Factors affecting uptake of private health insurance in the Philippines

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. 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. 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. 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.