Obra social vs prepaga

[Delaluz26]

Hi all, been in the country for just over a month and finally starting to feel at home and ready to tackle the health care system questions. I am curious what you recommend for my family and I. We plan to live in the country for years to come and both run our own companies in the US (we are sole employees of our corporations). It is possible my husband who works as a life coach will be establishing himself as a mono-tributista in Argentina so that he can pay into the system and see clients here etc.

My husband 46 (he's Argentine), our 11-year-child, and myself 42 who are all healthy and generally only go to annual doctor's checkups if that (always for our daughter but we often don't go ourselves. We tend towards holistic health and dental care as my husband studied Chinese medicine etc. So given that we likely will be using the healthcare system mostly for emergencies but also want to have access potentially if I succeed in getting pregnant with a 2nd baby now that our rhythm of life has slowed. What are you recs? (We are in Entre Rios not BA in case that makes a difference).

My husband's cousin sells insurance but before we commit to anything thought I'd check in with you all and in English

Thanks so much in advance for your wise counsel!

 

[HenryNisental]

Either Swiss Medical or Hospital Italiano.

 

[dsp27]

Either Swiss Medical or Hospital Italiano.

They don’t live in BA. Neither is a good option imo for Entre Rios.

 

[Delaluz26]

They don’t live in BA. Neither is a good option imo for Entre Rios.

IS that because they are both good in BA? Do you know one for Entre Rios?

 

[steveinbsas]

IS that because they are both good in BA? Do you know one for Entre Rios?

I asked my friend Patricia (who has been in the insurance business in CABA for over ten years). She said some obra social programs are Ok and some are horrible.

Within the past hour she asked a friend in Parana which prepaid program she would suggest.

Her friend told her Swiss Medical is "the best one."

 

[Delaluz26]

Thanks Steve! I guess my original question though was more about what the difference is between prepaid or obra social? Are they the same?
And is there anything I could compare it to in the states?

 

[steveinbsas]

Thanks Steve! I guess my original question though was more about what the difference is between prepaid or obra social? Are they the same?
And is there anything I could compare it to in the states?

If I understand correctly, an obra social is provided by the employer but I have no details about any of them and the prepaid are provided by private "all in one" providers who, generally have their own facilities, but that doesn´t mean you have to use only their doctors or their facilities (depending on the "level" of your plan).

At first I had Omint in Palermo and always went to the Hospital del Sol. I later switched to Medicus and always went to their facitlities in Recoleta and then in Belgrano after I moved to Nuñez.

After I moved to Punta Alta in 2010 I got a list of doctors who accepted Medicus and they all provided services at one small clinic (where I could also get ultra sound and vision exams). I had to keep the most expensive level of Medicus to see these doctors.

In about 2012, after one of the doctors told me I could see him for a consultation as well as many other specialists at no charge at the local public hospital and also get xrays, blood tests, hearing, vision, ultra sound exams, vaccinations (and more) there at very reasonable fees (not free), I dropped Medicus.

Since then I have had a number of exams and tests and four minor surgeries at the public hospital (which is more than adequate) and the staff is wonderful. As I indicated, there is no charge for the consultations or the surgeries, Noentheless, due to my modest income, I have to go to a pharmacy to purchase medications, but I am not complainingin the least about that.

 

[MilHojas]

... my original question though was more about what the difference is between prepaid or obra social? Are they the same?

Obras sociales: Todo lo que querés saber y nadie te ha contado

¿Sabés que son las obras sociales y para qué sirven? ¿Conocés cuáles son las mejores obras sociales y prepagas? ¿Qué servicios te debe prestar? Aprendé más aquí.

amparandosalud.com.ar

 

[steveinbsas]

I guess my original question though was more about what the difference is between prepaid or obra social? Are they the same?

Obras sociales: Todo lo que querés saber y nadie te ha contado

¿Sabés que son las obras sociales y para qué sirven? ¿Conocés cuáles son las mejores obras sociales y prepagas? ¿Qué servicios te debe prestar? Aprendé más aquí.

amparandosalud.com.ar

There are 292 obras sociales in Argentina with 25 million enrolled.

It looks like the major difference is:

To enroll in an obra social you have to be employed in Argentina.

To enroll in a plan pregada all you have to do is pay the premiums.

According to the article provided by MillHojas:

"Hay una distinción fundamental.

Mientras las prepagas funcionan como empresas privadas de asistencia de salud para clientes a través de una modalidad de asociación voluntaria abonan cuotas personales proporcionales al volumen de servicios que reciben, las obras sociales, cuya asociación es obligatoria, tienen por ley una constitución solidaria y una equidad en la distribución de las prestaciones.

La obra social es distinta de una prepaga y esto radica en que la obra social depende del estado o de un sindicato para su operación, mientras que la prepaga es una empresa privada que presta el servicio de salud y están reguladas por la ley 26.682 Marco Regulatorio de la Medicina Prepaga y la ley comercial.

Prestan mayores servicios que una obra social, pero con mayor costo."

GOOGLE TRANSLATE

"There is a fundamental distinction.

While prepaid companies function as private health care companies for clients through a modality of voluntary association, they pay personal fees proportional to the volume of services they receive, the social works, whose association is mandatory, have by law a solidarity and equity constitution. in the distribution of benefits.

The social work is different from a prepaid and this is because the social work depends on the state or a union for its operation, while the prepaid is a private company that provides the health service and is regulated by Law 26,682 Regulatory Framework of Prepaid Medicine and commercial law.

They provide greater services than a social work, but at a higher cost."


As Patricia told me earlier this afternoon, some obra sociales are good and some are horrible.

I imagine it would be best to ask anyone who is actually enrolled in one what their experinces have been.

 

[Delaluz26]

Thanks! I had read articles like that before, but wanted more clarity from expats who have dealt with US medical system too.
As we've always been self-employed and had to buy health insurance out of pocket, I was wondering what the equivalent system is here, and I assume it's way better here as healthcare from what I've observed here is way more human and humane!
So I guess we could have an obra social and a prepaga? I guess I'm not clear on the benefits of obra social if I can just pay for a prepaga? Especially given I'm not planning to use it much