June 23 2024 – 17:00 hrs.
The National Health Fund (Fonasa) corresponds to the public health insurance system and can be joined by workers, whether dependent or independent, as well as retirees and people without resources.
People who are affiliated with Fonasa can access a series of benefits ranging from health plan coverage to discounts on the purchase of medications at some pharmacies.
All about Fonasa
Benefits for Fonasa members
Zero Copay
Fonasa affiliates of all its sections, whether A, B, C or D, have free medical care that are carried out in the public health system.
The Zero Copay is activated automatically for all contributors, so it is not necessary to apply or request it.
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This benefit includes care in the public health network (Institutional Care Modality). Thus, the procedures of the Payment Associated with Diagnosis (PAD) and the people who are hospitalized in a pension correspond to the Free Choice Modality (MLE), therefore, they are not part of this announcement. For more information, check here.
AUGE-GES
He Universal Access Plan to Explicit Guarantees (AUGE)also known as the General Regime of Explicit Guarantees in Health (GES)provides coverage for 87 pathologies (learn about them here) through Fonasa or Isapre.
With the AUGE, Fonasa members and their charges can ensure care from suspicion or diagnostic confirmation, to treatment and subsequent follow-up or rehabilitation, depending on each health problem.
PAD bonus
He Bonus Payment Associated with Diagnosis (PAD) It is a benefit that allows members and their family members to access different benefit packages and health care, paying a fixed and known pricewhich applies to different surgical interventions or procedures.
The PAD Bonus can be accessed by those enrolled in sections B, C or D and covers complete care for the procedure. To learn about PAD diseases and their respective charges, go here.
Return of surpluses
Every year Fonasa carries out the massive refund of overpaid health contributions to their respective affiliates.
These monies arise when workers paid contributions above the monthly legal tax limit; or when employers (companies) mistakenly made a double identical payment.
The last refund period for contributions paid in excess ran until April 2024.
Discounts on medications
Those who are affiliated with Fonasa can have discounts on more than 6,900 medications. The reduction is obtained thanks to a direct agreement between the public health insurance agency and pharmacy chains established throughout the country.
Discounts are granted automatically for affiliates. To find out which pharmacies are participating in the discount, go to the Medication Finder in agreement.
Ricarte Soto Law
The Ricarte Soto Law allows access to a financial protection system that guarantees the diagnosis and treatment of 27 high-cost diseases.
The initiative covers 100% of the value of medicines, medical devices or food, which are expressly guaranteed for each defined health problem, according to the decree that establishes them.
This law is aimed at the beneficiaries of all Chilean health pension systems (Fonasa, ISAPRE, Dipreca or Capredena), regardless of their economic situation.
Economic protection
Fonasa also has a series of economic benefits whose purpose is to protect the financial stability of its members, such as medical leaves and work disability benefits; medical loans; and payment forgiveness. Details here.
Emergency Law
The benefit of Emergency Law provides immediate medical assistance at the nearest Emergency Service, whether public or private, in case of facing an emergency. emergency with risk of death or serious functional sequelae.
This law applies regardless of the person’s economic situation or if they are a beneficiary of Fonasa. In the event of an emergency, no health establishment can make medical care conditional on the signing of a guarantee document.
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