Authorization Letter for PhilHealth: Free Samples (2026)
The first authorization letter I helped a relative write got sent back at the window. She’d written “to process any and all PhilHealth transactions on my behalf,” thinking broader was safer. The officer asked her representative to come back with a letter naming the actual transaction. Vague is exactly what slows this down, not what speeds it up.
On this page
- Quick Answer
- When You Actually Need One
- What Your Representative Must Bring
- Does It Need to Be Notarized?
- How to Write One
- Two General-Purpose Templates
- Sample: General Transaction / MDR
- Sample: Adding a Dependent or Beneficiary
- Sample: Hospitalization Claim
- Sample sa Tagalog
- Mistakes That Get Letters Rejected
- Frequently Asked Questions
Quick Answer
An authorization letter for PhilHealth is a short, signed letter that lets a trusted representative handle a specific PhilHealth transaction for you, like claiming your MDR, picking up your ID, or updating your dependents, when you can’t go in person. Per PhilHealth Circular No. 2020-0001, your representative must present the signed letter together with one valid government-issued photo ID each, yours and theirs. It doesn’t need notarization for routine branch transactions. Six ready-to-use templates, two general-purpose and four scenario-specific, are below.
When You Actually Need One
You need this letter any time someone else is transacting with PhilHealth in your name and you aren’t there to sign or confirm it yourself, work schedules, illness, being based overseas, or simply not wanting to queue.
Common scenarios include claiming or updating your MDR, picking up a physical PhilHealth ID, adding a dependent to your record, checking your contribution history, submitting hospital claim documents on your behalf, or recovering a lost PhilHealth number.
One thing worth checking first: some of these no longer require a branch visit at all. You can view and print your own MDR through the Member Portal without involving a representative, if you’re the one with online access.
What Your Representative Must Bring
PhilHealth Circular No. 2020-0001 states plainly that a representative transacting on a member’s behalf must present an authorization letter signed by the member, together with one valid government-issued photo ID for both the member and the representative. PhilHealth’s 2024 Citizen’s Charter lists the same core documents for standard branch transactions.
| Document | Whose copy |
|---|---|
| Signed authorization letter | Original, from the member |
| Valid government-issued photo ID | Member’s (photocopy is usually accepted) |
| Valid government-issued photo ID | Representative’s (original, plus photocopy) |
| Transaction-specific documents | Varies, see samples below |
The ID requirement here is PhilHealth’s own, separate from the DFA’s much stricter passport-specific list, so a PhilHealth ID that isn’t accepted for passport applications can still work fine here. Any valid government-issued photo ID, from either of you, generally satisfies this.
Does It Need to Be Notarized?
No, not for routine PhilHealth branch transactions. Neither PhilHealth Circular No. 2020-0001 nor the 2024 Citizen’s Charter lists notarization as a requirement, a signed letter plus valid IDs is what’s specified.
How to Write One
- Write today’s date. This confirms the letter is current.
- State your full name and PhilHealth PIN. Use the name exactly as it appears on your PhilHealth record.
- Name your representative in full, plus their relationship to you.
- Name the exact transaction. “To claim my MDR” works. “To process my PhilHealth matters” doesn’t, that’s the vague phrasing that got my relative sent back.
- State the ID your representative will present. Type and number, if you know it.
- Sign it. Your signature should match the one on your ID.
That’s the whole structure. Nothing here needs legal language, PhilHealth just needs to confirm who you are, who you’re authorizing, and exactly what for.
Two General-Purpose Templates (Any Transaction)
These two work as a starting base for any PhilHealth transaction, not just the specific scenarios below. Fill in the purpose yourself, name the exact transaction rather than leaving it general, and the vague-letter mistake from the intro won’t happen to you.
Template 1: Basic
AUTHORIZATION LETTER
Date: ______________________
To: PhilHealth Office / Authorized Personnel
Subject: Authorization to Act on My Behalf
I, [Full Name of PhilHealth Member], hereby give permission to [Full Name of Authorized Representative] to represent me in connection with my PhilHealth-related transaction.
My representative is authorized to submit the necessary documents, make inquiries, receive applicable documents or information, and complete the required steps related to my request on my behalf.
Member Information
- Full Name: ______________________________
- PhilHealth Identification Number: ______________________________
- Address: ______________________________
- Contact Number: ______________________________
Authorized Representative
- Full Name: ______________________________
- Address: ______________________________
- Contact Number: ______________________________
- Relationship to Member: ______________________________
This authorization is being provided because I am unable to personally complete the transaction. I understand that my representative may be required to present a valid identification document and that additional requirements may be requested by the PhilHealth office.
Thank you for your assistance.
Respectfully,
______________________________
Signature of PhilHealth Member
Printed Name: ______________________________
Template 2: Detailed
This version adds a defined scope of authority, a validity period, and a counter-signature from the representative, useful when a branch wants more on record than the basic version provides.
PHILHEALTH MEMBER AUTHORIZATION
Date: ______________________
To: The PhilHealth Office / Concerned PhilHealth Representative
Re: Authorization of Representative
I, [Member’s Full Name], a PhilHealth member, authorize [Representative’s Full Name] to represent me for the purpose of handling my PhilHealth transaction described below:
Purpose of Authorization:
______________________________________________________
______________________________________________________
Scope of Authorization
My representative is authorized to:
- Submit and receive documents related to the above transaction
- Make inquiries and follow up on the status of my request
- Sign receiving copies or acknowledgment forms, where applicable
- Complete any other step reasonably necessary to finish the transaction described above
Member Information
- Full Name: ______________________________
- PhilHealth Identification Number: ______________________________
- Valid ID Presented: ______________________________
- Address: ______________________________
- Contact Number: ______________________________
Authorized Representative
- Full Name: ______________________________
- Relationship to Member: ______________________________
- Valid ID Presented: ______________________________
- Contact Number: ______________________________
Validity of Authorization
This authorization is valid from
______________________________ until the above transaction is completed, or until revoked by me in
writing.
I certify that the information above is true and correct, and I take full responsibility for the actions taken by my representative within the scope of this authorization.
______________________________
Signature of PhilHealth Member
Printed Name: ______________________________
______________________________
Signature of Authorized Representative
Printed Name: ______________________________
Sample: General Transaction / MDR
Use this for claiming your MDR, checking contributions, or picking up a printed PhilHealth ID.
[Date]
To the Officer-in-Charge
Philippine Health Insurance Corporation
[Branch / LHIO Name]
Subject: Authorization Letter for PhilHealth Transaction
To Whom It May Concern:
I, [Your Full Name], PhilHealth Identification Number (PIN) [Your PIN], hereby authorize [Representative’s Full Name], my [relationship], to request and claim my Member Data Record (MDR) on my behalf.
My representative will present a photocopy of my valid ID and their own original valid ID, [ID type], for verification.
I am executing this letter to confirm my consent to this transaction.
[Your Full Name]
[Your Signature]
[Your Valid ID Type and Number]
[Contact Number]
Swap “request and claim my Member Data Record (MDR)” for whatever single transaction applies, claiming a printed PhilHealth ID, checking your contribution history, or submitting registration documents.
Sample: Adding a Dependent or Beneficiary
Use this when someone else is updating your record to add a spouse, child, or other qualified dependent.
[Date]
To the Officer-in-Charge
Philippine Health Insurance Corporation
[Branch / LHIO Name]
Subject: Authorization Letter for Declaration of Dependent
To Whom It May Concern:
I, [Your Full Name], PIN [Your PIN], hereby authorize [Representative’s Full Name], my [relationship], to update my Member Data Record by adding [Dependent’s Full Name], my [relationship to dependent], as my qualified dependent.
My representative will submit the supporting document, [e.g., PSA Marriage Certificate / PSA Birth Certificate], along with this letter and both our valid IDs.
[Your Full Name]
[Your Signature]
[Your Valid ID Type and Number]
[Contact Number]
Check our membership category guide for which relatives qualify as dependents before you send someone to file this.
Sample: Hospitalization Claim
Use this when a family member is submitting your PhilHealth benefit claim documents to a hospital’s PhilHealth desk or a branch on your behalf after a confinement.
[Date]
To the Officer-in-Charge
Philippine Health Insurance Corporation
[Branch / LHIO Name or Hospital
PhilHealth Desk]
Subject: Authorization Letter for Filing of PhilHealth Benefit Claim
To Whom It May Concern:
I, [Your Full Name], PIN [Your PIN], hereby authorize [Representative’s Full Name], my [relationship], to file and submit my PhilHealth benefit claim documents for my confinement at [Hospital Name] from [Admission Date] to [Discharge Date].
This includes my Claim Form 1, Member Data Record, and any supporting documents required to complete the claim.
[Your Full Name]
[Your Signature]
[Your Valid ID Type and Number]
[Contact Number]
Sample sa Tagalog
Pwede itong gamitin para sa karaniwang transaksyon tulad ng pagkuha ng MDR o PhilHealth ID.
[Petsa]
Sa Opisyal na Nakatalaga
Philippine Health Insurance Corporation
[Pangalan ng Sangay / LHIO]
Paksa: Sulat ng Pahintulot para sa Transaksyon sa PhilHealth
Kinauukulan,
Ako, si [Buong Pangalan], may PhilHealth Identification Number (PIN) [Iyong PIN], ay nagbibigay ng pahintulot kay [Buong Pangalan ng Kinatawan], aking [kaugnayan], upang kunin at i-claim ang aking Member Data Record (MDR) sa aking ngalan.
Magdadala ang aking kinatawan ng kopya ng aking valid ID at ang kanilang orihinal na valid ID, [uri ng ID], bilang pagkakakilanlan.
Nilalagdaan ko ang sulat na ito bilang patunay ng aking pahintulot sa transaksyong ito.
[Buong Pangalan]
[Lagda]
[Uri at Numero ng Valid ID]
[Numero ng Telepono]
Mistakes That Get Letters Rejected
- Being vague about the transaction. “All PhilHealth matters” invites a second trip. Name the one thing you need done.
- Forgetting your PIN. It’s the fastest way for staff to confirm your identity against their system.
- Mismatched signatures. If your letter signature doesn’t resemble the one on your ID, expect questions.
- No ID copy attached. Bring the letter and the ID photocopies together, not just one or the other.
- Assuming email works everywhere. Some branches accept a scanned signed copy, particularly for members based overseas, but this isn’t guaranteed at every office. Confirm with your specific branch before relying on it.
Frequently Asked Questions
How do I make an authorization letter for PhilHealth?
State the date, your full name and PIN, your representative’s name and relationship to you, the exact transaction, and sign it. Use the samples above as a starting template.
Can I write my own authorization letter?
Yes. PhilHealth doesn’t require a lawyer or a pre-printed form. A clear, signed letter covering the required details, as shown in the samples above, is accepted.
What is an example of a basic authorization letter?
A basic authorization letter states who you are, who you’re authorizing, the specific task, and your signature. The general transaction sample above follows this exact structure.
Can a foreigner apply for PhilHealth in the Philippines?
Yes. Foreigners working, residing, or married to a Filipino citizen in the Philippines can generally register, under categories like foreign employee, expatriate, or retiree. See our membership category guide for specifics.
How much is PhilHealth monthly?
For 2026, the minimum monthly contribution is ₱500, based on the 5% rate applied to the ₱10,000 income floor, up to a maximum of ₱5,000 at the ₱100,000 ceiling. Use our contribution calculator for your exact amount.
Can I make an authorization letter online?
You can type and sign it digitally or print and sign by hand, then scan it. Whether a scanned copy alone is accepted, or you still need an original at the counter, varies by branch, confirm directly if you’re sending it electronically.
Does PhilHealth accept a handwritten authorization letter?
Yes, as long as it’s legible and includes all the required details, your name, PIN, your representative’s details, the specific transaction, and your signature.
Sending a representative to a PhilHealth branch?
Pair this letter with our PhilHealth online appointment guide if the branch requires booking, and our requirements guide for anything else they should bring.