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The Government anticipates that the new Fonasa modality could be operational during the first half of 2025

The short Isapres law approved on Monday in Congress not only implements the Supreme Court’s ruling that mandates insurers to apply the new table of factors to all affiliates and restore excess charges, but it also brought about , among other things, the creation of the Complementary Coverage Modality (MCC) in Fonasa.

The creation of this modality represents a victory for the Executive in the context of the short law, since it comes close to some of the health guidelines established by the government program.

Specifically, the MCC will be a voluntary insurance option that considers hospital and outpatient benefits and a network of private providers. which would be financed with legal health contributions (7%), plus a complementary flat premium per beneficiary, which will be administered by insurance companies tendered by Fonasa.

Specifically, the MCC was designed not only to reinforce the system in the face of the high migration that the public body is now receiving, but also to receive members who have to leave as a result of possible insolvencies of their insurer, or directly attract more people to the public health system.

With the project already approved, the director of Fonasa, Camilo Cid, explains that “in the current scenario, the first milestone is related to the fact that once the law is enacted, We have a period of three months to establish the tariff for the Complementary Coverage Modality, a resolution that must be signed by the Ministry of Health and the Ministry of Finance.”

Regarding timing, he adds that “in parallel we must advance in the bidding, which involves intense work by the technical teams to define the bases of this process. Thus we also have to establish agreements with private providers that will be part of the Complementary Coverage Modality network.” However, he esteems authority, “In the first half of 2025, people may already be opting for this new type of care that will increase their financial protection in health.”

You can register voluntarily for this modality contributors and their charges who belong to groups B, CYD, as long as they have made their health contributions during the last 6 months in Fonasa or isaprewhile special entry conditions will be established for people who contribute for the first time and for independent workers.

The cost of this bonus is still an unanswered question, since its price will be determined in the bidding process. Yes indeed, The first estimates suggest that it could be around 30 thousand pesos per person. What is known is that it will have a community nature, that is, the value will be the same for each person, regardless of their age, sex or health condition.

Regarding financial coverage, The organization anticipates that it is expected to be between 60% and 70% of the total value of care. Likewise, they maintain that Fonasa will articulate the network of private providers through agreements. In this way, people will be able to choose which professional or which establishment they seek treatment within the network.

In addition, other powers were approved so that Fonasa can provide continuity of treatment for people whose isapre of origin could result in their registration being canceled for not having complied with their adjustment and payment plan stipulated within the framework of the short law for GES, CAEC and judicial rulings or resolutions of the Health Superintendence.

“This new modality of care is based on a logic of equity, solidarity and that does not discriminate based on health condition, sex or age; fundamental principles of the work of the National Health Fund”announces Cid.

Meanwhile, the Minister of Health, Ximena Aguilera, highlights that “adherence to complementary insurance will allow Fonasa beneficiaries to use the private sector, but with greater financial security and coverage, generating a system that offers more access opportunities. to health care.”

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