural areas. The public system also suffers from overcrowding, long waiting times, and a shortage of medical staff, as so many graduates choose to go abroad to work. The government is attempting to address this by, for example, inducing recently qualified graduates to work in rural areas, but the system is still under pressure.

Due to the limitations of the system, many expats opt to take out private cover, in order to ensure that they can access treatment more quickly and can use better facilities. Check that your chosen healthcare clinic accepts your private cover, and see which form of payment they prefer. It is also worth making sure that your insurance policy has a medical evacuation clause. The Philippines is prone to a range of natural disasters, and you may wish to ensure that you can be airlifted out and treated in your home nation if necessary.

How To Keep Your Health Insurance Costs Low In The Philippines

As an expat living in the Philippines, your insurance choices will be limited. Until recently, foreigners were not eligible to join the national health scheme, but in 2017, PhilHealth was extended to apply to expat workers. However, public healthcare is patchy in the Philippines, particularly in rural areas, and there is a shortage of medical personnel. Therefore, many expats choose private health insurance to cover their time in the country. We will look at some of your options below.

Personalising your health insurance cover

It is advisable to check with your employer whether you are covered under a group health insurance package by your company in the Philippines. This will be a private scheme but worth considering depending on what it offers. Some expats may also take out private health insurance, either as a replacement or as a top up.

If you would rather not take out comprehensive private cover, you may instead choose to pay out of pocket expenses in the public sector. This could be worthwhile if you have only minor medical issues, but costs can escalate rapidly if you have a chronic condition, if you need to see a specialist, or if you spend a night or more in hospital. While healthcare costs in the Philippines are not as expensive as they are in the US, they are still not necessarily cheap.

Selectable options

Check the small print of any private health insurance policy you are interested in to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care.

Remember to check whether your potential policy covers pre-existing conditions. The definition of this will vary between insurers. Usually the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits for when the diagnosis must have been given.

Healthcare costs in the Philippines can be expensive, depending on what treatment you need

You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer. You may also wish to check whether there is a medical evacuation clause. It is not uncommon for expats resident in the Philippines to seek treatment in other Southeast Asian countries, such as Thailand or Malaysia, which have booming medical tourism markets. Alternatively, you may want to return to your home nation for healthcare.

Take a good look at your potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant then you may wish to reduce your policy costs by having such options removed.

Cost sharing

You may be able to reduce the cost of your premium through ‘cost sharing’. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.

Co-pay

This is where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.

Co-insurance

This is where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your coinsurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.

You may be able to reduce the cost of your premium through ‘cost sharing’

Deductibles

This is where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your healthcare clinic and then, once you have had 11 such appointments (€1000/€85 = 11.8), your insurance will begin to pay out to the doctor directly.

You may also need to look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met. Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. In this instance, you would pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1500 minus the deductible of €1,000). At that point, you would pay nothing more for the remainder of the plan year.

It is worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.

International private medical insurance

As so many variables have an effect on the cost of international private medical insurance, it is very difficult to give accurate estimates without knowing the full details of what coverage you require. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. If you want your coverage to include the US, the premium could increase to almost double this amount.

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