Obra social vs prepaga

[Rich One]

If
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

If you will be self employed you only need a Prepaga which you will pay out of pocket. Your husband with a DNI as an Argie citizen can buy into any prepaga.
However since you are in Entre Rios, must determine the best prepaga plan for your family and the best service provider in your city. A plan that includes dental care, etc. Since you are fairly young the cost may be reasonable for Swiss Medical.

 

[ventanilla]

There are very good obras sociales, private healthcare is better overall not in quality of actual care but rather in customer service and wait times. It's up to you if paying extra to see a doctor a few days earlier or to have to talk to fewer people to make an appointment is worth the extra money. There is more bureaucratic annoyances to deal with with obras sociales but in general they are still far superior to the US system, though less convenient than private healthcare here.

 

[lunar]

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 prepaga?

These are two different forms of health insurance providers. Obra social is socially-oriented and state-sponsored/subsidized. Prepaga is a privately owned health organization.

I believe, when you sign up for monotributo, you can select an obra social. The choice is limited, and it is not first tier companies, but you can select something like OSECAC. And many local people use it as a primary (and the only) health insurance.

You would probably be better by getting an insurance plan from a company of your choice. (Especially if you care about the results . You can go with either obra social or prepaga, there is usually no reason to have both. OSDE is good and it is an obra social. Swiss Medical is good and it is a prepaga. You need to figure out what is available locally and whether they would want to sign you directly (not through an employer).

 

[FrankPintor]

If you have a local employer, you will most likely be assigned an obra social (I don't know what the criteria for that are), with no input from you, nor any communication from the obra social, the money just gets discounted from your salary.

The good thing is, you can decide what insurance cover you really want, change to a new obra social or prepaga (e.g. OSDE), and switch your contributions to that company, and top up to the insurance cover you want.

You need a notarized declaration to do this, but larger companies keep tame notaries in some of their offices so it shouldn't be too inconvenient.

 

[dilmah]

is it mandatory for a monotributista to enroll into some kind of obra (either social or prepaga)?

 

[Brian_is_here]

I live in Entre Rios and have Swiss. We pay a bit of a premium for it.

The problem: The hospitals and clinicas in provincia are all the same. It doesn't matter if you're on a premo plan with Swiss or Italiano or whatnot. If you need emergency care (or dental work) you go to the same place.

That being said... if you have planned medical expenses, you're going to Buenos Aires anyways. My second son was born in Arcos. I had hernia surgery in Arcos. It is top rate. I recommend it.

Of what we use, we do the basics in Entre Rios (Concepcion/Gualeguaychu if its a bit of a specialist) but then we go to Buenos Aires for anything important. The hospitals are modern (and clean) and the training is what you'd expect.

If I was budget conscious (and we weren't considering another baby) i'd consider changing prepaga to something less expensive. (or use my wife's obra social). But I'm honest, Arcos was probably better and cheaper to have a baby in than any comparable facility in the US. No shared rooms, dedicated midwife, dedicated ob, clean and professional. Good english.

As it stands, we mostly use swiss for glasses/dentist and whatever medical stuff we plan to do in buenos aires. which means we probably overpay for the services we get. also like most insurance, you can be covered now.. but as you get older they may set a high premium to start covering you as you're old. if you start now, you should be locked into their program.

 

[Bajo_cero2]

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.

No.
The Obra Social is provided by the Union. When you enroll to Monotributo you can choose anyone you want.
33% of monotributo is for this semi public health insurance.
If you are over 40’ you are going to start using it a lot more than you think so.
The Obra Social is very cheap but if you can afford it, go for the private system.
Beware that in Argentina there is no limit on the cover.

 

[Bajo_cero2]

is it mandatory for a monotributista to enroll into some kind of obra (either social or prepaga)?

It is. But only the Obra Social is available. But you can deduct the money you pay to the prepaga.

 

[ventanilla]

I recently got Luis Pasteur obra social and it's pretty solid. Appointments with good doctors and specialists always available within a week and I haven't had to pay a cent beyond the monotributo contribution yet.

 

[Silvie]

Obras sociales are horrible, try to avoid them always if possible and go for the better prepaid medical coverage as long as you can.