DOH mulls higher PhilHealth premiums for members violating public safety laws

The Department of Health's move to study higher premiums for Philippine Health Insurance Corp. members who violate public safety laws, such as those who drive drunk and motorcycle riders who do not wear helmets, is an active effort to encourage better behavior from PhilHealth enrollees, Health Secretary Ted Herbosa said on Monday.

At a news conference, Herbosa said PhilHealth was akin to a health insurance provider that may increase premiums for users who tend to overuse their packages.

“Tumataas ang insurance lalo na pag mas madalas ka magkasakit… Pag ikaw nagoover-utilize, pwede talaga gawin ng insurance na taasan ang premium. Ito ay pagaaralan natin [as] this is one way to control behavior,” Herbosa said.

(The insurance increases especially if you often have illnesses… If you over-utilize, the insurance can decide to increase your premium. We are studying this, as this is one way to control behavior.)

“Pag ikaw nakadepende lang sa insurance, mauubos yung insurance. Pag kailangan mo na at pamilya mo na ang kailangan ng PhilHealth at inubos na ng pasaway, sayang tayo. So very important ang mga polisiya na ito. It’s to allow good behavior among members of PhilHealth,” he added.

(If you are just dependent on insurance, the insurance will run out. If you and your family eventually need PhilHealth and these stubborn ones have wiped it out, then it is wasted. So it’s very important to have these policies. It’s to allow good behavior among members of PhilHealth.)

Interviewed on Dobol B TV on Saturday, DOH spokesperson Assistant Secretary Albert Domingo said the proposed policy change would be a “deterrent” to discourage parents from letting their children use firecrackers and encourage traffic law violators to comply with road safety rules.

“We will study it… especially what if the parent of the [firecracker] victim was an informal settler or jobless and is being subsidized by the government… We always say that you shouldn’t let your children use firecrackers, but still, it happens. So, we are looking into ways to deter this,” Domingo said.

The DOH official also cited the 1,113 road accidents recorded from December 21, 2025, to January 2, 2026, some of which were caused by undisciplined riders who were either not wearing helmets or were under the influence of alcohol.

The number is 82% higher than what was recorded during the same period last year.

Domingo clarified that PhilHealth will continue to shoulder the expenses of victims, especially in DOH-run hospitals where zero-balance billing is in effect, regardless of the nature or cause of injury.

“But there should be a way to charge them… that’s why we are looking into what other countries are doing, which is increasing insurance premiums,” he said, referring to safety law violators.

The DOH said Friday that over a thousand individuals have been in road accidents and got injured during the holiday season.  –NB, GMA Integrated News