Are medical bills free with government’s zero-balance billing?

Government promised free services in Department of Health-run hospitals, raising hopes for Filipinos who equate quality healthcare with breaking the bank. But just how accessible are they?

The zero-balance billing program is supposed to give patients access to medicines, doctors’ and other medical services for free in DOH hospitals. This was announced by President Ferdinand Marcos Jr. during his fourth State of the Nation Address.

According to a 2022 National Demographic and Health Survey, hospital bills average about P27,136 in a public health facility and P70,568 in a private health facility.

Despite the Philippine Health Insurance Corporation’s (PhilHealth) assistance, there are still out-of-pocket (OOP) payments from patients. About 42% of 2024″s P1-trillion health spending was shouldered by patients, according to the Philippine Statistics Authority (PSA).

A recent survey by global consulting firm Boston Consulting Group showed 64% of Filipino families could not cover a healthcare emergency bill amounting to over P10,000 without tapping a health maintenance organization or borrowing money.

In a separate report in 2025, the PSA noted that almost half or 48.5% of the 694,821 registered deaths in 2023 were attributed to them being unattended by healthcare providers.

If you are in need of medical care amid financial constraints, here’s what you need to know to maximize the DOH’s zero-balance billing.

Who are covered and how?

All Filipinos are covered by the program for so long as they are admitted in a hospital’s basic accommodation or a shared or ward room.

The DOH stressed that its hospitals will not require documents and interviews for patients to avail of zero-balance billing.

Patients staying in private rooms will have to shell out their own money for their medical services. PhilHealth can help in paying for a portion of the bill.

What medical cases are free?

The DOH has not listed any specific medical cases which are covered by the program. It gave assurances there will be no charges for as long as a patient stays in a ward.

Based on the agency’s press releases, among the medical services covered by zero-balance billing are: kidney transplants, tuberculosis treatment, and surgical operations.

Where can patients avail of?

Across the country, there are only 87 DOH hospitals where patients can avail of the zero balance billing:

• 16 are in Metro Manila
• 28 in the rest of Luzon
• 12 in the Visayas
• 22 in Mindanao
• Philippine Heart Center
• National Kidney and Transplant Institute
• Philippine Children’s Medical Center
• Lung Center of the Philippines

Five other DOH hospitals are still under development.

The program does not cover other government hospitals which are operated by local government units and state universities and colleges.

Philippine Medical Association president Dr. Hector Santos Jr. said that while the program is beneficial especially to the poor, it also faces some challenges.

“Marami sa ating mga (Many of our) patients who are poor would go to government hospitals. But since the announcement was made, pati mga (even) middle income [earners], du’n na rin nagpupunta and du’n sila pumipila (also go and line up there). Na-o-overcrowded na ang mga (There is overcrowding of) government hospitals anywhere, both Manila and even in the provinces,” Santos told Rappler.

DOH Assistant Secretary Albert Domingo clarified that the zero-balance billing program is different from the no-balance billing that the PhilHealth has been implementing.

“Previous efforts at no balance billing (NBB) by PhilHealth in 2017 restricted eligibility to specific member types only. An updated policy sought to implement the same by bed type (i.e., basic accommodation) in compliance with the UHC [Universal Healthcare] Act. However, incomplete and inconsistent implementation such as charging of costs outside the formal hospital bill has sustained high OOP expenses. The way forward is true zero-balance billing by DOH,” Domingo explained.

The zero-balance billing is funded by the Medical Assistance to Indigent and Financially Incapacitated Patients, Philippine Charity Sweepstakes Office (PCSO), Philippine Amusement and Gaming Corporation (PAGCOR), and allocations to DOH hospitals.

The UHC law mandates that 50% of the national government share from the income of PAGCOR and 40% of the charity fund, net of documentary stamp tax payments, and mandatory contributions of the PCSO shall be remitted to PhilHealth for the improvement of its benefits. – Rappler.com