Learn how GES works in Chile and whether joining Isapre will affect your access to these valuable health care benefits.
go through Javiera Lopez Godoy
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