If I have Isapre, can I get these benefits?

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this medical care In Chile this is a very important issue, the public health system (Fornasa) such as elderly care institutions (Isapre) They play an important role in providing health services to the people. However, citizens often ask a question: If I have Isapre, can I access GES?

this Clear Health Guarantee (GES) is an important part of the Chilean health system, providing medical benefit plan To all residents of the country. Find out below about the requirements and benefits offered by the GES plan, and whether joining Isapre will affect your likelihood of receiving these important health care benefits.

If I have Isapre, can I access GES?

Yes. GES, also known as Plan Auge, Guaranteed coverage for 87 diseases Via Fornasa and Isapre.

Through GES, healthcare services are available from the moment a suspected disease is diagnosed or excluded until treatment, follow-up or recovery. If you have Isapre, please review the steps below to activate this benefit.

How to activate GES using Isapre?

If your doctor diagnoses you with GES disease, during the same consultation he must provide you with Global Environmental Services Notice or a medical certificate If in doubt.
You must then present these documents to the appropriate Isapre.can do online or in persondepends on each institution.

Once you present your documents, your Isapre will notify you Professional and clinical Where you can attend, and the final cost of treatment.

In addition, you will receive a medical history form If your illness includes a diagnosis confirmation phase, we will schedule your first hour.

After that you have to go to Gus Network Doctor This is indicated to you to confirm your pathological condition. The physician must complete a medical history form and submit necessary prescriptions and orders (if applicable).

Finally, you must Submit medical history form, prescriptions and orders to Isapre (If applicable) Validate authorization for covered visits, drugs, and procedures. Thereafter, your GES will be activated.

What happens if I decline the designated clinic?

You will be able to choose accept or reject Isapre designated clinic for you.

However, you should know that if you refuse and decide to seek treatment elsewhere, You will lose the benefits of GES And you’ll only be covered by your health plan.

What diseases does Auge cover?

Auge or GES covers 87 health problems:

• Chronic kidney disease stages 4 and 5
• Operable congenital heart disease under 15 years of age
• Cervical cancer in people 15 years and older
• Cancer pain relief and palliative care
• acute myocardial infarction
• type 1 diabetes
• type 2 diabetes
• Breast cancer in people 15 and older
• spinal insufficiency
• Surgical treatment of scoliosis under 25 years of age
• Cataract surgical treatment
• Total hip prosthesis for patients 65 years and older with hip osteoarthritis and severe functional limitations
• Cleft lip and palate
• Cancer in people under 15
• Schizophrenia
• Testicular cancer in people 15 and older
• Lymphoma in people 15 years and older
• acquired immunodeficiency syndrome HIV/AIDS
• Outpatient management of acute respiratory infection (anger) in people under 5 years of age
• Outpatient community-acquired pneumonia in people 65 years and older
• Essential or essential arterial hypertension in persons 15 years of age and older
• Non-refractory epilepsy in people aged 1 to less than 15 years
• Comprehensive oral health for 6-year-old boys and girls
• Premature birth prevention
• Impulse generation and conduction disorders in persons 15 years of age and older requiring pacemakers
• Prophylactic cholecystectomy for gallbladder cancer in people aged 35 to 49 years
• stomach cancer
• Prostate cancer in people 15 and older
• Refractive defects in people 65 years and older
• Strabismus in people under 9 years old
• diabetic retinopathy
• non-traumatic rhegmatogenous retinal detachment
• hemophilia
• Depression in people 15 and older
• Treatment of benign prostatic hyperplasia in symptomatic people
• Technical assistance for those 65 and older
• Ischemic stroke in people 15 years and older
• Outpatient treatment for chronic obstructive pulmonary disease
• Moderate and severe bronchial asthma in people under 15 years of age
• neonatal respiratory distress syndrome
• Medical care for patients 55 years and older with mild or moderate osteoarthritis of the hip and/or knee
• Subarachnoid hemorrhage secondary to ruptured cerebral aneurysm
• Primary tumors of the central nervous system in people 15 years and older
• Surgical treatment of lumbar nucleus pulposus hernia
• Leukemia in people 15 years and older
• Outpatient Dental Emergency
• Comprehensive oral health status of people over 60 years old
• severe polytrauma
• Moderate or severe head trauma
• severe eye injury
• cystic fibrosis
• Rheumatoid Arthritis
• Harmful use or low to moderate risk of dependence on alcohol and drugs in people under 20 years of age
• labor analgesia
• big burns
• People 65 and older who require hearing aids Bilateral hearing loss
• retinopathy of prematurity
• Bronchopulmonary dysplasia in premature infants
• Bilateral sensorineural hearing loss in premature infants
• Non-refractory epilepsy in people 15 years and older
• Bronchial Asthma in People 15 Years and Older
• Parkinson’s Disease
• juvenile idiopathic arthritis
• Secondary prevention of end-stage chronic kidney disease
• hip dislocation dysplasia
• Comprehensive oral health for pregnant women
• relapsing-remitting multiple sclerosis
• Chronic hepatitis caused by hepatitis B virus
• Chronic hepatitis caused by hepatitis C virus
• Colorectal cancer in people 15 years and older
• Osteosarcoma in people 15 years and older
• epithelial ovarian cancer
• Bladder cancer in people 15 and older
• Surgical treatment of chronic aortic valve disease in people 15 years of age and older
• Bipolar disorder in people 15 and older
• Hypothyroidism in people 15 years and older
• Moderate, severe, and profound hearing loss in people under 4 years of age
• systemic lupus erythematosus
• Surgical treatment of chronic disease of the mitral and tricuspid valves in people 15 years of age and older
• Helicobacter pylori eradication treatment
• Lung cancer in people 15 and older
• Multiple myeloma in people 15 years and older
• Thyroid cancer in people 15 years and older
• Kidney cancer in people 15 and older
• Alzheimer’s disease and other dementias
• Comprehensive Healthcare for Acute Sexual Assault
• SARS cov-2 recovery