The Government ordered enable prepaid and social insurance companies to freely set coinsurance prices, which were currently stipulated by the Superintendency of Health Services (SSS), through Resolution 1926/2024, published this Monday in the Official Gazette.
The regulations determined to leave “without effect the current tariffs for coinsurance established for the medical-care benefits contemplated in the Mandatory Medical Program (PMO) and its complementary regulations, which are not exempt according to the current regulatory framework; those who They may be freely set by the entities.”.
The official document argued that the decision is linked “with the objective of guaranteeing greater competitiveness and transparency in the Health Subsystem, ensuring at the same time that users clearly know which services may require an additional cost.”
In this way, Health Insurance Agents and prepaid medicine entities “will be able to freely set the coinsurance values of the different medical benefits included,” which “will allow more and better offers for beneficiaries,” according to the Executive. .
In that sense, he pointed out that The new regulations do not affect the public system and assured that “these changes promote free competition among the Agents of the Health Insurance System and allow beneficiaries to choose more freely.”
Prepaid and social works set their coinsurance: what are the exceptions
Measure impacts all medical benefits except those that were already exceptedWhat are they:
– those linked to oncological treatments,
– disability,
– maternal and child plan,
– those provided for in the regulations for the treatment of Hepatitis, HIV and communicable
– those included in the National Transplant Protection System.
Likewise, the resolution provides that the values of the coinsurance associated with each medical benefit must “be duly and reliably informed to the beneficiaries 30 days in advance and, in addition, they will be published on the website of the Superintendency of Health Services.”
The decision represents a new deregulation of the health sector, which with the beginning of Javier Milei’s administration had liberated prices in prepaid medicine installments and which, after the excessive increases, required a precautionary measure to limit the scope of the increases. However, it became void after the agreement with the companies on a reimbursement plan, so adjustments were once again allowed without restrictions.
In this regard, in the recitals of the resolution It was recalled that DNU 70/2023 “promoted the release of restrictions on values of the fees of the health plans of the prepaid medicine subsystem to increase the competitiveness of the Health Subsystem” and clarified that the liberation in the price of co-payments also responds to the aforementioned decree.
