Filipino patients may soon have fewer out-of-pocket expenses for hospitalization as the government expands efforts to make healthcare more affordable.
St. Luke’s Medical Center–Global City and the Philippine Health Insurance Corp. (PhilHealth) recently signed an agreement to implement the No Co-Payment Policy, allowing eligible PhilHealth members in ward or basic accommodations to access covered services without additional charges.
But how does this policy work, and how does it differ from Zero Balance Billing?
What does the No Co-Payment Policy cover?
Under the new arrangement, eligible PhilHealth members admitted to basic or ward rooms at St. Luke’s–Global City will no longer have to pay additional charges for medical services covered by their PhilHealth benefits.
The hospital will also allocate at least 10% of its total bed capacity for basic or ward accommodations.
According to the Presidential Communications Office, PhilHealth-covered procedures, operations, and medicines should be provided without additional charges as long as the patient is confined in an eligible accommodation.
How is it different from Zero Balance Billing?
The No Co-Payment Policy supports the government’s broader Zero Balance Billing (ZBB) initiative, which is already being implemented in 79 Department of Health hospitals and four government-owned or -controlled hospitals.
Under ZBB, PhilHealth members admitted to ward or basic accommodations are not required to pay out-of-pocket expenses for medical services covered by their PhilHealth benefits.
The main difference lies in where the policies are being implemented. ZBB is currently available in participating government hospitals, while the new partnership with St. Luke’s–Global City extends the no additional payment approach to a private hospital.
Who can benefit from the policies?
The ZBB policy covers all PhilHealth members, regardless of socioeconomic status.
Patients who are admitted to eligible ward or basic accommodations and receive services covered by PhilHealth may qualify for the benefit. A PhilHealth ID can be presented to avail of coverage.
Patients without a PhilHealth ID may also seek assistance from the hospital, which can help facilitate their PhilHealth enrollment.
With both the No Co-Payment Policy and Zero Balance Billing in place, the goal is to reduce the financial burden of hospitalization and ensure that more Filipinos can access necessary healthcare without worrying about additional expenses.
