PH Health Insurance

Mandatory Coverage: All Filipinos are automatically included in the program. Employed individuals have contributions automatically deducted from their salaries, while self-employed or voluntary members must pay their contributions directly.

Benefits: PhilHealth provides basic coverage for inpatient hospital care, selected outpatient services (e.g., dialysis, chemotherapy, outpatient blood transfusion, TB treatment), maternity care, and "Z Benefits" for catastrophic illnesses like certain cancers and heart conditions.

Limitations: PhilHealth coverage is generally a fixed reimbursement rate and often does not cover the full cost of medical treatment, especially in private hospitals, leaving patients to pay the difference out-of-pocket. The quality of public healthcare can also vary between urban and rural areas.

2. Health Maintenance Organization (HMO) Plans

HMO plans are a popular form of private, prepaid healthcare services, typically offered by employers as an employee benefit.

Coverage: HMOs usually cover day-to-day healthcare needs such as doctor's consultations, laboratory tests, diagnostic procedures, and emergency room treatment within a specific network of accredited hospitals and clinics.

Key Feature: They often provide cashless access to services within their network, which is a major convenience.

Limitations: Coverage is generally limited to a specific network of providers and may have annual coverage caps. Most HMO plans do not offer coverage once you retire.