Isapre Prices

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Britkid
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Isapre Prices

Post by Britkid » Sat Apr 06, 2019 4:55 pm

Here are the prices of our Colmena Isapre for the 4 of us. Monthly fees in thousand pesos. Plan Line 6013.

Date -------------- Price
December 2015 ---168
December 2016 ---189
December 2017 ---201
December 2018 ---217
2019 --------------- 231

Do these prices look reasonable?

Each year the price has increased by between 6% and 13%, always way above inflation. The total increase will soon reach about 37% within 4 years.

Do they get customers on low prices and then bump it up? Can you beat these rises by switching suppliers every couple of years? Possibly not by the look of things. http://www.t13.cl/noticia/nacional/vide ... sus-planes suggests all the providers are putting prices up.

Has anyone ever successfully negotiated prices down? I tried this once in 2014-2015 and only "succeeded" in getting the price down by going to a lower value plan. If you can negotiate, how can do this? By phone/ in person/letter? Threatening to leave or actually sending a cancellation letter? Offering to pay the whole year up front? Or are all these ideas just a waste of time?

They always send some wordy letter about how their costs are really increasing. Is that really the case? The letters are always unconvincing to me since they don't really explain why medical costs are going up well above inflation. Is it just another cartel?

Is there any major provider that offers a plan that doesn't cover pharma.cy or simple doctor visits and therefore slashes the costs? Such a plan would probably be more efficient and better value for money. Does it exist?

Are there smaller providers also with good deals and coverage? Who?

Thanks if anyone can provide any insight on any of these points. Hope you are all having a great weekend.

thisisreallycomplicated
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Re: Isapre Prices

Post by thisisreallycomplicated » Sat Apr 06, 2019 5:14 pm

Keep in mind you're getting a year older, with each increase. That probably accounts for part of it.
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tiagoabner
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Re: Isapre Prices

Post by tiagoabner » Sat Apr 06, 2019 5:46 pm

Mandatory disclaimer: I'm not your insurance broker. This comment doesn't constitute insurance advice and it is for your entertainment only. Use a professional insurance broker for professional, customized advice.

There's an online plan comparison tool named "QuePlan", as far as I know, it's the only such tool. I won't link it here, but Google is your friend. Fill your data in it (ages, mostly) and it will cook up the premium for all Isapre plans. This will let you to select the plan that covers what you really care about. I'll be moving back to Chile in a few months and I've used it to select our new plan.

We'll be getting the "Plan Preferente Plus Especial 6800" with Cruz Blanca (Isapre code 2PSPE68218) for roughly $149.000 a month. It has 80% outpatient, 100%-80% inpatient coverage with no maximum for both. The 100% inpatient coverage is for a couple of places only (hence the "Preferente"), but the places they have are good enough. It has reduced pregnancy coverage, but my research shows that the lower premiums are worth it unless we have 3+ kids. Not planning on having any, so we're good to go.

For the record, the one we had up to March last year was the "Plan Vivo 3100" (Isapre code 3V+310E118). It had 100% inpatient cover & 90% outpatient cover, but it had lower "topes". We ended up paying some not-too-high copays during our first run. Nothing too expensive, but we decided to get better coverage this time. This one would go for $102.500 if we signed up for it. [EDIT]: this plan also has reduced pregnancy coverage.

I've decided to go with Cruz Blanca after doing some research on the Isapre web interfaces. I've huddled up with some friends who had Isapre plans already and asked for them to show me what it looked like. I was interested in how the "bono" purchases worked and how responsive the interfaces were. Cruz Blanca wasn't - and still isn't - the cheapest option for us: that would be Banmedica. But I'm happy to pay an extra $20-30 to have an interface that doesn't look like it's straight out of the 90s.

I hope this helps. I'm happy to share if you would like to hear some Cruz Blanca anecdotes.
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.

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41southchile
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Re: Isapre Prices

Post by 41southchile » Sat Apr 06, 2019 5:53 pm

Britkid , Your Colemna price seems right and my experience too with regard to Increases is the same, did you get the email yesterday? Here's all the excuses. I have also heard people fight increases and have had no plan increase in 4 years, does that mean that those that dont challenge it are disportionatly paying more?

Estimado(a) Mathew,

Como es de público conocimiento, la última semana todas las Isapres informaron su política de adecuación de precios para 2019 – 2020. En el caso de Colmena, el alza en el precio será de 6,3%. Este proceso de reajuste, que está contemplado en la ley, es necesario para sostener el aumento anual de los costos de salud y garantizar así la cobertura financiera y los beneficios de todos nuestros asegurados.

¿Por qué Colmena decidió subir el precio de sus planes a pesar de que estos están expresados en UF?

Porque los gastos en salud y licencias médicas en Chile crecieron más que el IPC. De hecho, en promedio, los gastos en UF de los afiliados al sistema Isapre aumentaron 9,4% entre el 2017 y 2018.

¿Por qué suben los costos de salud?

1. Las licencias médicas aumentan en cantidad y costo.

El número de días pagados a causa de licencias médicas creció un 17,1% en 2018. Con esto el número de días de licencia por persona aumentó de 5,1 en 2013, a 6,2 en 2018.

2. La población envejece y, con ello, aumenta el uso de su plan de salud.

El índice de envejecimiento del INE crecerá un 12,1% entre 2018 y 2021. El mayor uso del plan de salud producto del aumento de la expectativa de vida solo puede reflejarse a través de un reajuste.

3. Los centros de salud incrementan sus costos de atención.

El valor promedio por prestación subió de UF 0,66 en 2017 a UF 0,69 en 2018 (esto es, un 4,7%).

4. Surgieron nuevos tratamientos y medicamentos de hasta 1 millón de dólares por paciente.

Algunos de los nuevos tratamientos a financiar tienen costos altísimos y el sistema de salud ha debido soportar sin contrapeso estas coberturas.

5. Las personas van cada vez más al médico y se hacen más exámenes.

Las prestaciones aumentaron de 18,3 a 20,3 desde 2013 a 2018.


En Colmena realizamos permanentes gestiones por contener el incremento en los costos de salud. Sin embargo, este aumento es una realidad que afecta a todo el sistema y que también se presenta en otros países del mundo.

Sabemos que la adecuación de precios es una mala noticia y que sumada a otros problemas estructurales (falta de movilidad, preexistencias, tarificación por edad y sexo, entre otros), genera una preocupante percepción ciudadana sobre el sistema de salud.

Por ello, creemos que es imprescindible y urgente que las autoridades de nuestro país materialicen el envío de una Reforma a la Salud Privada que aborde todas estas problemáticas y establezca una nueva regulación, capaz de satisfacer las necesidades de más 3,4 millones de beneficiarios y asegurar la sostenibilidad financiera de todo el sistema.

Una nueva ley será la única manera de lograr cambios de fondo y en Colmena estaremos siempre disponibles para avanzar en esa tarea.

Atentamente,

Nicolás Donoso
Gerente General Isapre Colmena
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Britkid
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Re: Isapre Prices

Post by Britkid » Sat Apr 06, 2019 11:41 pm

Yeah, I I got that same email. Our charges are going up because our costs are going up. But why are the costs going up? Trends like people going to the doctor more and an aging population won't have a nearly 40% impact over 4 years. I think it's all BS and a smokescreen for increasing profit margins. It smells like a cartel to me. (Not that convinced about this mind you, just a suspicion, but could be.)

I am not sure if these company's profit margins and executive salary compensations and stock options year by year for the last 4 years are publicly available. This can be tricky if you are trying to get the data for one division of a much larger company. I can't be bothered with that wild goose chase but if anyone can, it might have the answer. Maybe.

It needs the media to do an expose on it. So let us know if you see one.

Tiago Abner re 149 and 102.5 - that level of pricing is for 2 adults total I think, right?

In the past, we had executives come out to our house to discuss the options. Is that a mistake? Should we cut our their commissions and look for deals online or direct over the phone or in their offices?

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tiagoabner
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Re: Isapre Prices

Post by tiagoabner » Sun Apr 07, 2019 5:42 am

You're correct: our prices are for two adults.

The executivos are commission salesmen. They work for the insurance companies and they get paid commissions when you sign up for a plan. There's a conflict of interest between you and them.

Online shopping is the way to go, even if 7% of your total combined "Renta imponible" is greater than the plan's premium. Say, if 7% of our income was 200.000 and we chose the 150.000 plan, the difference would generate an "excedente". It would work kind of like a checking account with the Isapre that could be used for medical expenses and <SPAM WORD> payments only.
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.

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fraggle092
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Re: Isapre Prices

Post by fraggle092 » Sun Apr 07, 2019 11:31 am

Interesting and useful discussion. There are also the effects of the legal (not literal) "ambulance chasers" to consider:
.
Screenshot-2019-4-7 Abogados “cazaisapres” ganaron más de $16 mil millones durante 2018, un 31,6% más que en 2017 .png
.
https://ellibero.cl/actualidad/abogados ... e-en-2017/
Après moi, le déluge

Britkid
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Re: Isapre Prices

Post by Britkid » Mon Apr 08, 2019 9:17 pm

I asked a number of Chileans I know and here are some of the things some of them said. I would take them all with a pinch of salt. These are just random people saying things that might be wrong. However, combining bits and pieces from different people you can build up a picture. It does look like the prices are reasonably consistent. I don't think some people are paying 2x for the same service at others at a different company or anything like that.


---One said he used to be with Colmena but they weren't very good and now he is with Consalud which is better. He is paying 186 and there are only 3 of them, but he is on quite a high level plan.

---Someone told me you can negotiate the prices but it's time consuming and hardly worth it. Another said get a lawyer and you can fight it (as referenced above) - doesn't seem worth it though for the cost and expense of a lawyer. Seems a screwy system that you have to go through tramites to fight the price and those who don't just pay more. I wonder if changing supplier might be easier.

---Someone told me that they have been with Vida Tres for a while and not seen price rises.

---Someone told me getting an executive to come to the house is the way to go (I still have my doubts) while another recommended internet pricing.

---Someone told me Ban Medica and Vida Tres own Clinica Santa Maria so are good choices for that (Santiago) clinic.

scandinavian
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Re: Isapre Prices

Post by scandinavian » Tue Apr 09, 2019 1:30 pm

Britkid wrote:
Mon Apr 08, 2019 9:17 pm

---Someone told me you can negotiate the prices but it's time consuming and hardly worth it. Another said get a lawyer and you can fight it (as referenced above) - doesn't seem worth it though for the cost and expense of a lawyer. Seems a screwy system that you have to go through tramites to fight the price and those who don't just pay more. I wonder if changing supplier might be easier.

---Someone told me Ban Medica and Vida Tres own Clinica Santa Maria so are good choices for that (Santiago) clinic.
I haven't tried, but apparently the lawyer will not charge you. They will make their money from the Isapre. Google it and you will find several law firms offering this service.

Banmedica does own Clinica Santa Maria (or the other way around), and yes, having prefential treatment there seems to be a decent deal. Banmedica raised their prices for the first time in several years this year. I am currently considering whether I will try to fight it.

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Space Cat
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Re: Isapre Prices

Post by Space Cat » Tue Apr 09, 2019 3:23 pm

I just learned that I can't refund the difference between the 7% healthcare contribution (charged by SII) and my plan's cost, like 60% of the total payment in my case. ISAPRE is going to keep it in Fondos Mutuos and I’m not allowed to spend it outside of ISAPRE-backed clinics and pharmacies. So even my dentist is not an option.

What a moronic system, I don’t spend a thousand dollars per year on doctors and meds, neither does my wife. If I can’t find a way out, I’ll start buying meds in bulk with this frozen money (“excedentes”) and donating them just to screw whatever scammy scheme they codified into this law.

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tiagoabner
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Re: Isapre Prices

Post by tiagoabner » Wed Apr 10, 2019 9:22 am

Britkid wrote:
Mon Apr 08, 2019 9:17 pm
(Lots of stuff I'll address below)
"I would take them all with a pinch of salt. These are just random people saying things that might be wrong. However, combining bits and pieces from different people you can build up a picture.": I'm sorry, but this is an example of the bandwagon logical fallacy. Just because they have all been doing something a certain way doesn't mean they're correct. Take anecdotes with a truckload of salt.

"It does look like the prices are reasonably consistent. I don't think some people are paying 2x for the same service at others at a different company or anything like that.": Isapre pricing is based on your age. People in the same age group should be paying about the same, assuming they have shopped online.

"One said he used to be with Colmena but they weren't very good and now he is with Consalud which is better. He is paying 186 and there are only 3 of them, but he is on quite a high-level plan.": ask for the plan name and code to verify his claims.

"Someone told me you can negotiate the prices but it's time-consuming and hardly worth it.": insurance prices are based on actuary charts. The plans will at best negotiate a 5%-ish discount, but that will be deducted from the commission that would be paid to whoever is your agent/"ejecutivo". Thus, it's in their best interest to avoid giving out discounts.

"Another said 'get a lawyer and you can fight it'": I'm unfamiliar with this, but from my research, it seems that this may be an option in Chile due to increases above the established rates, or something along these lines. It might be worth pursuing, assuming you can get a lawyer to work on contingency.

"I wonder if changing supplier might be easier.": AKA price shopping, the true and tested way to get better prices. :wink:

"Someone told me that they have been with Vida Tres for a while and not seen price rises.": while this may be correct, past performance doesn't warrant future performance. Just because their prices haven't been adjusted (allegedly), it doesn't mean they won't be in the future.

"Someone told me getting an executive to come to the house is the way to go (I still have my doubts) while another recommended internet pricing.": getting advice from a salesman without knowing the market is Very Bad Advice. The executives are commission salesmen, and they are not fiduciary professionals. It's in their best interest to sell you the most expensive plan that looks like what you asked for. The moment you want to get in touch with an executive is after you have pinpointed a couple of plans that you would like to pursue. This way you can use the knowledge that they presumably have about the plans to pinpoint which one you will purchase.

"Someone told me Ban Medica and Vida Tres own Clinica Santa Maria so are good choices for that (Santiago) clinic.": clinic ownership is indeed a nice bonus. Cruz Blanca owns Integramedica, so things were rather smooth whenever we wanted/needed to be seen at one of their places. It shouldn't be too hard to o some Google-fu to double check on who owns Clinica Santa Maria.
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.

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tiagoabner
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Re: Isapre Prices

Post by tiagoabner » Wed Apr 10, 2019 9:29 am

Space Cat wrote:
Tue Apr 09, 2019 3:23 pm
I just learned that I can't refund the difference between the 7% healthcare contribution (charged by SII) and my plan's cost, like 60% of the total payment in my case. ISAPRE is going to keep it in Fondos Mutuos and I’m not allowed to spend it outside of ISAPRE-backed clinics and pharmacies. So even my dentist is not an option.

What a moronic system, I don’t spend a thousand dollars per year on doctors and meds, neither does my wife. If I can’t find a way out, I’ll start buying meds in bulk with this frozen money (“excedentes”) and donating them just to screw whatever scammy scheme they codified into this law.
I've heard about this, but it didn't affect me because we were on our tax holiday during our first run. Have you checked with them if the <SPAM WORD> use is restricted to meds only, or can you also use it to purchase other non-med items? It might be worth taking a look at it, specially if you live close to one of the pharmacies where you can spend this money.
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.

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