Factors affecting uptake of private health insurance in the Philippines

Abstract Background As the Philippines transitions to universal health coverage, private health insurance (PHI) may contribute to bridging the health financing gap. However, only 13.0% of the country’s total health expenditure is attributed to PHI and information on why there is low PHI uptake remai...

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Main Authors: Excellces Dee Montemayor, Patricia Anne P. Chua, Leivanne S. Delos Santos, Danica Isabel S. Perez, Regina Louise A. Bumatay, Jonas Francis D. Kosca, Gianella Bianca C. Samonte, Veincent Christian F. Pepito
Format: Article
Language:English
Published: Springer Nature 2025-08-01
Series:Discover Health Systems
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Online Access:https://doi.org/10.1007/s44250-025-00279-7
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author Excellces Dee Montemayor
Patricia Anne P. Chua
Leivanne S. Delos Santos
Danica Isabel S. Perez
Regina Louise A. Bumatay
Jonas Francis D. Kosca
Gianella Bianca C. Samonte
Veincent Christian F. Pepito
author_facet Excellces Dee Montemayor
Patricia Anne P. Chua
Leivanne S. Delos Santos
Danica Isabel S. Perez
Regina Louise A. Bumatay
Jonas Francis D. Kosca
Gianella Bianca C. Samonte
Veincent Christian F. Pepito
author_sort Excellces Dee Montemayor
collection DOAJ
description Abstract Background As the Philippines transitions to universal health coverage, private health insurance (PHI) may contribute to bridging the health financing gap. However, only 13.0% of the country’s total health expenditure is attributed to PHI and information on why there is low PHI uptake remains lacking. This study aims to understand the factors affecting uptake of PHI among Filipinos. Methods This study employed a qualitative design. We initially administered an online self-administered questionnaire and interviewed respondents with and without PHIs from July to September 2022. A modified socio-ecological framework was used to guide the thematic analysis of the qualitative data. Results We interviewed 17 respondents. Factors that affect uptake of PHI in the Philippines include: (1) Perception of insurance as an investment and a safety net; (2) Age at enrolment; (3) Perceived difficulties in applying for PHI; (4) Perceived difficulties in understanding certain aspects of PHI; (5) Perceived lack of need for PHI; (6) Perceived additional costs of PHI; (7) Perceived need to complement mandatory government health insurance; (8) Feedback from family and friends; (9) Quality and extensiveness of health insurance coverage; and (10) Proximity and accessibility of healthcare providers partnered with PHI providers. However, these findings should be interpreted with caution due to potential sample bias from online recruitment and missing data. Conclusion Individual, community, and PHI factors collectively influence the decision to obtain PHI in the Philippines. Addressing enrollment barriers, improving health literacy, and enhancing insurance understanding, alongside supportive government initiatives, are crucial for increasing PHI uptake and possibly contribute to bridging the health financing gap and the implementation of universal health coverage in the Philippines.
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spelling doaj-art-b9a52e8360834d1fac5065eb48f9b68f2025-08-20T03:43:11ZengSpringer NatureDiscover Health Systems2731-75012025-08-014111410.1007/s44250-025-00279-7Factors affecting uptake of private health insurance in the PhilippinesExcellces Dee Montemayor0Patricia Anne P. Chua1Leivanne S. Delos Santos2Danica Isabel S. Perez3Regina Louise A. Bumatay4Jonas Francis D. Kosca5Gianella Bianca C. Samonte6Veincent Christian F. Pepito7School of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversitySchool of Medicine and Public Health, Ateneo de Manila UniversityAbstract Background As the Philippines transitions to universal health coverage, private health insurance (PHI) may contribute to bridging the health financing gap. However, only 13.0% of the country’s total health expenditure is attributed to PHI and information on why there is low PHI uptake remains lacking. This study aims to understand the factors affecting uptake of PHI among Filipinos. Methods This study employed a qualitative design. We initially administered an online self-administered questionnaire and interviewed respondents with and without PHIs from July to September 2022. A modified socio-ecological framework was used to guide the thematic analysis of the qualitative data. Results We interviewed 17 respondents. Factors that affect uptake of PHI in the Philippines include: (1) Perception of insurance as an investment and a safety net; (2) Age at enrolment; (3) Perceived difficulties in applying for PHI; (4) Perceived difficulties in understanding certain aspects of PHI; (5) Perceived lack of need for PHI; (6) Perceived additional costs of PHI; (7) Perceived need to complement mandatory government health insurance; (8) Feedback from family and friends; (9) Quality and extensiveness of health insurance coverage; and (10) Proximity and accessibility of healthcare providers partnered with PHI providers. However, these findings should be interpreted with caution due to potential sample bias from online recruitment and missing data. Conclusion Individual, community, and PHI factors collectively influence the decision to obtain PHI in the Philippines. Addressing enrollment barriers, improving health literacy, and enhancing insurance understanding, alongside supportive government initiatives, are crucial for increasing PHI uptake and possibly contribute to bridging the health financing gap and the implementation of universal health coverage in the Philippines.https://doi.org/10.1007/s44250-025-00279-7Private health insuranceHealth maintenance organizationsHealth financingUniversal health coveragePhilippines
spellingShingle Excellces Dee Montemayor
Patricia Anne P. Chua
Leivanne S. Delos Santos
Danica Isabel S. Perez
Regina Louise A. Bumatay
Jonas Francis D. Kosca
Gianella Bianca C. Samonte
Veincent Christian F. Pepito
Factors affecting uptake of private health insurance in the Philippines
Discover Health Systems
Private health insurance
Health maintenance organizations
Health financing
Universal health coverage
Philippines
title Factors affecting uptake of private health insurance in the Philippines
title_full Factors affecting uptake of private health insurance in the Philippines
title_fullStr Factors affecting uptake of private health insurance in the Philippines
title_full_unstemmed Factors affecting uptake of private health insurance in the Philippines
title_short Factors affecting uptake of private health insurance in the Philippines
title_sort factors affecting uptake of private health insurance in the philippines
topic Private health insurance
Health maintenance organizations
Health financing
Universal health coverage
Philippines
url https://doi.org/10.1007/s44250-025-00279-7
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