Can Employers Charge Applicants for Pre-Employment Medical Exams in the Philippines?

Short answer

As a best-practice—and in many situations as a legal expectation—employers should shoulder the cost of any medical examination they require as a condition for hiring. Philippine labor and OSH (occupational safety and health) policy is anchored on the principles that (1) recruitment must be free from abusive charges and (2) employer-mandated medical assessments connected to work should be at the employer’s expense. There are also limits on what tests may be required (e.g., job-relatedness, non-discrimination, privacy) and special regimes for certain sectors (e.g., overseas work, hazardous jobs, domestic work) that typically place costs on the employer.

Below is a comprehensive, practical guide in the Philippine context.

The legal and policy architecture (plain-English overview)

Labor standards & recruitment fairness
- Philippine labor policy generally prohibits shifting employer costs onto workers/applicants during hiring. While the Labor Code’s clearest “no fee” rules focus on recruiters/placement agencies, the same worker-protection logic applies to employers that make medical exams a pre-hire condition: if you require it, you pay for it.
Occupational Safety and Health (OSH) rules
- OSH rules require employers to identify workplace hazards, provide medical surveillance, and conduct pre-placement, periodic, and exit examinations when work conditions warrant. Where examinations are mandated because of job risks (e.g., chemicals, noise, confined spaces, food handling), the employer bears the cost—both because the exam is work-necessitated and because OSH compliance costs are the employer’s responsibility.
Data Privacy & medical confidentiality
- Medical data are sensitive personal information. Any pre-employment testing must be proportionate, necessary for the specific job, and handled with strict confidentiality, with access limited to those who need to know for a legitimate HR/OSH purpose.
Anti-discrimination limits on testing
- Pre-employment tests must be job-related and consistent with business necessity. Policies that screen out by sex, pregnancy, disability, HIV status, age, or other protected statuses are unlawful. Several sectoral laws and policies reinforce that certain tests (e.g., pregnancy or HIV testing) cannot be used as hiring filters.
Sector-specific regimes
- Overseas employment: Stringent rules apply; medical exams are typically employer-shouldered through the foreign principal or covered by specific recruitment rules.
- Hazardous/regulated jobs (e.g., construction, mining, healthcare, food & beverage): Pre-placement and periodic health checks are part of OSH compliance and therefore employer-paid.
- Domestic work (kasambahay) and public sector roles may have specific implementing rules; in practice, when an employer requires a medical clearance to enter into employment, employer-shouldering is the prevailing, risk-averse approach.

What an employer may (and may not) require

Allowed—if job-related, necessary, and proportionate

Basic pre-placement evaluations limited to the bona fide requirements of the job (e.g., fitness to perform essential functions).
Risk-based tests mandated by OSH (e.g., audiometry for high-noise work, chest X-ray where clinically indicated, vaccinations for healthcare workers, food-handler medical certificates).
Return-to-work/fit-to-work assessments for safety-sensitive roles.

Cost rule of thumb: If you require the exam (general fitness or risk-based), you should pay.

Not allowed (or extremely restricted)

Pregnancy testing as a hiring screen.
HIV testing as a condition for employment.
Blanket “health screens” that aren’t tied to the job, or that are overbroad relative to the role.
Any medical data processing that breaches privacy (e.g., sharing results beyond HR/clinic, retaining data without purpose/time limits).

Practical scenarios & compliance answers

1) We ask finalists to undergo a “pre-employment medical.” Who pays?

Employer pays. If the company requires the medical evaluation to finalize hiring, the cost should not be pushed to the applicant.

2) We impose specialized tests (e.g., drug/alcohol, pulmonary, vaccinations) for safety-sensitive roles.

Ensure there is a clear risk basis (documented in your OSH program).
Employer pays and keeps results confidential, retaining only fitness determinations where possible (e.g., “fit,” “fit with restrictions”).

3) We used to ask applicants to get a City Health clearance at their own expense.

Avoid this. If the clearance is your requirement for entry into employment, you shoulder the fee. If the “clearance” is purely a government licensing requirement for the person independent of the employer (rare for ordinary employment), you must still evaluate whether requiring it at the applicant’s expense is lawful and non-discriminatory; in most typical private employment, you should pay.

4) We reimbursed the exam only for those we hired; unsuccessful applicants got no reimbursement.

Risky. That arrangement deters applicants and may be viewed as shifting recruitment costs. The safer practice is to pay the clinic directly or reimburse all who took the exam because you required it, regardless of outcome.

5) We want to deduct the medical fee from the first salary.

Don’t. Wage deductions are tightly regulated, and this would shift an employer cost onto the new hire. It undermines recruitment fairness and wage protection.

How to structure a compliant policy (employer playbook)

Principle statement
- “All medical examinations required by the Company for pre-employment, placement to specific risk-exposed roles, periodic surveillance, and return-to-work evaluations shall be Company-shouldered.”
Scope & timing
- Conduct only after a conditional job offer, except where safety/fitness must be confirmed earlier for compelling reasons tied to the role.
- Specify which roles need which tests and why (link to the OSH risk assessment).
Approved providers and direct billing
- Maintain a panel of accredited clinics. Use direct billing to avoid out-of-pocket payments by applicants.
Data minimization & confidentiality
- The company receives only fitness determinations where feasible (e.g., “fit,” “fit with restrictions”). Full medical results stay with the medical provider/company physician.
- Keep records separate from general HR files; restrict access on a need-to-know basis with retention limits.
Non-discrimination guardrails
- Ban testing that is not job-related (e.g., pregnancy or HIV testing).
- Provide reasonable accommodation processes for disabilities/medical conditions, consistent with essential job functions and safety.
Applicant-friendly mechanisms
- If an applicant inadvertently pays, reimburse promptly (set a 5–10 business day SLA).
- Clearly communicate that the company shoulders required exams and which clinic to visit.
Dispute & escalation
- Designate contacts (HR and OSH) to resolve billing errors and privacy concerns.
- Incorporate a clinic service-level agreement (SLA) covering turnaround time, confidentiality, and invoicing accuracy.

For applicants: what to watch for

Ask: “Is the medical exam required? Who pays?”
Don’t pay up front unless absolutely unavoidable; if you must, keep receipts and request reimbursement in writing.
Challenge requests for non-job-related or sensitive tests (e.g., pregnancy, HIV).
Protect your data: authorize the clinic to release only a fitness certificate to the employer.

Risk analysis for employers

Legal risk: Shifting exam costs to applicants can be challenged as an unfair recruitment practice and, in risk-regulated roles, as an OSH compliance failure.
Discrimination risk: Overbroad or targeted tests can create disparate impact or direct discrimination (e.g., against women or persons with disabilities).
Privacy risk: Collecting or sharing unnecessary medical details breaches data privacy obligations.
Reputation & talent risk: Charging applicants erodes brand reputation and may chill applications—especially for entry-level roles.

Frequently asked questions

Q: Can we require a drug test for all applicants? A: Treat drug testing as a safety-sensitive control. If you require it, you shoulder the cost, and you should be able to show job-related necessity and privacy safeguards. Prefer post-offer testing tied to role risk.

Q: May we reimburse only upon hiring? A: Safer to pay or reimburse all who undergo your required exam, whether or not they’re ultimately hired.

Q: Can we ask for a chest X-ray for every role? A: Blanket X-rays with no risk basis are hard to justify. Tie tests to actual job demands or documented workplace risks.

Q: We’re hiring food-handlers; the LGU requires a health certificate. Who pays? A: If the certificate is a condition you impose for the job, shoulder the fee and related medical checks and streamline it via direct billing with an accredited clinic.

Model policy clause (you can paste this into your handbook)

Pre-Employment and Occupational Medical Examinations Where the Company requires a medical examination or health-related clearance for the purpose of recruitment, pre-placement, deployment to risk-exposed roles, periodic surveillance, or return-to-work, the Company shall shoulder all costs of such examinations, including clinic fees and medically necessary tests. Examinations shall be job-related and proportionate to the role’s risks, conducted by Company-accredited providers, and processed in compliance with data privacy and non-discrimination laws. The Company shall receive only the fitness-to-work determination; detailed medical information remains confidential with the medical provider. Applicants and employees shall not be required to undergo pregnancy, HIV, or any other test that is not job-related or is otherwise restricted by law. If an applicant or employee incurs any expense due to Company-required examinations, the Company shall reimburse within 10 business days upon submission of receipts.

Bottom line

If you require the exam, you pay—that’s the safest, most compliant reading of Philippine labor, OSH, privacy, and anti-discrimination policy.
Keep exams job-related, minimize data, and ban unfair or discriminatory testing.
Use direct billing and clear communication so applicants never bear the cost of getting hired.