The Philippine Health Insurance Corporation (PhilHealth) was created in

1995 to create a universal health coverage for the Philippines. It is a tax-exempt,

government-owned

and

government-controlled

corporation

(GOCC)

of

the

Philippines, and is attached to the Department of Health. It states its goal as

insuring a sustainable national health insurance program for all. In 2010, it claimed
to have achieved "universal" coverage with 86% of the population, although the
2008 National Demographic Health Survey showed that only 38 percent of
respondents were aware of at least one household member being enrolled in
PhilHealth. Nevertheless, this social insurance program provides a means for the
healthy to pay for the care of the sick and for those who can afford medical care to
subsidize those who cannot. Both local and national government allocate funds
to subsidize the indigent.
In 2010 and 2015, reform efforts were outlined to make decentralization and health
insurance work more effectively, including an expanded government subsidy for the
enrollment of the poor, the creation of local health service delivery/planning units to reduce
fragmentation, and a stronger DOH role in regulation.
PhilHealth and SSS has four categories of enrollees encompassing nearly the entire
population. The "informal" sector is for workers employed by companies and other
institutions. Indigents have no means of support. Retirees (non-paying members) have
already paid premiums for 120 months of membership and are 60 or older. The individual
paying program (IPP) is for those not eligible for the other three categories. Although treated
separately, the Overseas Filipino Workers (OFW) program can be considered as part of the
IPP category.
Since 1996, the benefits package and delivery system have improved. For example,
PhilHealth now has an Outpatient and Diagnostic Package limited to indigent enrollees. This
addition creates nearly comprehensive coverage for indigents. All other beneficiaries have
access to nearly comprehensive services, excluding some outpatient care. PhilHealth
introduced an accreditation program for private hospitals.