HMO · Philippines 2026
HMO Coverage Rates
Philippines 2026
HMO Coverage Comparison by Tier
Indicative rates — varies by provider and plan year.
| Benefit | Basic | Standard | Premium |
|---|---|---|---|
| Annual Benefit Limit | ₱100,000 | ₱200,000 | ₱300,000–₱500,000 |
| Room & Board (per day) | ₱1,500 | ₱2,500 | ₱4,000–₱6,000 |
| Outpatient Consultation | ₱300/visit | ₱500/visit | ₱800–₱1,000/visit |
| Emergency Room | Up to ₱15,000 | Up to ₱25,000 | Up to ₱50,000 |
| Surgery (minor) | ₱10,000–₱30,000 | ₱30,000–₱60,000 | ₱80,000+ |
| ICU / CCU | ₱2,000/day | ₱3,500/day | ₱5,000–₱8,000/day |
| Cancer Treatment | Minimal / excluded | Partial, within ABL | Partial, within ABL |
| International Coverage | None | None | None (PH only) |
*Rates are indicative for 2026. Actual benefits depend on HMO provider, plan code, and individual underwriting.
When HMO Runs Out
Real Cebu hospital costs vs. HMO coverage limits
Appendectomy
₱150K–₱300K
HMO covers: ₱100K–₱200K
₱0–₱200K gap
Heart Attack (5d ICU)
₱500K–₱1.2M
HMO covers: ₱100K–₱300K
₱400K–₱900K gap
Cancer Treatment (1yr)
₱1M–₱4M
HMO covers: ₱100K–₱300K
₱700K–₱3.7M gap
Stroke (rehab)
₱300K–₱800K
HMO covers: ₱100K–₱300K
₱200K–₱500K gap
Childbirth (C-section)
₱80K–₱200K
HMO covers: ₱30K–₱80K
₱0–₱120K gap
International Evacuation
₱200K–₱500K
HMO covers: ₱0 (not covered)
Full cost gap
AXA GHA fills every gap above — up to ₱175M lifetime coverage.
Close My Coverage GapHMO Coverage FAQ
What is the average HMO annual benefit limit in the Philippines?
The average ABL (Annual Benefit Limit) for individual HMO plans in the Philippines is ₱100,000–₱300,000. Premium corporate plans can reach ₱500,000. This limit resets each year, but any claim in a single year that exceeds your ABL is paid entirely out of pocket.
Does HMO cover cancer treatment in the Philippines?
Most standard HMO plans have limited or no cancer-specific coverage. Some premium plans include partial chemotherapy or surgery benefits, but these are still subject to the Annual Benefit Limit. AXA GHA covers cancer treatment in full, worldwide, with no annual cap.
Does HMO cover international treatment?
No. All major Philippine HMO providers (Maxicare, Medicard, PhilCare, Intellicare) are limited to accredited hospitals in the Philippines. For international coverage, you need a health insurance policy like AXA Global Health Access.
What is the HMO room and board rate in the Philippines?
HMO room and board allowances in the Philippines range from ₱1,500/day (basic) to ₱6,000/day (premium). If you stay in a private room costing ₱7,000/night and your HMO only covers ₱3,500, you pay the ₱3,500 difference daily.
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