MANILA, Philippines — Intellicare paid ₱9.35 billion in healthcare benefits and claims during the first half of 2026, accounting for nearly 23% of all HMO claims paid across the Philippines, as rising medical expenses continue to put pressure on Filipino households and the country’s private healthcare system.
The scale of the payout places Intellicare at the center of an HMO industry that is becoming increasingly important to families and employees trying to avoid paying the full cost of consultations, diagnostic procedures, emergency treatment and hospitalization from their own pockets.
Industry-wide healthcare benefits and claims reached approximately ₱41.23 billion from January to June 2026, up 13.62% from ₱36.29 billion during the same period in 2025, according to figures attributed to the Insurance Commission.
Intellicare’s ₱9.35-billion payout therefore represented roughly 22.7% of the entire HMO industry’s claims and benefits during the six-month period.
That means almost ₱1 out of every ₱4 paid by Philippine HMOs for healthcare benefits during the first half came through Intellicare.
₱9.35 Billion Went to Actual Healthcare Services
The company said the payouts helped members access a broad range of medical services, including consultations, diagnostic procedures, treatments, emergency care and hospitalization through its healthcare network.
“For many Filipinos, healthcare concerns are also financial concerns,” Intellicare president Jeremy Matti said, stressing that paid claims represent actual members receiving medical care and financial support.
GMA News separately reported the same ₱9.35-billion first-half payout and noted that the company described the claims as healthcare coverage being converted into actual medical care when members needed it.
The size of the payout also highlights Intellicare’s scale.
The HMO generated approximately ₱12.57 billion in revenue during the first half, meaning benefits and claims were equivalent to roughly 74% of its reported revenue during the period.
Intellicare also reported ₱21.88 billion in assets as of June 30, equivalent to about 22% of the industry’s reported ₱99.64 billion in total assets.
Philippine HMO Industry Is Growing Fast
Intellicare’s numbers come amid a broader expansion of the Philippine HMO market.
Total industry revenue climbed 19.99% to ₱56.43 billion during the first half of 2026, while membership fees increased 19.71% to ₱54.82 billion, according to Insurance Commission figures cited by GMA News.
The numbers suggest that demand for prepaid healthcare coverage is continuing to rise, particularly as companies compete for workers by strengthening employee health benefits and Filipino families look for protection against expensive hospital bills.
Intellicare itself says it serves more than 1.2 million members nationwide, supported by a network of more than 64,000 doctors and specialists.
But rising membership and revenue do not mean healthcare is becoming cheaper.
The industry’s ₱41.23-billion claims bill increased by double digits, showing that medical utilization and the amount HMOs are paying for healthcare are also climbing rapidly.
Filipinos Still Shoulder a Large Part of Their Medical Bills
The wider issue is the amount Filipino families continue to pay themselves.
Philippine healthcare spending reached about ₱1.87 trillion in 2025, while out-of-pocket spending represented approximately 41.2% of current healthcare expenditure, according to Philippine Statistics Authority figures cited in recent healthcare industry reporting.
That means private insurance, HMOs and PhilHealth remain critical financial buffers when families face hospitalization or prolonged medical treatment.
This pressure has also made HMO coverage more important in the workplace.
Earlier reporting citing Intellicare noted that healthcare benefits have become an increasingly significant consideration for Filipino employees when choosing employers. One study cited by the company found that six in 10 Filipino families would struggle to cover a ₱10,000 hospital bill without borrowing money or relying on HMO protection.
Government and Private Health Coverage Are Starting to Work Together
The growing role of HMOs is also intersecting with efforts to reduce out-of-pocket healthcare costs through PhilHealth.
Under PhilHealth’s YAKAP initiative, participating HMOs and private insurers can function as secondary payers after PhilHealth benefits are applied, potentially allowing patients to use government coverage first before tapping private healthcare plans for additional expenses.
Such coordination could become increasingly important as medical costs rise.
HMOs can absorb a significant portion of healthcare expenses, but coverage remains subject to plan limits, exclusions, hospital networks and benefit ceilings. Patients may therefore still face significant expenses even when they have private healthcare plans.
Intellicare’s Numbers Show How Big the Stakes Have Become
Intellicare’s ₱9.35-billion payout is more than a corporate performance statistic.
It shows just how much of the country’s healthcare spending now passes through private health plans before patients ever see a hospital bill.
With Intellicare responsible for almost 23% of Philippine HMO claims during the first half of 2026, the company’s financial health, provider network and ability to manage rising medical costs carry implications for more than one million members.
For the wider HMO sector, the numbers are encouraging but also revealing.
Revenue is increasing quickly. Membership collections are rising. Assets are expanding.
But healthcare claims are rising too.
And as hospital charges, medical utilization and treatment costs continue to climb, the bigger question is whether HMOs can keep absorbing billions of pesos in additional healthcare expenses without eventually passing significantly higher costs on to Filipino employers and families.
