Malasakit Center: who can get help, requirements and how to apply

A Malasakit Center is a one-stop shop for medical and financial help inside a government hospital. "Malasakit" is the Filipino word for real care and concern for others.

Before these centers, a family with a big hospital bill often went from office to office: PhilHealth, the Department of Health (DOH), the Philippine Charity Sweepstakes Office (PCSO) and the Department of Social Welfare and Development (DSWD). A Malasakit Center puts these agencies under one roof, so you can ask for help without leaving the hospital.

• The first Malasakit Centers opened in 2018. One early center opened that June at the Western Visayas Medical Center in Iloilo City.
• The Malasakit Centers Act of 2019 (Republic Act 11463) made the program a law. Its rules were signed in February 2020.
• As of September 2024, the latest national count we found, DSWD reported its staff in 166 Malasakit Centers in government-run hospitals across the country.

Why this matters: in 2019, WHO noted that about 55% of health spending in the Philippines came straight from people's own pockets, and paying for care pushes many families into poverty. Malasakit Centers exist so that money does not keep you from the care you need.

Each agency at the center pays for a different part of your costs:

• PhilHealth pays first, through its benefit packages (for example, its case rates). Its staff check your membership and help with your claim.
• DOH medical assistance, called MAIFIP (Medical Assistance to Indigent and Financially Incapacitated Patients), and PCSO help pay for medical costs that PhilHealth does not cover. This can include the rest of the hospital bill, medicines, laboratory tests and procedures.
• DSWD, through its AICS program (Assistance to Individuals in Crisis Situations), helps with non-medical needs. The 2020 operating rules list transport, food, burial costs, general assistive devices that the other agencies do not give, and cash for other urgent needs.

Help comes as cash or as a guarantee letter (GL): a written promise from an agency to pay part of your bill. The hospital accepts it in place of cash, so you do not pay first and claim later.

There is no fixed amount. The social worker looks at your bill and your family's situation. The help adds to what your family can manage, so you may still pay part of the bill.

Which agency pays for what has changed over the years. In late 2024, DSWD said it was working to widen its medical help inside Malasakit Centers. The staff will tell you the rules that apply today.

Malasakit Centers are for two groups of patients:

• Indigent patients: people who are poor and cannot meet basic needs.
• Financially incapacitated patients: people who are not usually counted as poor but cannot pay this bill right now. This can happen after a long hospital stay, an operation, cancer treatment or dialysis.

So you do not need to be a 4Ps member, or already be listed as indigent, to ask. Some hospitals still ask for a certificate of indigency with your papers (see the list below). A medical social worker interviews you, checks your papers and decides what help fits.

Who can apply:

• the patient
• a family member or other representative with a signed authorization letter from the patient (not needed if the patient is under 18 or too sick to act)

Outpatients can often ask too, not only admitted patients. At the Philippine Children's Medical Center, for example, any patient being treated there can apply, using a prescription, a laboratory request or a hospital bill as proof of need.

Malasakit Centers are found in DOH hospitals, including regional hospitals and medical centers, in the Philippine General Hospital (PGH) in Manila, and in other public hospitals. They are not found in private hospitals.

To find one:

• Ask the hospital's information desk, admitting section or Medical Social Service office. In some hospitals, the Malasakit Center is part of the patient assistance or social service office.
• Use Find care to look for government hospitals near you, or ask our navigator which one to try.

We could not find one official, up-to-date list of all centers, so check with the hospital before a long trip. Many centers keep office hours on working days.

In an emergency, go to the nearest ER first. You can ask about help with the bill once the patient is being treated.

Requirements differ a little between hospitals. Most ask for these papers. Bring the original and a photocopy of each.

1. One valid ID of the patient or the person being interviewed, best a government ID such as the National ID, UMID, PhilHealth ID, driver's license, voter's ID, senior citizen, PWD, 4Ps or barangay ID. If you truly have no ID, DSWD may accept a barangay certification of your identity.
2. Medical certificate or clinical abstract (also called a medical abstract or discharge summary). It must show the diagnosis and your doctor's full name, license number and signature, and be issued within the last three months. Ask your doctor or the medical records office early, as it can take time to prepare.
3. Proof of what you need to pay for. For a hospital bill, bring the statement of account (SOA) signed by the billing clerk, or a certificate of balance and promissory note from the credit and collection office. For medicines or devices, bring the dated, signed prescription. For tests or procedures, bring the laboratory request or doctor's order.
4. Social case study or case summary, prepared by a social worker from the hospital, DSWD or your city or municipal social welfare office (LSWDO). DSWD asks for it with hospital bills and with larger requests. In its 2023 charter, that means medicines or tests costing more than ₱10,000, together with a price quotation.
5. Certificate of indigency or barangay certificate of residency, if asked. Some hospitals issue their own.
6. Authorization letter and the representative's ID, if someone else applies for the patient.

Not yet registered with PhilHealth? Some government hospitals, such as the Philippine Children's Medical Center, can enroll an admitted ward (service) patient who cannot pay on the spot through PhilHealth's Point of Service (POS). They usually ask for a registration form (PMRF), a birth certificate and an ID.

1. Go early. As soon as the patient is admitted, or when you hear what an operation or medicine will cost, ask where the Malasakit Center is. Do not wait until discharge day.
2. Get a queue number and hand in your papers at the counter. Staff check that they are complete and tell you what is missing.
3. Have your interview. A social worker asks about your family, work, income and the illness. Answer honestly: this is how they decide what help fits.
4. PhilHealth is applied first. PhilHealth staff check your membership, and your benefit is taken off the bill.
5. The rest is matched to the right agency. The social worker decides which help you can get from DOH, PCSO or DSWD, and how much.
6. Receive the help. You sign an acknowledgement form. DSWD's 2023 service charter aims to finish cash help in about 13 hours of working time and a guarantee letter, which goes to the billing office, in about one day, not counting time in the queue. It takes longer when many people are waiting or papers are missing.
7. Get your discharge clearance once the bill is covered or settled. Keep all your papers in one folder.

For long treatments such as dialysis or chemotherapy, ask how often you need to apply again. If you are turned down, ask politely why and what else you can try.

There is no fee at any step. The official lists of requirements do not include a letter from a politician or anyone else. Do not pay anyone who offers to speed things up.

PhilHealth is always applied before other help, so knowing your benefits lowers what you need to ask for.

• Ask for a ward bed if you can. Under PhilHealth's 2020 no co-payment rules, a member in a basic or ward bed (a shared room with regular meals, a fan and a shared toilet) should have nothing more to pay for covered care. A private room, aircon, a phone, a TV or extra food can be charged.
• No balance billing. PhilHealth's 2020 rules list indigent, sponsored, senior citizen and lifetime members as covered by its no balance billing policy.
• When care costs more than the case rate, PhilHealth itself tells patients to go to the Malasakit Center for more financial help.
• Talk to the PhilHealth staff in the hospital. Some hospitals have a PhilHealth nurse, called P-CARES, who helps members with their benefits.

To see what PhilHealth pays for, read our guide What does PhilHealth cover?. For check-ups and medicines outside the hospital, see our PhilHealth YAKAP guide. For how hospitals, health centres and agencies fit together, see our guide to the health care system in the Philippines.

Private hospitals, and some smaller public hospitals, do not have a Malasakit Center. You still have options:

• Ask the hospital's social service or billing office what help they know of.
• Go to DSWD. Apply for medical assistance under AICS at the Crisis Intervention Unit of your regional DSWD field office, or at a SWAD office in your province. Bring the same papers listed above.
• Visit your city or municipal social welfare office (LSWDO) at the town or city hall. It can prepare a social case study and help you apply.
• Ask about a transfer. If the patient is stable and the bill keeps growing, ask the doctor whether moving to a government hospital is safe. Moving a sick patient has risks, so this is the doctor's call.

If you have an HMO, ask first what it pays: see our guide to health insurance and HMOs. You can also book a call with one of our nurses to talk through your options.

• "It is only for the very poor." No. It is also for patients who are financially incapacitated, meaning they cannot pay a large bill right now, even if they usually get by.
• "You need a backer or a politician's letter." The social worker decides, based on the interview and your papers. You can walk in and ask on your own.
• "You have to pay first, then get a refund." Not usually. A guarantee letter goes straight to the hospital, so the amount is taken off your bill.
• "Asking for help is nakakahiya." Many families feel hiya about asking. But the law was written so that every Filipino can reach government help more easily. Social workers handle these requests every day. The program exists for exactly this, so asking is not begging.