Tuesday, January 3, 2023 | 12:15 p.m.
As determined by the Government, prepaid medicine companies may only charge copayments or coinsurance for the following benefits
1st level benefits
- Medical consultations;
- Psychology;
- Laboratory practices;
- Diagnostic-Therapeutic Tests;
- Kinesio-Physiatric Practices;
- Phonoaudiology Practices;
- Phoniatrics;
- Home care (green and yellow codes);
- Odontology.
2nd level benefits
- Computerized 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 medium;
- Diagnostic/therapeutic endoscopic practices, excluding those neurosurgical and cardiovascular, in all its modalities, whether central or peripheral.
- The resolution also establishes that the following are exempted from the collection of co-payments: pregnant persons, girls and boys up to 3 years of age (Law 27,611); cancer patients, transplant recipients and people with disabilities, in accordance with the regulations applicable in each case.
Who will NOT have coinsurance
There will be no coinsurance for preventive programs; practices and emergency benefits; and all those cases that are excepted or could be excepted in the future due to the application of specific coverage regulations.
For this purpose, prepaid medicine entities must complete and generate, for each of the comprehensive coverage plans that they market to the general public, the affidavit form for the registration of comprehensive coverage plans with copayment, which will be found Available on the institutional website of the Superintendence of Health Serviceswhich will publish the reported copayment lists, it was remarked.
