Health risks from climate change are increasing and becoming a critical global concern. Implementation of health adaptation policies is vital, particularly in settings with high socioeconomic vulnerability and physical exposure to climate-risks, such as the Philippines. We identified from the literature a set of reference principles and categories of barriers to the implementation of national health adaptation policy. These were then used to assess the extent to which these policy principles and barriers are evident in Philippine national health adaptation. This assessment was undertaken based on data and information from policy analysis, key informant interviews, and an expert workshop. The results suggest that the Philippines have made notable progress on health adaptation by establishing a strong policy framework. However, implementation remains challenging and requires continued commitment. The health adaptation policy principles identified in the Philippines are policy congruence, mainstreaming, multi-sectoral approach, multiscale approach, adaptive management, and evidence-based decision-making. The most important implementation barriers are uncertain leadership, appropriateness and longevity of the governance structures within the Department of Health, and data and evidence. The value of considering policy principles alongside implementation barriers is twofold. First, this enables understanding of how implementation barriers relate directly to policy principles. Second, it facilitates identification of future implementation barriers that may arise in relation to current policy principles. Multi-sectoral governance and the integration of evidence in decision-making arose as potential future challenges in the Philippines. These areas may require special consideration in future policy design and planning.