If you are planning to live or retire abroad, chances are you have questions about the healthcare system in your overseas destination: How good is it? How affordable? What about insurance?

One spot popular with expats is the Philippines, an archipelagic nation of some 7,000+ islands known for its powdery white-sand beaches and endless natural beauty. Expats choose the Philippines not just for the beaches and tropical climate, but for the friendly, English-speaking population, a lower cost of living and access to what is considered good, affordable healthcare. But just how reliable is it? Can you trust it? Here’s a closer look at healthcare in the Philippines.

Healthcare Outlook in Southeast Asia

The demand for healthcare in Southeast Asia as a whole is rapidly increasing thanks to population growth rates and “an epidemiological shift from infectious diseases to a chronic disease pattern matching western markets,” according to a 2015 healthcare report from Deloitte, a tax, consulting and financial advisory services firm. Most of Southeast Asia’s healthcare spending comes from the public sector, and many of the region’s governments are under fiscal constraints that make it difficult to meet the growing needs of their citizens.

In the Philippines, the reports notes, the level of per-person healthcare spending is one of the lowest among Southeast Asia’s major economies. At 4.6%, the same holds true for spending as a proportion of GDP. Due to weak public financing, that number is expected to drop to 4.5% by 2018. At the same time, the nation’s healthcare spending is projected to increase an average of 8% annually, from an estimated $12.5 billion in 2013 to $20 billion in 2018. To address the growing need for improved healthcare coverage, the government in 2013 passed the Universal Healthcare Bill, which promises health insurance for all Philippine nationals, especially the poor.

Medical Personnel Shortages

Another challenge facing many countries in Southeast Asia is the chronic shortage of medical personnel. The average number of physicians in Southeast Asia is 0.6 per 1,000 people; in the Philippines, that figure is slightly higher at approximately one physician per 1,000 Filipinos. Southeast Asia as a whole, including the Philippines, has figures that are substantially lower than those in developed economies such as Germany (3.7 per 1,000), the U.K. (2.8 per 1,000) and the U.S. (2.4 per 1,000). The number of dentists and midwifery personnel in the Philippines are similar, again falling well below the averages of more developed economies.

In 2014, Leo Olarte, president of the Philippine Medical Association (PMA), noted that the Philippines has only 70,000 “active” PMA members [physicians] to serve some 100 million Filipinos, adding that “the growth in our population should be complemented by the increase in the number of doctors.” Part of the problem is that a significant percentage of licensed physicians no longer practice in the Philippines. Of some 130,000 licensed doctors, only 70,000 are still practicing, according to Olarte. “Over the past 10 years, there were around 10,000 doctors who shifted to nursing and then worked in other countries,” he said. Others have retired or emigrated.

Where Does This Leave Expats?

Despite these challenges, expats are generally able to access good, affordable healthcare – as long as they live in (or are willing to travel to) Manila, where the standard of care is much higher than in the rest of the Philippines. Most medical practitioners in the Philippines have graduated from the country’s top universities and studied in U.S. medical schools, and many practiced in the U.S. before returning to the Philippines.

The Philippines has both private and public healthcare facilities. In general, the private hospitals tend to be rated higher in terms of facilities and technologies offered; they are also more expensive because government hospitals don’t charge any fees. That being said, it’s important to note that some of the country’s best doctors serve in the public sector.

According to global health insurer Allianz, the top hospitals in the Philippines – all private hospitals located in Manila – are:

  • The Alabang Medical Center
  • The Asian Hospital and Medical Center
  • The Makati Medical Center
  • The Medical City
  • St. Luke’s Medical Center – Quezon City

As far as healthcare costs are concerned, most locals and expats consider both services and medications to be very affordable. Another plus: Expats should have no trouble communicating with medical personnel since nearly all speak and understand English.

Insurance

The Philippines has a universal health coverage system called PhilHealth (the Philippine Health Insurance Corporation), a government organization attached to the Department of Health. The agency’s mandate is “to provide health insurance coverage and ensure affordable, acceptable, available and accessible healthcare services for all citizens of the Philippines.” The system is designed to be a way for the healthy to help pay for the care of the sick, and for those who can afford medical care to subsidize those who can’t. Premiums vary based on age and income.

Under certain circumstances, foreign nationals can enroll in PhilHealth. If you are married to a Philippine national, for example, you can get coverage as a dependent. The vast majority of expats, however, must purchase private health insurance policies. Depending on your situation, health and comfort level with the local healthcare, you might want to consider adding a policy that includes evacuation to your country of choice, such as Malaysia, Singapore or Thailand – countries with booming medical tourism industries.

The Bottom Line

If you live or retire in the Philippines, you can reasonably expect good, affordable healthcare if you are in the capital city of Manila. Outside Manila, it might be a different story. The U.S. Embassy in Manila notes that “Hospitals in and around Manila often offer high-quality medical care....Many hospitals outside major urban areas may offer only basic medical care in rudimentary conditions. It is wise to evaluate the standards of medical care at a hospital before contemplating a medical procedure.” If you live in a rural area in the Philippines, it’s a good idea to research your local options and decide how you’ll get to better care – before any healthcare services are needed. See also Is My Health Insurance Good Abroad? and How to Plan Your Retirement in the Philippines.

Note: Because of continued violence, certain areas in the Philippines should be avoided by travelers. The U.S. Department of State (www.travel.state.gov) updated a travel warning on Oct. 21, 2015 regarding the Philippines, and in particular the Sulu Archipelago, the island of Mindanao and the southern Sulu Sea area. Other areas in the Philippines are generally considered as safe as other places in Southeast Asia. U.S. citizens traveling to or residing in the Philippines are encouraged to research current U.S. Department of State travel alerts and warnings, and enroll in the Department of State’s Smart Traveler Enrollment Program (STEP), which provides security updates and makes it easier for the nearest U.S. embassy or consulate to contact you and your family in case of an emergency.

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