anyone use fonasa ?

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paladin
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anyone use fonasa ?

Post by paladin » Sat Feb 17, 2018 4:01 pm

We’ve been with Banmedica since arriving here 20 years ago, and originally it covered 80% of costs, but over the years, to avoid paying more and more in premiums, we’ve opted for lower cover, and now, in general they pay about 30%.
I have heard horror stories in the past about fonasa, but believe now, you can use “libre eleccion”, and see a doctor , I guess of your own choice (?) and get back 40%.
I was thinking that maybe it would be worth moving to fonasa , mainly because the premiums are lower and we’ll get more back.
If , on the other hand, people suggest we stay away from fonasa, maybe we’ll move away from Banmedica and just pay doctors bills ourselves, as our premium works out at around US$4000 a year, which translates to quite a few consultations, exams etc. If we were to need hospitalization, the isapre pays very little anyway.
Does anyone have experience of being with fonasa , as I understand around 80% of the population uses them , so isapres arent as well subscribed to as I thought they were?

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tiagoabner
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Re: anyone use fonasa ?

Post by tiagoabner » Sat Feb 17, 2018 4:33 pm

While I don't have experience with Fonasa, I did a very (read: VERY) extensive research about Isapres when applying last year.

At least at the time I was applying, Cruz Blanca was the only Isapre offering plans that covered up to 90% of ambulatory and doctor visit costs and 100% of emergency and hospitalization. Now, both me and my wife have used their services during the last year and sometimes there are added charges that weren't covered (IE. admin fees, supplies for procedures), but as a rule they offer a pretty decent coverage and they do cover the advertised values most of the time.

We pay CLP $117.000 for the Isapre and two extras: an emergency & hospitalization insurance that bumps the "topes" top coverage amount by 100% and a dental insurance that covers 60% of all dental bills on IntegraMedica. At least for us it was a good deal, and it seems that fellow forum user at46 has also applied for the same plan, based on what I've read at the topic where I originally posted about it.

You can check the fees for the plan here: https://queplan.cl/Isapre-CruzBlanca/pl ... E17/precio

You can also use this same tool to shop for Isapres. I've talked to a couple of Chileans and they pretty much agree that Fonasa can be used if you have no option, but it can be slow if you want/need to do something that is not an emergency, specially if you're in a place that doesn't have good coverage.

Of course, this is all anedoctal reference, but I hope it helps you.
I'm NOT your lawyer, accountant or financial planner. All information at this post should be considered for your entertainment only. Consult a professional before making a decision regarding whatever topic was mentioned in this post.

AHusband
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Re: anyone use fonasa ?

Post by AHusband » Sat Feb 17, 2018 5:44 pm

It worked well for my family. Note that there is actually more bureaucracy for FONASA than for ISAPRE so ISAPRE is actually easier if you make a reasonable salary (in addition to providing more bang for the buck).

jehturner
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Re: anyone use fonasa ?

Post by jehturner » Sat Feb 17, 2018 10:17 pm

I don't have any personal experience with Chilean insurance, but a Chilean colleague with Fonasa had a heart attack just before Christmas. It turned out that his arteries were quite seriously clogged up and he had to stay under observation in intensive care until he could be operated on. He has waited almost 2 months in the local hospital for a triple bypass operation, apparently until a slot finally opened up in Vina del Mar in between Isapre patients last week. I've been told that it takes a few days if you do have the Isapre. Rather eye-opening that the scheduling would depend so little on medical priority...

StrawberryHeartsForever
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Re: anyone use fonasa ?

Post by StrawberryHeartsForever » Sat Feb 17, 2018 10:27 pm

You do realise that you can contest the yearly price hikes of the isapre? When they send you that yearly letter you go to the superintendencia de salud webpage and file a complaint. You upload a copy of your letter within a month of being received and a copy of your cedula. The Isapres can not raise the price of your plan during this time and the customer always wins. You keep your plan for the same price year on year. I contest this every year.

http://www.supersalud.gob.cl/servicios/ ... 10044.html

This is the link above to get started.

Best of luck.

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eeuunikkeiexpat
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Re: anyone use fonasa ?

Post by eeuunikkeiexpat » Sat Feb 17, 2018 11:01 pm

Remember, there are two options available under FONASA if you pay in at the level of a minimum wage worker:

(1) You use the doctors,clinics, hospitals in the public system with virtually full coverage. Yes, there will be waiting lists and sometimes horror stories.
(2) You can choose a particular in the private system for immediate and usually better care but FONASA will only pay roughly 50%.

For persons in good health, who usually want to avoid the allopathic system for most things unless it is a break/fix situation which they excel at and you are viejos culia.. como yo that would find an ISAPRE USA-like expensive, paying the monthly FONASA fee is a bargain.

Highly recommend this option for those who fit into the prior description and want to make sure they have reasonable and especially catastrophic coverage if you get wheeled unconscious into an emergency room (where they know all about your affiliation when they scan your dedo).
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paladin
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Re: anyone use fonasa ?

Post by paladin » Sun Feb 18, 2018 7:51 pm

thanks for your replies. I forgot to mention that we are retired, so naturally, premiums are higher. We arent looking to have a high coverage, but are rather looking at it from the angle that if we are having to pay 30% with an Isapre costing us US$4000 a year, we could be better off by paying say 40% or whatever with fonasa, but with a much lower premium.
Gloria; your example what was what I was getting at. I’ll PM you to ask a little more, if that’s OK?

bow26
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Re: anyone use fonasa ?

Post by bow26 » Mon Feb 19, 2018 4:34 pm

My wife was always in Fonasa until we left Chile because of her extensive medical history making her/our quotations really high. She was always really happy with it and even tried to convince skeptics such as myself and other family members to ditch isapre. Her preference was for using it in conjunction with the Universidad Católica health centres and at least just before we left in 2015 they had stopped accepting Fonasa completely. Just something to look into/consider if it may affect you.

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RocketRichard
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Re: anyone use fonasa ?

Post by RocketRichard » Tue Feb 20, 2018 8:07 pm

I am actually very happy with Fonasa. I had cataracts removed from both eyes this past year with lens replacements at an eye clinic in Viña, and the medical services were very good and it paid for approx 80% as I remember.

jehturner
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Re: anyone use fonasa ?

Post by jehturner » Thu Feb 22, 2018 10:40 pm

paladin wrote:
Sun Feb 18, 2018 7:51 pm
we could be better off by paying say 40% or whatever with fonasa, but with a much lower premium.
On average yes, but two people over a couple of decades can't be sure that their costs will fall close to the average... I tend to see insurance as being useful primarily for catastrophic events that I couldn't manage myself. On average, you could probably 100% self-insure yourself for less than $4000/year, but what if you have to pay 40% of a 40M peso operation (maybe more than one)? Will you be able to manage that? Is there some cap on your 40% contribution? Just saying...

PS. But maybe 30% vs 40% doesn't really make all the difference; both are a bit high for very expensive procedures.

paladin
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Re: anyone use fonasa ?

Post by paladin » Fri Feb 23, 2018 8:08 pm

Today I went to the Superintendencia de Pensiones, for them to calculate what my monthly premium would be. The service there was immediate, and the interesting thing was that I receive a govt pension from both the UK and the US. As Chile hasnt signed a convenio with the UK, they ignore that pension for the purposes of calculating the fonasa premium ( great, but I dont understand the logic). My premium will be around P 40000 a month. My wife, who gets a lower US pension, will pay around P25000, so in total P65000 compared with P200000 with Banmedica. My reimbursement will be higher with fonasa. I noticed that CLC accepts fonasa for exams but not consultas . So I look at it this way- if I want a consulta in CLC ( the most expensive, and I normally go to Tabancura anyway) , I guess I’d pay say P60000, all out of my pocket. With my isapre, they only reimburse me P15000, but apart from the P45000 difference I’d have to pay, I have to pay the annual isapre premium of P2400000 as well ! So all in all, if the isapre is reimbursing a max of 30% of everything, I’d have to have bills totalling P8,000,000 just for me to recover what I’ve already paid them in premiums, and on top of that, I have to pay the remaining 70% of the bills!
If I needed hospitalisation, I’d choose Davila anyway, for a fraction of the cost and they accept fonasa as well. I’ve had very good attention from Davila on various occasions, and dont look to be attended to by the country’s top medical staff anyway. If I were to live in the US or UK, I wouldnt expect to choose their top specialist to attend to me, so why would I feel it important to do that in Chile?
My only problem now, is joining fonasa looks like a pain, as I trotted along to their office in Los Dominicos, but wa# put off by the enormous queue waiting to be attended to. I guess we cant have it all our own way M

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eeuunikkeiexpat
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Re: anyone use fonasa ?

Post by eeuunikkeiexpat » Fri Feb 23, 2018 9:27 pm

Interesting, thanks for the informative post.

I am a non-pension extranjero with no ingresos in Chile who voluntarily wanted to become part of the national healtcare system. So I enrolled at the lowest rate possible (based on whatver the current Chilean minimum wage) that allows for CHOICE in coverage public (virutally full) vs. private systems (usually around 50%).

It was one the easiest tramite I've ever done in Chile and the line minimal (as is characteristic of the regions oustide of Santiasco) but before the Haitian flood.

So currently $19.320 per month paid online via PreviRed.
There are two ways to be fooled.

One is to believe what isn't true;

the other is to refuse to believe what is true.

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