Five Western Visayas hospitals join PhilHealth no co-payment policy

ILOILO CITY — Five private hospitals in Western Visayas have formally committed to the Philippine Health Insurance Corporation’s (PhilHealth) no co-payment policy, giving members another way to access hospital care without extra charges for covered services when admitted to designated ward accommodations.

Under a memorandum of agreement signed Tuesday, Sept. 15, PhilHealth and five hospitals joined the arrangement: Asia Pacific Medical Center-Iloilo, Healthway QualiMed Hospital-Iloilo, Iloilo Doctors’ Hospital, Saint Gabriel Hospital in Kalibo, and the hospital facility operated by Semirara Mining and Power Corp.

Collectively, the five facilities have 64 ward-type beds and have committed to allocate 10% of their bed capacity for eligible PhilHealth members.

PhilHealth President and Chief Executive Officer Beverly Lorraine Ho attended the signing and underscored the importance of stronger partnerships with private hospitals in advancing accessible and affordable health care.

Ho described the policy as part of PhilHealth’s efforts to strengthen financial protection for members and ease the burden of hospitalization.

PhilHealth-Western Visayas Regional Vice President Marjorie A. Cabrieto likewise welcomed the initiative, saying it gives members greater access to quality health care in private facilities.

“This is welcome news for PhilHealth members, as they can now access quality healthcare services in private facilities without worrying about out-of-pocket expenses,” Cabrieto said.

Under PhilHealth’s no co-payment policy, members admitted to designated basic or ward accommodations should not be required to pay additional charges for covered essential health services.

These include covered drugs and medicines, professional fees, laboratory procedures, room and board, and other necessary services under the applicable benefit package.

The policy, however, does not mean all hospital services are automatically free, as the no co-payment provision applies only to eligible members admitted to basic or ward accommodations.

Patients who choose nonbasic or upgraded accommodations may still incur charges for services or amenities not covered by their PhilHealth benefits, subject to existing PhilHealth rules.

Participating hospitals are also required to provide the minimum standard of care without charging qualified patients for covered services.

The 10% bed allocation is a minimum commitment under the agreement, and hospitals may admit more eligible members under the policy if ward beds are available.

The policy is part of the government’s broader effort to protect Filipinos from the financial burden of hospitalization under Republic Act 11223, or the Universal Health Care (UHC) Act.

Signed into law by then-President Rodrigo Duterte in February 2019, the UHC Act automatically enrolled all Filipinos in the national health insurance program.

The law seeks to ensure that all Filipinos have access to quality and affordable health care while protecting them from financial hardship.

The UHC Act strengthened PhilHealth’s role in providing financial risk protection to members and paved the way for reforms aimed at reducing out-of-pocket health care spending.

PhilHealth subsequently issued policies governing no co-payment and no balance billing for its benefit packages.

PhilHealth Circular No. 2020-0024 established the governing policies on no co-payment and no balance billing, while succeeding circulars further clarified implementation of the policy for patients admitted to basic or ward accommodations.

Under more recent PhilHealth rules, the no co-payment policy applies to patients in basic accommodations at accredited government and private health care facilities.

The Sept. 15 agreement therefore does not create a new benefit but strengthens implementation of an existing policy by bringing more private health care providers into the arrangement.

Other private hospitals across the region have also expressed their intention to participate in the initiative.