Covid-19, a pre-existing disease for prepaid medicine companies?

September 5, 2021 by archyde

covid coronavirus intensive care hospital

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On the other hand, it is very important to be able to know what the implications of COVID will be in the future for each person and for the health system. For example, we do not know what studies (if any) a person who has had the disease should undergo. Or if you should have regular consultations with medical specialists or if you will require any chronic medication. This generates uncertainty for patients, health professionals and health workers, both public and private.

Altogether, this situation also raises many questions about facts that exceed medicine, such as those related to insurance, coverage and legislation, among other aspects.

In this scenario, and under the argument that it is a pre-existing disease, Is it possible that the companies of prepaid medicine can deny membership to a person who had COVID?

In Argentina, the legislation in relation to the practice of prepaid medicine companies (Law 26.682) provides for these cases, understanding that pre-existing diseases cannot be criteria for refusal of admission, as long as they are declared by means of an affidavit. That is, regardless of their health situation, a person who wishes to hire these services must be admitted.

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Covid-19, a pre-existing disease for prepaid medicine companies?

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In case of doubts or complaints, there is the Superintendency of Health Services, a state entity that regulates and controls national social works and prepaid medicine entities, providing information and advice, in order to guarantee the exercise of users’ rights. in relation to health benefits. It is important to mention that this The body has the power to authorize, at the request of the prepaid, differential values ​​for the treatment of pre-existing diseases, in accordance with the expense that the treatment of the patient is expected to entail given the services that his clinical condition may require.

In conclusion, prepaid companies cannot deny admission to patients who have had COVID. At present, due to little knowledge about the disease, a history of COVID infection is not in itself a pre-existing condition. Then, the application of a differential value in the fee for this service is not justified, since the need for medical benefits, foreseeable and calculable in terms of expenditure, that may be required has not yet been quantified.

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Natasha Kumar

By Natasha Kumar

Natasha Kumar has been a reporter on the news desk since 2018. Before that she wrote about young adolescence and family dynamics for Styles and was the legal affairs correspondent for the Metro desk. Before joining The Times Hub, Natasha Kumar worked as a staff writer at the Village Voice and a freelancer for Newsday, The Wall Street Journal, GQ and Mirabella. To get in touch, contact me through my