Understanding Health Insurance in the Philippines | Coins.ph

Understanding Health Insurance in the Philippines


Getting sick is costly. While Philhealth helps lift some of the financial burdens of medical bills, it doesn’t always cover all of the expenses.

Related: How Much Do I Pay if I Get COVID-19 in the Philippines?

This is where health insurance comes in. If you’re looking into health insurance in the Philippines, here are the basics you need to know.


What is Health Insurance in the Philippines?

Health insurance provides you with financial security when you need health, medical, and surgical services from a hospital. This comes in a form of insurance that covers preventive or corrective check-ups and procedures so you won’t have to pay when all is done.

While the initial investment in health insurance products may seem expensive, the benefits outweigh the costs when you realize that it can take a small fortune to pay for medical procedures in the Philippines.


Basic Benefits of health insurance

1. Emergency Care

Should you ever need immediate care due to an accident or other similar case, your health insurance will cover all procedures that require immediate medical attention.

This benefit typically covers Critical Care and Travel Coverage as these are the most common types of emergency cases.


2. Outpatient Care

Should you require medical attention but don’t need to be admitted inside the hospital, you can receive outpatient care. This is for your typical check-ups where your physician will ask you a series of questions for diagnosis, then prescribe medication or treatment that can be done in your own home or for a brief period in a doctor’s clinic.

This benefit includes preventive care, wellness, laboratory, and non-admission Annual Physical Examinations.


3. Inpatient Care

Health insurance covers medical care, specialized procedures, and facilities fees required for when you are admitted to the hospital or require care that can only be performed inside the hospital.

This benefit covers ambulance fees, hospitalization, laboratory tests, and medicine while in admission.


Optional benefits

Depending on your premium, you may also receive these health insurance benefits in your package:

  • Optical
  • Dental
  • Maternity


What to consider when choosing a provider

While it can be tempting to just go for the cheapest option available, there are a few things to consider before you choose a health insurance provider:

1. Inclusions

Not all policies and companies will be suited to your lifestyle, so the first thing you need to look for is what exactly is included in your policy.

Let’s say you’re into contact sports. If your policy doesn’t cover emergency care for sports-related accidents, then you’ll still have to spend a considerable sum for medical care related to your favorite hobby.

Some providers only provide inpatient services. This means expensive diagnostic and rehabilitative procedures like MRI, CT scans, and physical therapy may not be covered.

The point is, you have to be sure to cross-check the inclusions with your lifestyle before choosing a provider and policy. This way, you can get the most of your health insurance.


2. Lists of accredited hospitals, clinics, and physicians

You’re going to want to choose a provider with as many accredited hospitals, clinics, and physicians nationwide with partners overseas. The reason for this is so you have more choices on where to have yourself treated when you are ill no matter where you are in the world. Remember that different hospitals have different fees, and if you’re going to need expensive treatment you’re going to want to go for bang for buck rather than hotel-like amenities.

Apart from this, having more accredited physicians means more specialists to consult with for rare diseases. Should you ever be diagnosed with a rare disease, the last thing you want is to have to travel to a different region because the only accredited specialist doctor is far from your home.


3. Policy updates

Most policies will have price escalations as you grow older. This is absolutely normal. However, you should check the fine print if the coverage also increases over time. Between a cheaper policy with the same coverage and a lower escalation and a slightly more expensive one with a similar escalation but with expanding coverage, the latter will be more beneficial as you grow older and certain age/lifestyle-related conditions start to appear.


Top health insurance providers in the Philippines

  • Maxicare
  • MediCard
  • Sun Life
  • Pru Life
  • Intellicare
  • EastWest Health Care
  • Caritas Health Shield
  • Pacific Cross Health Care


Pay your insurance premiums with Coins.ph

With COVID-19 still present, the last thing you want is to contract an illness while ensuring your health. Pay your health insurance premiums with your Coins Wallet from the safety of your home.

You can find insurance providers in the Pay Bills feature or you can also transfer directly to your provider’s bank account using your Coins Wallet.

my phone is my wallet

Questions or feedback? Email us at help@coins.ph or tap Send us a message in your app. Our operating hours are from Monday – Friday, 9AM – 6PM

Coins.ph is regulated by Bangko Sentral ng Pilipinas (BSP). BSP Financial Consumer Protection Department: (02) 708-7087 or consumeraffairs@bsp.gov.ph

 In Blog, Money Matters
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