July 17, 2026 Statement in Support of Philippine Health Insurance Corporation (PhilHealth)

The Health Maintenance Organization (HMO) industry in the country has resiliently been in existence for over four decades and counting. For the longest time it has been and continues to be an integral part of the country’s health delivery systems.

The Association of Health Maintenance Organizations of the Philippines, Inc. (AHMOPI) is a recognized trade organization of HMOs in the country. Organized and registered with the Securities and Exchange Commission on November 13, 1987, it undertakes to protect the interest of the industry and all stakeholders of the business, its valued clients and plan holders in particular – the Filipino people.

So far, the Universal Health Care Act of 2019 (UHC) is considered the most comprehensive healthcare act to have been enacted to date.  More than just expanding health coverages and improving access to healthcare services across the country, it provides for the automatic enrollment of all Filipinos in the National Health Insurance Program administered by the Philippine Health Insurance Corporation (PhilHealth).

Significantly, under the UHC framework, the pooling of health financial resources as well as health risks across the populace have resulted to an ever-increasing PhilHealth benefits program both in terms of individual-based services and population-based services – coming from the perspective that the healthy and the employed essentially help subsidize the care for the sick and the marginalized. Significant benefits include Primary Care  through its “YAKAP” (Yaman ng Kalusugan Program) which expanded its outpatient benefits program that integrates consultations; medicines; and basic and preventive cancer screening; Outpatient Emergency Care Benefit; Outpatient Care which includes minor surgeries, chemotherapy and hemodialysis; Inpatient Care with enhanced “All Case Rates;” Zero Co-payments for basic or ward room accommodation in government and private hospitals; Maternity and Newborn Care; and specialized and highly subsidized packages for catastrophic or prolonged illnesses under its “Z” Benefits Package.

Considering that all Filipinos are now PhilHealth members, HMO benefits support PhilHealth benefits, PhilHealth being the “first payor” for the same. HMOs complement PhilHealth benefits in terms of huge coverage limits on a per illness or injury per year basis, or aggregate benefit limit per year.  This significantly reduces out-of-pocket expenses and essential drugs covered under coordinated UHC pathways.

The HMO industry and especially the AHMOPI is privileged to have PhilHealth as an invaluable partner in providing the Filipino people with accessible, affordable, and more importantly, preventive as well as life-saving medical interventions and treatment which result in favorable health outcomes. Under the leadership of its President and CEO,  Dr. Edwin M. Mercado, MHA, MMSc, the AHMOPI firmly resolves to work hand-in-hand with PhilHealth, our accredited institutional healthcare providers and doctors nationwide, and the rest of our stakeholders in the industry — to further enhance the Filipino people’s well-being leading to a healthier nation.

                                                               AHMOPI MEMBERS