Millions of Filipinos may soon be able to walk into private primary care clinics for government-covered medical treatments, following a landmark agreement between the Philippine Health Insurance Corporation (PhilHealth) and Maxicare Group.
Under a new Memorandum of Understanding signed at the Department of Finance Building in Manila, PhilHealth members will eventually gain access to PhilHealth-covered medical services across Maxicare Clinics nationwide.
The public-private partnership aims to eliminate high out-of-pocket costs that frequently force patients to delay treatment or accumulate debt for healthcare expenses.
Through the agreement, PhilHealth members will be able to utilize Maxicare Clinics for essential medical services, including:
- General medical consultations
- Animal bite treatments
- Maternal care services
- Mental health consultations and support
- Preventive health screenings and risk diagnostic care
The collaboration also extends to beneficiaries of PhilHealth’s Yaman ng Kalusugan Program (YAKAP), a initiative focused on preventive medicine and health risk management. YAKAP members will be eligible to receive covered care at both Maxicare-owned primary care centers and its broader network of accredited clinics.
For decades, public health insurance and private Health Maintenance Organizations (HMOs) have operated independently. Officials say this new framework establishes a coordinated, complementary system designed to reduce administrative friction and simplify the patient journey.
“PhilHealth and the HMOs have served the same Filipinos in parallel for decades. Today we take another step towards the progressive implementation of Universal Health Care by improving the complementation of benefits of both payors,” said Christian Argos, Maxicare Group President and CEO.
The integration is structured to allow both organizations to maximize their respective coverage scope, allowing members to receive broader healthcare value without duplicate payments.
“The HMOs are making a commitment of our own,” Argos added. “As PhilHealth covers more of primary care, we will use that room to expand what our members receive. The value should go back to the member.”
By opening private clinic infrastructure to public health program beneficiaries, the agency hopes to establish a more accountable, patient-centered financing model across both sectors.
“Today’s signing is an important event for a more coordinated, complementary, and member-centered health financing system, where PhilHealth and HMO work together rather than in parallel,” said Dr. Beverly Lorraine Ho, PhilHealth President and CEO. ”The goal is a more seamless patient journey, with less duplication, fewer administrative barriers, and greater accountability amongst us payors and the providers.”
To know more about PhilHealth’s benefits and programs, visit philhealth.gov.ph. Walk into any Maxicare Clinic and visit maxicare.com.ph/get-care/maxicare-clinics/ to find the nearest Maxicare Clinics.
Leave a Reply