First, let me thanks those of you have been sending me questions in support of this weekly feature. It’s a big, big help to me to know what things people want to know about regarding the Philippines … be sure to send me yours, no matter how trivial you may feel it is. I know from watching some of the searches for information here that there are many things I have glossed over in the past, thinking they are simple, yet they are not so easily understood … or my answers are not, more accurately. There’s an old saying that asserts, “The only stupid question is the one you didn’t ask” and I feel that’s pretty much true.
You can reach me directly via my secure, spam-free contact page or call me on 1-719-966-4295 or text me on 0919-231-5625. This week’s offering is a composite answer to a number of questions I’ve received.
What’s Available for Health Insurance in the Philippines
First Americans and visitors from many other developed countries have got to understand a few basic Philippine health care industry facts. By and large, there is no way to live here and operate as many do in the US … plunking a Blue Cross or other health insurance carrier card on the cahier’s counter and in many cases having all their medical needs (or perhaps less a known co-pay) being taken care of. To my knowledge, that will not happen here. Health care is essentially a cash and a pay as you go industry. There are insurance plans, though and here are some of the options:
PhilHealth: This is a nation-wide, partially government funded plan which covers all Filipinos from cradle to grave. In most cases it covers spouses (Filipino or foreign) and all recognized children. Sound too good to be true? Well perhaps in some cases it is, but in my direct experience PhilHealth is a lot more useful than many give it credit for. There are three main categories of members … employed, whose premiums are paid by their employers, Direct paying … which most eligible readers will fall under, and the Elderly, those over 60, not covered by other plans and with incomes under PhP 1,000 per month.
Phil Health costs PhP 100 pesos per month for ‘self-payers’. That’s right, about $24 or $26 USD per year and believe it or not, many people search on the phrase “is Phil Health worth it”? I really don’t know about your budget, but PhP 100 pesos per month is less than I give to charity or lose from holes in my pants pocket. Is it worth it? I recon so. My mother-in-law has used it fro several hospitalizations in the past few years and the payment .. Phil Health’s share … has never been less than PhP 5,000 or PhP 6,000 pesos. That’s a pretty good rate of return, to my non-numerical brain.
Of course to many Americans the payments Phil Health will make are tiny .. and they are, but as my daddy always said, “better than a poke in the eye with a sharp stick”. As with almost all other insurance, though, Phil Health pays in arrears, after a patient files for benefits. Many hospitals do have a PhilHealth department which may be able to get the reimbursement applied before the final bill is die … otherwise you pay no and collect later.
I strongly recommend Phil health coverage for employees like domestic helpers .. it costs so little and could save you some distinct out of pocket expanses if say, the maid cuts of her thumb. Those with elderly parents should make sure their mom and dad are enrolled too … it’s free and yet many, many Filipinos think they aren’t eligible and can’t afford it.
So what if you need more in the way of benefits, or aren’t qualified for Phil Health? One next logical source is commercial health insurance. I’ll divide this into two sections .. Us or home country insurance and Philippine commercial insurance.
Home Country: I can really speak only to US commercial insurance here. Those from other countries need to do their own research before the move. If you have insurance on your own in the US or commercial plans like Blue Cross that you can carry into retirement, the answer to what that insurance will cover here is dependent upon your individual carrier. Even “Blue Cross” is just a label, there are literally hundreds of different plans all marketed under the Blue Cross logo. read you plans documentation and perhaps call them and ask … it’s the only sure way to know. If you are a federal retiree, as I am, with FEHB coverage, you’ll find there are as many as 6 of the many plans u8nder FEHB that will pay claims no matter where you live. There are a large number that do not. Check first. If you plan covers you, there should never be an issue of amounts of re-imbursement, because medical costs here are very significantly lower than the US. No matter which plan you use, almost certainly you will pay first and submit for reimbursement later.
Philippine Commercial: There are many, many commercial health insurance carriers here in the Philippines, even including Philippine Blue Cross. Here are links to a few others.
http://www.pacificprime.com/countries/philippines/
http://www.sunlife.com.ph/group/profamily.asp
http://www.bcbuddy.com/health.htm
I don’t use any of these plans and I can’t speak to their various levels of value and/or goodness. An important consideration is, in general these plans are no where near as liberal as US plans for covering pre-existing illnesses and many of them stop insuring folks in the 65 to 75 year old range. In short, you must check.
US Medicare: This I add just because it forms the basis of many US citizens retirement health care strategies. Medicare, by law, does not cover US citizens living outside the US or US possessions. Thus, you can live in, say, Guam and be covered, but you can not live in the Philippines and be covered. Especially after age 65 when you will have to accept (and pay) or reject Medicare Part B payments, this can be a big factor. No easy answers here.
Social Security: strictly speaking, this is not health insurance, but there are many folks today who are relying on “Social Security Disability payments. This name is misleading, because there are several categories of disability payments. Some are 100% payable overseas and some are 100% not payable overseas. Rather than go into what I think the rules are, go to www,ssa.gov for yourself and research. I know of a number of US expats here who came with expectations of what they were going to receive and are now very disappointed … or broke. Social Security retirement benefits, by the way are fully payable here, even direct deposit, and the Philippines has the only Social Security office on foreign soil, in Manila, with a staff who has impressed me with their level of service.
Former Military and Military retirees: Again, US forces only. basically this can be divided into veterans Administration and TRICARE.
US VA benefits: If you are a US veteran with a service connected disability, you are probably entitled to benefits from the VA office and VA clinic in Manila … contracted care is provided in other areas by the VA. Pharmacy be3nefits are included, for those qualified as well. very important on this issue to check for yourself with the VA before assuming you’ll get care. Relying upon what some other vet may have told you, or what you read on some independent website, including this one, is a recipe for future disappointment. In the US almost every vet is entitled, here the rules are very strict about the service connection disability. You may not be entitled to what you are entitled to within the US. (Side note. there is not a VA hospital in the Philippines. there is a free-standing VA clinic. What I frequently see references to is the large and impressive “Veteran’s Hospital complex in Quezon City. This is a Philippine government organization which serves Filipino veterans … just to avoid confusion).
TRCARE: This is an insurance plan implemented by the US government to cover active duty and retired military members. TRICARE comes in several “flavors. Some are totally free to members, some have fees. The one applicable to the Philippines is TRICARE Standard. This is the only TRICARE plan that can be used here until age 65. After age 65, members must switch to TRICARE For Life (TFL) which requires that the member pay Medicare Part B … even though s/he can’t use Medicare here in the Philippines. Sounds like the proverbial “Catch 22” and in some ways it is, but better that you know now than later.
OK … my own plan? I have FEHB coverage but I placed it in suspension … no pay status .. since I am also covered by TRICARWE. Monthly cost: $0 I have yet to accumulate enough bills to try out TRICARE’s reimbursement system. Monthly cost so far: $0 My wife and I have Phil Health. monthly cost ~$2 USD. Aside from that, plan to live forever 
… or nearly that long.
Any other questions?
Popularity: 21% [?]
