DOH to Extend Zero Balance Billing Benefits to PhilHealth Direct Contributors
The Department of Health (DOH) has unveiled a significant expansion of healthcare benefits for members of the Philippine Health Insurance Corporation (PhilHealth). In a recent social media announcement, the DOH revealed plans to provide Zero Balance Billing (ZBB) coverage specifically for PhilHealth Direct Contributors, including the option for accommodation in private rooms.
New Initiative for Middle-Class Earners
DOH Secretary Ted Herbosa announced the forthcoming issuance of a Department Memorandum Circular that will mandate all DOH hospitals to implement Zero Balance Billing for pay wards catering to PhilHealth Direct Contributors. This move aims to enhance the healthcare experience for middle-class earners who have the capacity to pay.
"We want middle-class earners to better feel the benefits of healthcare," stated the DOH, emphasizing the program's goal to recognize the direct contributions of these members. Pay wards, which offer upgraded accommodations, are distinct from the basic wards currently covered under the existing ZBB program.
Current Zero Balance Billing Program Details
Under the current Zero Balance Billing program, the DOH covers a comprehensive range of hospital expenses, including:
- Hospital bills
- Professional fees
- Laboratory tests
- Operating room services
- Medicines
These benefits are provided to patients who stay in the facility's basic ward. From July to December 2025, the DOH allocated a substantial P74.65 billion for the ZBB program, benefiting approximately 1.3 million patients across the country.
Who Are PhilHealth Direct Contributors?
Direct Contributors are PhilHealth members with the financial capacity to pay premiums. This group includes:
- Employees with formal employment
- Kasambahays (household helpers)
- Self-employed individuals
- Professional practitioners
- Overseas Filipino workers
- Filipinos living abroad, including those with dual citizenship
- Lifetime members
According to PhilHealth data, there are around 36.5 million direct contributors, highlighting the potential widespread impact of this new benefit expansion.
Implications for Healthcare Accessibility
This initiative represents a strategic effort by the DOH to improve healthcare accessibility and affordability for a broader segment of the population. By extending ZBB coverage to private room accommodations, the program seeks to provide more comfortable and dignified hospital stays for those who contribute directly to PhilHealth.
The expansion is expected to roll out following the formal issuance of the Department Memorandum Circular, marking a progressive step in the Philippines' healthcare landscape.
