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Authorization Letter for PhilHealth: Free Sample and Template

Copy a ready-made letter, see what to attach and learn when a representative can transact for you.

✓ Last reviewed: [DATE]5 min readIndependent guide

Authorization letter

Quick answer

An authorization letter for PhilHealth lets a representative transact for you. PhilHealth’s policy is that the representative presents a letter signed by the member together with one valid government-issued photo ID of both the member and the representative. Some sensitive transactions may need a notarized special power of attorney.†

When you need an authorization letter for PhilHealth

✓Submitting your PMRF or supporting documents for you
✓Requesting or picking up your MDR or ID
✓Following up on a record correction or dependents update
✓Paying or checking contributions in person
✓Filing or following up a claim on your behalf

If you can complete the task without visiting, consider that first. Your options are in PhilHealth online registration and the Member Portal.

PhilHealth authorization letter template: what to include

Date and the office you are addressing
Your full name, PIN, address and contact number
The representative's full name, ID type and ID number
The specific task authorized, such as “submit my PMRF” or “request my MDR”
Your signature above your printed name
Photocopies of both valid IDs attached

PhilHealth authorization letter sample (free template)

Replace the bracketed items and print or write it clearly. Sign it yourself.

[Date]The Local Health Insurance OfficerPhilHealth [Office Name][Office Address]Subject: Authorization LetterDear Sir/Madam:I, [Your Full Name], PhilHealth Identification Number (PIN) [XX-XXXXXXXXX-X], residing at [Your Address], hereby authorize [Representative Full Name], with [ID Type and Number], to [state the task, e.g., submit my PhilHealth Member Registration Form] on my behalf.Attached are photocopies of my valid ID and my representative's valid ID for your reference.Thank you for your assistance.Respectfully,_____________________[Your Full Name][Contact Number]Authorized Representative:_____________________[Representative Full Name]

Authorization letter for PhilHealth MDR request

Use the same letter and replace the task line with: “to request and receive a printed copy of my Member Data Record (MDR).” Attach your ID and your representative’s ID. If your MDR has errors, add the correction form and supporting documents, as listed in the PhilHealth ID guide.

Authorization letter for PhilHealth claim

For claim-related tasks, use: “to submit documents and follow up my PhilHealth claim for [patient name and confinement dates].” Add your PIN, the hospital’s name and any reference number. Hospital claims are typically filed by the hospital itself, so ask its PhilHealth desk what is needed.†

IDs and documents to attach

Item	Who provides it	Notes
Signed authorization letter	Member	Signature must match your ID
Valid photo ID of the member	Member	Photocopy, and an original if requested
Valid photo ID of the representative	Representative	Bring the original
Documents for the task	Member	See documents needed for PhilHealth

Special power of attorney PhilHealth may require: letter vs. SPA

An authorization letter is enough for most simple transactions. Some sensitive or high-value actions may require a notarized special power of attorney (SPA in legal usage). This is different from the “Statement of Premium Account” that is also abbreviated SPA in payments. Ask your Local Health Insurance Office which document applies.†

Common authorization letter mistakes

A vague purpose such as “to process my papers”
Missing PIN or missing ID copies
An unsigned letter, or a signature that does not match the ID
An expired ID
Sending the representative without checking the office's requirements

Call or check announcements first. Find your office through PhilHealth near me and consider an online appointment where available.

Sample authorization letter for record correction

Use the sample authorization letter above and replace the task line with: “to submit my Updating/Amendment PMRF and supporting documents for correction of [name / birthdate / civil status] and to receive the updated Member Data Record.” Attach the PMRF, your PSA certificate and both IDs.

Sample authorization letter for contribution inquiry

For payment concerns, use: “to inquire about and submit proof of payment for my PhilHealth contributions for [months and year].” Add your PIN, receipts and, if possible, screenshots from your Member Portal. See how to pay PhilHealth online and confirm posting.

Authorization letter template in Filipino

[Petsa]Ang Local Health Insurance OfficerPhilHealth [Pangalan ng Opisina][Address ng Opisina]Paksa: Liham ng PahintulotGinoo/Ginang:Ako si [Buong Pangalan], PhilHealth Identification Number (PIN) [XX-XXXXXXXXX-X], nakatira sa [Address], ay nagbibigay ng pahintulot kay [Buong Pangalan ng Kinatawan], na may [Uri at Numero ng ID], upang [ilagay ang gawain, hal. isumite ang aking PMRF] para sa akin.Kalakip ang photocopy ng aking valid ID at ng ID ng aking kinatawan.Salamat po.Ngunit,_____________________[Buong Pangalan][Contact Number]

Some offices prefer English letters. Ask your office whether a Filipino letter is acceptable before you go.

Tips for a smooth visit with a representative

✓Call or check the branch’s announcements before sending someone.
✓Give your representative complete copies, not just the letter, so the staff can process everything in one visit.
✓Ask your representative to keep the claim stub or receipt and send you a photo.
✓For transactions that involve your personal data, be present if possible.

How to customize the task line

If you need this	Write this task line
Submit registration	to submit my PMRF and documents for first-time registration
Update a record	to submit my Updating/Amendment PMRF and supporting documents
Get MDR	to request and receive my Member Data Record
Settle a payment issue	to submit proof of payment for [months]
Follow a claim	to submit and follow up documents for my PhilHealth claim

Sample authorization letter for a family member of an OFW

OFWs often authorize a spouse, parent or sibling. In your letter, add your overseas address and contact, and attach a copy of your passport data page and a valid ID that shows your signature. Send a signed scan and mail the original if the office requires it.†

Signing rules for the authorization letter

✓Sign in ink with the signature that appears on your ID.
✓If you cannot sign, use a right thumbmark as PhilHealth allows for its forms, and ask the office if witnesses are needed.†
✓Date the letter close to the visit.
✓Do not sign a blank letter.

Authorization letter for PhilHealth: common questions

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Independent guide. Not affiliated with PhilHealth. Official services: philhealth.gov.ph

Related guides

PhilHealth Requirements

Document checklist for every member type.

PhilHealth Near Me

Find your local office (LHIO).

Online Appointment

Book a visit and prepare your papers.

Sending a representative? Confirm the checklist.

Next step in your PhilHealth journey.