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.
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%.
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.