PhilHealth Premium Payment Slip
Fill PhilHealth Premium Payment Slip online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: SPA No, AMOUNT, MEMBER’S/ AGENCY NAME, PIN/ PEN, CERTIFIED CORRECT, CONTACT NO./ EMAIL.
When it is due: All premiums for the calendar year by December 31; interest-free grace to January 31 (PhilHealth Circular PC2026-0011).
The form is the agency's own, from philhealth.gov.ph (checked 2026-10-14): the PDF you download is that form with your values printed in its boxes.
Part of the form pack: Overseas Filipino worker (land-based) (You pay the year's premiums yourself. Generate your Statement of Premium Account (SPA) in the PhilHealth Member Portal first, then bring this slip with the SPA number to any payment channel).
The free clean PDF is that pack’s shortest form. A later form in the same pack needs the Starter plan (₱499) or above. Preview, check, and verify stay free. Not affiliated with BIR, SSS, PhilHealth, Pag-IBIG or any government agency.