Philippines PhilHealth Premium 2027 Calculator

Philippines PhilHealth premium 2027 is 5% of monthly salary, split 50/50 employer-employee. Monthly salary credit cap ₱100,000. Per Universal Healthcare Act RA 11223 + PhilHealth Circular 2023-0001. Source: philhealth.gov.ph.

Capped at ₱100,000 MSC
Total Monthly Premium
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5% employer + employee
Salary Credit
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Employee 2.5%
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Employer 2.5%
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Total Premium
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Annual
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Cap Status
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Ad Space

PhilHealth 5% Premium — Universal Healthcare Era

RA 11223 (Universal Healthcare Act 2019) mandated phased premium increases: 3% (2019), 3.5% (2020), 4% (2022), 4.5% (2023), 5% (2025+). Split 50/50 employer-employee. MSC bands range ₱10,000 minimum to ₱100,000 cap (2027). Self-employed pay full 5% themselves. Source: philhealth.gov.ph.

What PhilHealth Covers (No-Balance Billing)

Inpatient (case rate system), outpatient surgery and procedures, primary care visits, maternity, hemodialysis (90 sessions/year), HIV treatment, cancer treatment, mental health, Z-benefit packages for catastrophic conditions. No-balance billing in government hospital wards (full coverage, no out-of-pocket).

PhilHealth vs Private Health Insurance (HMO)

PhilHealth is mandatory, covers basics. Private HMOs (Maxicare, Medicard, etc.) cover gaps: private rooms, broader specialist access, dental, optical, faster service. Many employers provide HMO as supplement. HMO premiums ₱20-50k/year for individual coverage. Both can be used together — PhilHealth pays first, HMO covers balance.

Filing Reimbursement Claims

Most PhilHealth-accredited facilities (hospitals, clinics) automatically deduct PhilHealth coverage from your bill — no paperwork. For non-accredited or direct reimbursement: file PhilHealth Claim Form 1 + medical certificate within 60 days of discharge at any PhilHealth office or online via member portal.