Prepaid health plans are authorized to apply increases freely according to the region

The The Superintendency of Health Services is advancing in the deregulation of medicine prepaid and enabled companies in the sector to freely apply increases in plan fees of coverage in a variable manner according to the conditions of the plan (with or without copayments) and according to the regions or zones in which provide medical care.

This was established through a rule that implements that companies will have the responsibility to inform to the Superintendency of Health Services of these increases, specifying the criteria used for each zone or region, as well as the existence or not of co-payment systems.

In its second article, it is stated that the communication of the adjustments of the quotas must be issued by the entities five days after the publication of the inflation data reported by INDEC and must be done in a clear and prominent manner, detailing the percentage of increase applied and the new value of the monthly fee.

In its article 3, the SSS indicates that the entities They must provide their members with a detailed breakdown of the concepts included in the fees billed monthly, meeting the following requirements:

1. Base cost of the contracted plan

2. Additional costs for specific coverages

3. Adjustments for age or risk factors.

4. Contributions, contributions and/or capita payments received.

5. Taxes and/or fees applied.

He Breakdown must be presented in a clear and understandable mannerusing simple language and avoiding unnecessary technicalities. Any change in the invoiced concepts The affiliate must be notified at least THIRTY (30) days in advance, explaining the reasons for said modification.

Finally, the head of the SSS, Gabriel Gonzalo Oriolo, ruled that failure to comply with these provisions will be considered a serious violation and will be subject to sanctions.

Deregulation of prepaid health insurance prices: what is the objective of this new measure?

According to the Resolution, The objective is to establish andThe “right to adequate and equitable coverage” and highlights the need for the adjustment policy to reflect a difference between entities, avoiding cost disparities between different regions.

“Allow this differentiation in the values ​​of the quotas Depending on the type of plan and the region, this contributes to a more appropriate application of tariff increases,” they explained.

The emphasis is also placed on the efficiency of communication, which takes into account the most up-to-date market indicators “that reflect the prevailing economic reality with the greatest transparency.”

In this sense, they justify that the updating of prices according to the CPI allows them to be carried out taking into account the “real conditions of the market and the economy in general” maintaining a balance between financial sustainability and the users’ ability to pay. In addition, it insists on the need to keep data updated so that users can have a better understanding of the justification behind the changes.