The health insurance company claims that this announcement will allow more than 5,300,000 members to continue with their medical treatments.
He Comprehensive Health Care Program (PAMI)ratified the continuity of its drug programs, which include Discounts up to 100%guaranteeing a full coverage of oncological treatments and chronic treatments of prevalent diseases, as well as special treatments that require sustained attention, such as cardiovascular, oncological, diabetes, HIV, hemophilia, transplants and hepatitis.
This announcement allows More than 5,300,000 members can continue with their medical treatmentssince most people have access to 5 free medications per month that are included in the PAMI Vademecum. From the social work, They highlighted that it is the only one that offers coverage of this nature in the country.
PAMI added: ”Those active ingredients that do not have 100% coverage are applied a differential sales price known as PAMI Pricewhich allows the Institute’s members to purchase their medicines at a price that is on average 30% below the price that members of other social works have access to. Regarding this price, PAMI members receive discounts ranging from 40% to 80%”.
This way, They modified the requirement to apply for the social subsidywhich covers 100% of the medicines for a small group of people who cannot afford their treatment and who are in a situation of economic vulnerability. That is, for those people who have to pay a co-payment and still cannot afford that cost.
They also made a change in the coverage of some medicines included in the PAMI Vademecum, such as those that are not a priority for curing long-term illnesses. In this way, some antibiotics, antiparasitics, corticosteroids, ibuprofen and omeprazole, They went from having a coverage of 40% to 70% on the final price.
”To obtain the medicines, the affiliated person only needs to ask his or her primary care physician to send the electronic prescription to the pharmacy. Then, the same affiliate or someone he trusts They can withdraw the medicines with the beneficiary’s ID and their PAMI credential”, they revealed from the institute.
PAMI: who can apply for the social subsidy
These are the requirements for those members who cannot pay the cost of the medicine with the usual discount to access the social subsidy offered by PAMI:
- Have an income less than or equal to 1.5 minimum pension payments. For households that have a cohabitant with a Unique Disability Certificate (CUD), the total monthly income must be less than 3 pension payments.
- Not to own more than one property, nor to possess a car less than 15 years old, aircraft or luxury boats.
- Not being affiliated with a pre-paid medical system
- Not being the owner of corporate assets that demonstrate full economic capacity.
If the affiliated person does not meet the requirements to access the social subsidy, but spends 15% or more of their income on medicines, they can request the exception for special situations; where they will be asked for a social and medical report. For more information, members can go to https://www.pami.org.ar/tramite/medicamentos-razones-sociales.
The new management of the organization aims to achieve efficient and planned management of resources. That is why it was decided to prioritize investment in the most severe pathologies, prioritizing coverage of chronic and oncological medications over those for mild treatments, such as antacids, analgesics or vitamin supplements.
Source: Ambito
