Segmented increases and copayments for prepaid medicine began to apply

Prepaid medicine: Segmented increases and copayments begin to apply at the start of 2023

The new regime of segmented increases and copayments for prepaid medicine began to operate. From the Superintendence of Health Services, the measures for the segmentation of the increases were regulated, which will be linked to the income of the holder of the service and the creation of co-payment plans whose value must be at least 25% less than those currently offered by companies.

Secondly, each prepaid medicine company must present an affidavit that can be found on the institutional website of the Superintendence.

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The form to moderate the increases of the prepaid, which began to be activated these days, although without details for the companies that are the ones that, finally, must apply the differentiated increases in the invoices of their clients. The doubts will be resolved this coming week in a meeting between the private medicine companies and the Superintendency of Health Services (SSS), the body that regulates them.

Each company must attach the rate charts with the detail of the co-payment values ​​for all benefits. The Superintendency will publish the reported values ​​for each entity on its website.

Each plan will be identical to those already offered by prepaid, The difference applies in that they may be applied to certain first and second level benefits, that is, paying an extra sum when receiving care.

What are the first and second level benefits achieved by the standard?

The first level covers health services such as medical consultations, psychology, laboratory practices, diagnostic-therapeutic tests, kinesio-physiotric practices, speech therapy/phoniatric practices, home care (green and yellow codes) and dentistry.

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The second level are: Computed Axial Tomography (CT); Nuclear Magnetic Resonance (NMR), Radio Immuno Assay (RIE), Biomolecular, Genetic Laboratory, Nuclear Medicine, Imaging studies that require prior preparation and/or use of contrast media; among other.

In any of all these attentions, the rule excludes pregnant people and girls up to three years of age from paying the copayment; cancer and transplant patients, people with disabilities or those who are in preventive programs or receive benefits and emergency practices.

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Source: Telam

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