About PhilHealth: Philippine Health Insurance Corporation

The Philippine Health Insurance Corporation, popularly known as PhilHealth, is the government corporation responsible for implementing universal health coverage in the Philippines. Established under the National Health Insurance Act of 1995, PhilHealth ensures that every Filipino has access to affordable and quality health care services.

Also Read: About Philippine Red Cross Humanitarian Organization

PhilHealth operates as a tax-exempt, government-owned and controlled corporation (GOCC) under the Department of Health. It is primarily financed through member contributions and government subsidies. With its wide coverage, it has been instrumental in making healthcare more accessible and affordable to Filipinos.

philhealth philippine health insurance corporation

Mission and Vision of PhilHealth

PhilHealth’s mission is to ensure a sustainable national health insurance program for all Filipinos. Its vision is to become a world-class health insurer recognized for its sustainable funds, extensive healthcare benefits, excellent service, and responsive policies and programs.

To fulfill this mission and vision, PhilHealth works closely with various stakeholders, including government agencies, private institutions, healthcare providers, and the public.

History and Development

PhilHealth was created in 1995 through Republic Act No. 7875, also known as the National Health Insurance Act. This law mandated universal health insurance coverage for all Filipinos, both in the formal and informal sectors.

Over the years, PhilHealth has undergone several reforms to expand its coverage and improve its services. Amendments to the original law have included the inclusion of overseas Filipino workers, the indigent population, senior citizens, and people with disabilities under PhilHealth’s coverage.

PhilHealth’s journey has been marked by several key milestones. One significant milestone was the passage of the Universal Health Care Act, which further expanded PhilHealth’s coverage and introduced new benefits.

Another notable milestone was the introduction of the Z Benefit Package, which covers catastrophic illnesses. This package has greatly eased the financial burden of patients suffering from serious conditions like cancer, kidney disease, and heart disease.

philhealth logo
PhilHealth logo

PhilHealth Features

Enrollment Process

Enrollment in PhilHealth is open to all Filipinos, whether employed, self-employed, retired, or unemployed. The process involves filling out a registration form, providing necessary documents, and paying the required premium.

For employed members, the premium is automatically deducted from their salary. For voluntary members, they can pay their premiums at PhilHealth offices or accredited collecting agents.

Coverage and Benefits

PhilHealth provides a wide range of benefits, covering different types of health services. These include inpatient care, outpatient care, emergency care, and preventive health services.

The benefits are designed to be comprehensive, covering not just hospital bills but also professional fees, medicines, laboratory tests, and other medical expenses. The amount of benefit depends on the type of illness and the type of health facility.

Membership Categories

Formal Economy Members

Formal economy members include those who are gainfully employed and bound by an employer-employee relationship. This includes both government and private employees. Their PhilHealth contributions are shared equally by the employee and the employer.

Informal Economy Members

Informal economy members include those who work in the informal sector or are self-employed. This includes vendors, taxi drivers, freelancers, and others who do not have a fixed employer. They pay their PhilHealth contributions voluntarily.

Steps to Filing a PhilHealth Claim

Filing a claim with PhilHealth involves several steps.

  1. First, the member or their representative must fill out a claim form.
  2. Then, they need to attach the necessary documents, such as hospital bills, medical records, and proof of contribution.
  3. Once the claim form and documents are ready, they can be submitted to PhilHealth.
  4. The claim will then be processed, and if approved, the benefit will be paid either through direct reimbursement to the member or through deduction from the hospital bill.

Partnerships and Collaborations

PhilHealth has partnered with a wide network of hospitals and healthcare providers across the country. These accredited providers agree to provide health services to PhilHealth members and comply with PhilHealth’s standards and guidelines.

In return, they receive payment from PhilHealth for the services they render to members. This partnership ensures that PhilHealth members can easily access health services whenever they need them.

Issues and Challenges

Like any large organization, PhilHealth has faced its share of controversies and legal issues. These have ranged from allegations of corruption and fraud to issues of mismanagement and inefficiency.

Despite these challenges, PhilHealth remains committed to its mandate of providing universal health coverage. It has taken steps to address these issues, including strengthening its internal controls, improving its systems, and holding erring officials and employees accountable.

Future Plans and Aspirations

PhilHealth is continuously working on reforms and changes to improve its services. These include expanding its benefit packages, improving its claim processing system, and enhancing its customer service.

As part of its commitment to universal health care, PhilHealth also plans to further expand its coverage, especially among the poor and vulnerable populations.

Video: Philhealth Role to Filipinos

Check out this GMA news report featuring how PhilHealth helps Filipinos with their healthcare needs and the importance of being a Philhealth member.

Since its establishment, PhilHealth has made significant strides in advancing the health of Filipinos. It has expanded health insurance coverage, made healthcare more affordable, and improved access to health services.

Despite the challenges it faces, PhilHealth remains a crucial player in the Philippine healthcare system. Its efforts contribute significantly to the country’s pursuit of health for all.


PhilHealth’s journey reflects the broader challenges and opportunities in achieving universal health care. As it continues to evolve and adapt, it serves as a model of how health insurance can play a pivotal role in promoting health and well-being.

Through its programs and initiatives, PhilHealth gives us a glimpse of what is possible when a nation commits to the health of its people. And while there is still much work to be done, the progress made so far gives us reason to hope for a healthier future for all Filipinos.

Contact Information

PhilHealth Philippines
Address: Citystate Center 709 Shaw Blvd., Brgy Oranbo, Pasig City.
Call Center Hotline 84417442 (PHIC)
Email: actioncenter@philhealth.gov.ph
Website: https://www.philhealth.gov.ph/

Facebook Page: https://www.facebook.com/PhilHealthOfficial/
Twitter: https://twitter.com/teamphilhealth

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