DOH: Guarantee letters unnecessary as zero balance billing takes full effect

Patients seeking treatment in Department of Health (DOH)–run hospitals no longer need guarantee letters from politicians, as the government’s zero balance billing policy is now fully in effect, Health Secretary Teodoro Herbosa said Wednesday.

In a Palace press briefing, Herbosa clarified that the use of guarantee letters issued by political figures is not government policy in DOH hospitals and emphasized that all eligible patients should receive care without out-of-pocket expenses.

“We do not really use guarantee letters. The DOH does not use guarantee letters,” Herbosa said.

“We only issue guarantee letters to private hospitals with which the DOH has a Memorandum of Agreement. Other than that, we do not use guarantee letters,” he added.

Herbosa noted that if a politician or private individual issues a guarantee letter to a hospital, the responsibility for payment rests with the issuer and not with the government.

According to Herbosa, the zero balance billing policy has been fully implemented since July 2025. Under the program, patients admitted to basic or ward accommodations in DOH-run hospitals are entitled to medical services without paying any hospital bills.

The health secretary assured the public that the program is financially sustainable, citing increased funding for the health sector.

President Ferdinand R. Marcos Jr. on January 5 signed the P6.793-trillion General Appropriations Act (GAA) for Fiscal Year 2026, which allotted the DOH its largest budget to date at P448 billion.

Herbosa also clarified that restrictions on political involvement in the distribution of financial assistance were imposed by lawmakers, not the DOH.

Under the 2026 GAA, the distribution of cash and other forms of financial aid must be carried out solely by authorized government personnel or accredited partner agencies.

The law explicitly prohibits elective officials, candidates, political parties, and their representatives from participating in or influencing the distribution of assistance, except for officials with direct administrative authority over the implementing agency.

The DOH reiterated that patients should directly approach government hospitals for medical care and services, without seeking political endorsements or guarantees.