Middle-class Filipinos who are just one hospitalization away from financial strain may soon breathe easier under the zero balance billing (ZBB) program being implemented in selected government hospitals, Executive Secretary Ralph Recto said.
In a recent meeting with Department of Health (DOH) officials and Philippine Health Insurance Corp. (PhilHealth) leadership, Recto emphasized that the program should extend benefits to middle-class families who consistently contribute taxes and PhilHealth premiums. The meeting on Jan. 20 with Health Secretary Teodoro Herbosa and PhilHealth President Edwin Mercado focused on “system-wide solutions that will ensure the ZBB is genuinely felt by Filipino patients.”
How Zero Balance Billing Works
Under the ZBB program, all patients admitted to the basic ward of any of the 87 DOH-operated hospitals no longer need to pay out of pocket. Hospital and professional fees are covered by PhilHealth, with the remaining costs absorbed by the hospital’s budget for operations and maintenance.
Patients opting for private rooms, however, will still have to pay a portion of the bill under regular PhilHealth benefits. Private hospitals can also implement ZBB, but only up to 10 percent of ward bed capacity, limiting coverage compared with government hospitals. Unlike the earlier PhilHealth “no balance billing” policy, which only covered indigents and select sponsored groups, the current ZBB benefits a wider population.
Who Qualifies and What’s Next
Middle-class families, defined as a family of five earning between P18,200 to P109,200 per month, make up nearly 47 percent of the country’s population, according to the Philippine Institute for Development Studies. In 2025, over 1.3 million patients in DOH hospitals benefited from ZBB, with P74.65 billion in hospital bills fully covered.
The 2026 General Appropriations Act provides P448 billion for the health sector, including additional funds to expand ZBB in select local government hospitals and specialty hospitals like the Lung Center, Philippine Heart Center, and Philippine General Hospital. Recto stressed that closer coordination among national agencies and LGUs is essential to ensure that health financing reforms translate into real relief for patients across all income groups.
