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Explicit health guarantees in Chile: the AUGE benefit plan - P4H Network

Explicit health guarantees in Chile: the AUGE benefit plan

The Universal Access with Explicit Guarantees (AUGE) benefit plan initially defined a basic plan for social health insurance in 2006, consisting of guaranteed and explicit treatments for 56 priority health conditions. In 2010, it was expanded to 69 and subsequently expanded to 80 covered health conditions. AUGE not only guarantees treatments, but also limits the maximum waiting time and the amount of money the patient pays for a treatment. Coverage for services that are not included in the AUGE benefit plan is not guaranteed by the National Health Fund, which is the public insurer that invests more than half of its budget in financing services not covered by AUGE. The Social Security Health Institutions provide additional coverage to that included in the AUGE, but this varies from beneficiary to beneficiary, depending on their contribution and the health plan they purchase.

Reference
07 Jan 2013