Health

The copayment for social and prepaid works is back: how it will affect users

Prepaid at the national level agreed to collect a coinsurance. Which will take effect at the start of 2022. For which rate increases are expected, which would reach 9%. 

The president of the Chamber of Outpatient Diagnosis and Treatment Entities confirmed that as of January 1, health providers (hospitals, sanatorium clinics, emergency medical services, geriatric, psychiatric, dental care centers, etc.) will charge a copayment of 9% of the value of each medical benefit to patients of Prepaid Medicine and Social Work companies.

“It will be an amount that will be paid on everything that the patient does. A clear example is that to build a laboratory that is worth $ 5,000. You will have to pay 450 pesos. It is not a threat to allow us to increase, in principle it is a fact unless some change covers the financing, “ said the head of the organization. 

One of the main reasons. That the business leader pointed out is that in the face of an increase in the costs. That financed prepayments and social works planned for January. Will not materialize and that forces the providers to collect the co-payment.

Barataria Affects 60%

At the same time, Marcelo Kaufman said: “To go not far behind, I only leave in mid-2021, we had to sign a joint venture. The Barataria affects 60% of the expenses of health providers that have to do with human resources. That joint venture was signed at the beginning with a 45% increase. That is, the one that charged $ 100 is charging $ 145 at the moment. It needed financing ”.

Holding that the increase will be 9% and through coinsurance, the president of CEDIM explained: “Inflation is an unfortunate fact and I cannot tell you what it means in medical services. You have experienced an increase in medicines during the pandemic. Health has its inflation that is above what is the CPI. You think that if the IPC marks you 10 points. Health spending increases by 13 because of technology. New drugs, new practices and since the Prepaid Medicine Law exists ”.

Argentine Federation of Health Providers

The Argentine Federation of Health Providers (FAPS) reported this Sunday that, as of January 1, health providers will charge a copayment of 9% of the value of every one of the medical benefits that patients receive. José Luis Sánchez Rivas, president of the Argentine Confederation of Clinics, Sanatoriums, and Private Hospitals (Confeclisa) explained the reason for the measure and said that the affiliates must claim their private medicine company to avoid assuming the cost.

José Luis Sánchez Rivas said in One Never Knows  that prepaid and social works “have one more week to define this behavior that they have taken.” It is that, according to the account, on December 9 they announced to the providers that the 9% of the increase agreed for January they will not be able to transfer, although they will charge their affiliates. 

Private Medicine

“We are financers, not lenders, and we cannot assume the position. That we are lacking or transfer it to our employees. They tell us that they cannot pay it and the money has to come from somewhere,” said the president of Confeclisa to justify this decision. which he assumes as “unpleasant”, but for which he holds the private medicine companies responsible. “They are going to charge their affiliates 9%. But they do not want to transfer it to us, as agreed,” he insisted.

Copayment:

Anyway, José Luis Sánchez Rivas understands that if an affiliate contracted a plan without a copayment, he must present the invoice to the social work or prepaid and demand that they make the reimbursement. “The member has to claim and they will have to return it. Because that is signed.”

“We have conveyed what is happening in advance. On December 9 they told us that they will not be able to cope with this increase. We denounced it to the Superintendency of Health and the Ministry of Labor. But we have not had a response from the Government or the prepaid, “said the interviewee, although he emphasized that it is the latter that should respond.

Finally, the president of Confeclisa said that if the resolution goes ahead, a copayment of 9% of what the service comes out will be charged in every one of the health benefits. Although he foresaw that emergencies. And certain cases in which a person cannot pay will be considered.

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