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@uhrigg

I am new here and have no clue what I am doing

That's what concerns me. Presumably you took out travel insurance before leaving the States?

Welcome! None of us had a clue when we first got here, lol.

You can use travel insurance for short trips (under 90 days)  and pay out of pocket for longer trips.  Keep your US health insurance. Most doctor's appointments here are really cheap ($20-50 at most). I had a knee MRI and it was 15K pesos - 1/10 of what it would have been in the States. For anything serious - off to Thailand or Malaysia for better quality care/facilities, or back to the States.

There are international firms that offer health insurance, ie. Pacific Cross, but I believe they all operate on a reimbursement basis.

@pnwcyclist

There are international firms that offer health insurance, ie. Pacific Cross, but I believe they all operate on a reimbursement basis.

Which is rather important because the hospital wants payment when patient is discharged and reimbursement will take longer. That means you need self-insurance to cover the bill for which you hope to later be reimbursed.

@Lotus Eater

No, I did not ..

@pnwcyclist

Thanks for the information.

@danfinn

Thank you .. I will have to check some of these companies out. Does anyone have any of the local insurances?

btw, I ride also .. at least I did when I was back in the states ..

@uhrigg

Google wins the day, then boots on the ground.

I posted on one of your other threads "new members"  that for us a doctors visit in a private hospital is 400 pesos or around US 7 bucks. I have no complaints.

Cheers, Steve.

@uhrigg

@Lotus Eater

No, I did not ..

I see. Did you remember to pack your ‘I’m the new guy in town’ t-shirt?

uhrigg said . . . . .Hello, I am new here and have no clue what I am doing but... anyways..
I just got here to Cebu and I am wondering about health insurance/coverage.. any input ..
Thanks..
btw, I am George

The real answer depends on your age and if you have any preexisting conditions. As your age increases so does your premiums, at the same time your coverage is likely to go down, maybe to the point of being useless.

Hello, I am new here and have no clue what I am doing but... anyways..
I just got here to Cebu and I am wondering about health insurance/coverage.. any input ..  Thanks.. btw, I am George - @uhrigg

Hello George, and all

As well as the excellent Forum responses already, George ..

An AI answer to:  "Philippines medical insurance?"

DeepSeek: Excellent question! The medical insurance system in the Philippines is a mix of public and private, and understanding it is crucial for residents, expats, and visitors.

Here’s a comprehensive breakdown:

1. Public National Health Insurance: PhilHealth

The cornerstone of public healthcare.

What it is: A government-administered social health insurance program under the Universal Health Care Act.

Who it's for: All Filipino citizens, and resident aliens who have been in the Philippines for at least 6 months. Contributions are mandatory for employed, self-employed, and indigent members.

How it works: Members and their employers make monthly contributions (based on income). In return, PhilHealth provides coverage for a wide range of medical cases, including:

Inpatient hospital care (room & board, drugs, labs, surgeries)

Outpatient care and day surgeries

Z-benefits (critical illnesses like breast cancer, prostate cancer, kidney transplant)

Dialysis sessions

Maternity care

Key Point: PhilHealth operates on a case rate or fee-for-service system. It does not cover 100% of costs. It pays a fixed amount per illness or procedure. The patient is often responsible for the balance billing (the difference between the hospital's bill and what PhilHealth pays). This is why most people supplement it with private insurance.

2. Private Health Insurance

Essential for filling the gaps left by PhilHealth and providing access to better facilities.

Providers: Major companies include Pacific Cross, AXA Philippines, AIA Philippines, Manulife, and Sun Life.

Coverage Types:

Hospitalization Plans: Covers in-patient costs, including the balance not paid by PhilHealth.

Major Medical/Comprehensive Plans: Covers in-patient, out-patient, emergencies, and sometimes dental and vision.

Health Maintenance Organizations (HMOs): Very popular, especially through employers. Companies like Maxicare, Intellicare, and Medicard provide network-based care. You pay an annual premium and get access to a network of doctors, clinics, and hospitals, often with no cash-out for consultations and confined cases (subject to limits).

Critical Illness Plans: Provides a lump-sum cash payment upon diagnosis of a covered critical illness (cancer, stroke, heart attack).

Who it's for: Middle to high-income Filipinos, expatriates, and anyone wanting more comprehensive coverage and access to private hospitals.

3. Specific Situations

For Expats and Foreign Residents:

Long-term: Private international or local comprehensive health insurance is HIGHLY recommended. Some get local PhilHealth coverage if eligible, but it's rarely sufficient alone.

Short-term/Visitors: Travel insurance with strong medical evacuation coverage is a must. Healthcare costs for non-residents can be high.

For Senior Citizens:

PhilHealth coverage continues.

The Senior Citizen's Act provides a 20% discount on medical services and medicines.

Private insurance becomes more expensive and may have limited coverage options. HMOs often have age limits for new applications.

For OFWs (Overseas Filipino Workers):

They are mandatory PhilHealth contributors with a special rate.

Many also have insurance or HMO provided by their foreign employer or through POEA requirements.

The Typical Healthcare Financing Stack for a Filipino Employee:

PhilHealth (Mandatory public base)

Company-provided HMO (Covers outpatient, consultations, and supplements hospitalization)

Personal Private Health Insurance/Critical Illness Plan (For additional security and higher coverage limits)

Important Considerations & Challenges

Balance Billing: The biggest gap. Always ask: "After PhilHealth and my HMO/insurance, how much will I pay out-of-pocket?"

Pre-existing Conditions: Private insurers often have waiting periods (e.g., 1-2 years) or exclusions for pre-existing conditions. HMOs may cover them after a period.

Network Restrictions: HMOs and some insurers have specific hospital and doctor networks. Check if your preferred hospital is included.

Costs: Quality private insurance can be expensive. It's crucial to compare benefits, coverage limits, and exclusions.

Recommendations

Enroll in PhilHealth. It's the basic safety net.

Get an HMO if your employer doesn't provide one. It's the most cost-effective way to manage outpatient and day-to-day medical needs.

Supplement with a private insurance plan for major medical expenses, critical illness, or if you are not part of an employer HMO plan.

For foreigners/expats: Secure a robust international health insurance plan (like those from Allianz Care, Cigna Global, or GeoBlue) before arriving, especially if you are not employed locally.

In summary: Relying solely on PhilHealth is risky for anything beyond basic care. The standard approach is PhilHealth + HMO + Private Insurance for comprehensive protection against the potentially high cost of medical care in the Philippines, especially in private hospitals. Always read the policy wording carefully to understand the coverage and exclusions.

Check out a post of mine from 12 July 2025 titled Healthcare In The Philippines. It explains about a vlogger who interviewed and Ex Pat on the subject and he had experience in the field and was talking about Cebu. See if you can find the video by Chad Foster and watch.

@PalawOne

1. Public National Health Insurance: PhilHealth

The cornerstone of public healthcare.

Cornerstone indeed. For citizens.

Expats are charged several multiples of the premiums charged citizens. Expat benefits for serious illnesses do not include so-callec "Z benefits" provided to citizens, i.e. the expensive treatments like heart and cancer. So...what we have is essentially foreign expat funding  of Filipino citizen's Healthcare. That is a noble cause for some but it is not for everyone, even if we generally empathize with thr conditions of poverty here

A few years ago, I was in a private hospital in Dumaguete and after 6 years of paying 15K per year, phil health reimbursed me 10K out of a 190k bill. So, expecting, but not receiving, about 20% or 40K, i dropped them after that claim. I almost didn't even get the 10k because I nearly missed the 24 hour deadline to notify them of my hospital admission.  Remember that if if you have PhilHeakth because nobody tells you that critical piece of information. Phil Health had and has run out of money. For citizens, it is OK, maybe great, especially when treated in local "dive" government hospitals. But for expats who prefer actual healthcare that approaches western quality it is not health insurance at all nor is it a cornerstone of anything and in fact it is not even a very good discount card. My wife and I now save the money and will use the cash in the future coming out ahead that way if we need it

Good points Dan and while my experience has been different don't discount what you say after all this is the country we live in.

As for the affordability after the thievery? What used to be P2,400 per year for locals has pushed its way up firstly to P4.8 and now P6K, is that affordable for the locals?

Sure us blow ins like me pay P17K but one hospital stay for 2 days and nights with a multitude of tests the bill was like P61K, in a private room, after PhilHealth we paid P40K so for us about a 30% saving. We pay our caretakers PhilHealth, He had a few issues and was in hospital for 2 days and nights,  the bill was close on P40K but after P.H. was P17K out of pocket so more than 50% but he was in a public ward.

I think P.H. is the minimum and if an admission show the members number for the record, the rest we self fund.

I do feel for the locals with the price hikes and affordability and the reason all these issues arise,,,,,,, greed and corruption like most countries and the average worker picks up the tab.

But hey OMO.

Cheers, Steve.

@bigpearl

... but one hospital stay for 2 days and nights with a multitude of tests the bill was like P61K, in a private room,

In Dumaguete a private room at Silliman SUMC University (US) hospital is about 3K per night and a full blood panel is about 6K. Easily self-insured. I guess it makes a difference where you live.

Yes too true Dan and the fees you quoted seem similar to our hospital. Our hospital was set up 90 odd years ago and is still owned by the same Filipino family so no hand outs to foreign owners.

I will keep paying our PhilHealth as I consider it cheap for the benefits.

Cheers, Steve.