The Department of Health (DOH) will begin piloting the zero balance billing (ZBB) program in selected local government unit (LGU)–run hospitals in five provinces, expanding the government’s effort to eliminate out-of-pocket medical expenses for eligible patients.

Health Secretary Teodoro Herbosa said the initiative builds on President Ferdinand R. Marcos Jr.’s directive to strictly implement zero balance billing for patients admitted to basic or ward accommodations in DOH hospitals.

“With our P448-billion budget this year, we are expanding the President’s zero balance billing policy beyond DOH hospitals,” Herbosa said during a Malacañang Palace press briefing on Wednesday.

Herbosa said the DOH will allocate P1 billion this year to support the pilot implementation in select secondary and tertiary LGU hospitals.

“We have selected provinces that have fulfilled their commitments to universal health coverage. These include Sarangani, Laguna, Aklan—there are about five of them, and they will be prioritized,” he said.

The pilot phase will focus on Level 2 and Level 3 LGU hospitals, which provide more specialized services and handle more complex and costly medical procedures.

“For Level 1 hospitals, we feel that the increased PhilHealth benefits are already sufficient. But for LGUs with Level 2 and Level 3 hospitals, where procedures are more complex and the cost of care is higher, they will be our pilot sites,” Herbosa explained.

The DOH will also prioritize LGU hospitals in provinces that do not have DOH-managed hospitals. For other LGUs not included in the pilot, Herbosa said assistance may still be extended on a per-patient basis through the Medical Assistance for Indigents and Financially Incapacitated Patients (MAIFIP) program, which covers medical costs beyond PhilHealth benefits.

As part of the expansion, DOH hospitals will enter into formal agreements with LGU hospitals to accept patients who cannot be accommodated in DOH facilities.

“I will ask my medical center chiefs to have a memorandum of agreement with LGU hospitals. If DOH hospitals are already full, patients can be transferred to LGU hospitals, and we will ensure that they still have zero balance billing there,” Herbosa said.

The DOH said around one million patients have benefitted from the zero balance billing program since President Marcos ordered its strict implementation during his fourth State of the Nation Address on July 28 last year.

Health officials said the pilot program is expected to improve access to affordable healthcare, particularly in provinces where DOH hospitals are limited or unavailable.