In the last few hours, a process of adjustment, deregulation and review of all areas of public administration has been launched. One is the health sector, where the closing of a group of prepaid health insurance companies at the same time is being considered, and social security agencies will also be intervened.
Added to this and due to high inflation, prepaid health plans are already announcing new increases for September, which has a great impact on users.
What is happening with prepaid health insurance companies is that, following audits, SSSALUD detected a group of medical companies that registered in the National Registry of Prepaid Health Insurance Entities (RNEMP), but did not submit important documentation such as the user registry, coverage plans, rate tables, financial statements or balance sheets.
All of this constitutes a serious offence which may result in your registration with the RNEMP being cancelled.
Apparently, 60 prepaid health insurance companies will be removed from the registry in the next few days and the situation of another 70 is being studied. There are around 180 in the pipeline.
The goal is to ensure that registered prepaid health insurance companies comply with the documentation they have to submit and do not fail to provide the health services they are required to provide. For this reason, the SSSALUD has significantly increased the fines that can be imposed on Health Agents who commit minor, moderate or serious violations.
For its part, the Ministry of Health, through the Superintendency of Health Services, updated the procedures for fines to social works and prepaid health insurance companies that turned a deaf ear to the complaints of their members.
What happens with prepaid health plans that don’t lower their fees?
On the other hand, the updates to the prepaid rates are above the inflation of July, which was 4%. Thus, health plans will have an increase between 4.5 and 8%, according to the company during the ninth month of 2024.
Since July, health insurance companies can once again freely set increases in premiums and co-insurance.
In this way, private medical firms will apply the third increase in the values of their plans after the legal dispute that prevented increases above the price index.
Health specialist lawyer and Director of COINSALUD
Source: Ambito
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