The Philippine Health Insurance Corp. (PhilHealth) has signed an agreement with 13 health maintenance organizations (HMOs) and private health insurers that makes its Yaman ng Kalusugan Program (YAKAP) the first payer for primary care. Private plans will then cover eligible costs beyond what the government program pays.
The memorandum of understanding was signed on October 1 at the Department of Finance in Manila. It created the PhilHealth YAKAP-HMO/PHI Benefit Complementation initiative under the Universal Health Care law. The insurers will act as secondary payers for expenses that exceed PhilHealth’s benefit limits or fall outside its primary care package, such as specialized procedures, branded medicines and hospital room upgrades.
The change affects Filipinos who hold both PhilHealth coverage and a private plan. PhilHealth acting president and CEO Dr. Beverly Lorraine Ho said the arrangement will remove duplicate coverage for an estimated 7 to 10 percent of Filipinos enrolled in both. The framework is also meant to reduce patients’ out-of-pocket spending.
“With PhilHealth YAKAP as the first layer of protection, our private partners can focus their benefits on what lies beyond the program package,” Ho said.
Finance Secretary Frederick Go, who sits on the PhilHealth board and attended the signing, said the partnership aims to provide a more integrated health financing system.
Maxicare president and CEO Atty. Argos, who also chairs the Philippine Association of Health Maintenance Organization Companies, said insurers can now direct their coverage toward services such as mental health care, vaccinations and critical illness benefits. “If we can create outpatient products with PhilHealth as the first payer, then more people can actually buy an HMO product because it will be cheaper,” Argos said.
Here are the accredited HMO and private health insurance partners:
- Maxicare Healthcare Corp.
- MediCard Philippines, Inc.
- PhilhealthCare, Inc.
- Health Plan Philippines, Inc.
- United Coconut Planters Life Assurance Corp.
- Asalus Corp. (Intellicare)
- Medicare Plus, Inc.
- Avega Managed Care, Inc.
- Cooperative Health Management Federation
- Pacific Cross Health Care, Inc.
- Insular Health Care, Inc. (iCare)
- The Manufacturers Life Insurance Co. (Phils.)
- InLife Benefits Insurance Co., Inc.
YAKAP has been running since July 2025. It covers routine diagnostic services and 75 types of maintenance and preventive medicines worth up to P20,000 a year through GAMOT facilities. It also covers six cancer-detection procedures: colonoscopy, mammography, liver ultrasound, breast ultrasound, Alpha-Fetoprotein testing and Pap smear. Age- and risk-based laboratory screening is available depending on a member’s health assessment.
Members who are not yet enrolled can register through the eGovPH app, the PhilHealth Member Portal or a PhilHealth office. Registration includes a first patient encounter with medical history taking, health screening and health education, and members sign a form at their selected YAKAP clinic. PhilHealth urged members with private plans to register so they can use both coverages together.
PhilHealth has invited other HMOs and private insurers to join the arrangement as it expands.
