Private Health Insurance 2019

gracielle

Member
I'd recommend this site instead/as well: https://www.miobrasocial.com.ar They have quite a lot of info.
Have also been looking into OSDEPYM health insurance. They cover empresarios, profesionales and monotributistas.
Ambito just published a short about them today actually: https://www.ambito.com/osdepym-aumento-un-76-la-venta-los-planes-superadores-n5053465
That insurance is a disgrace, and the article you cite is a sponsored commercial. Be careful.
7 August 2019
 

Stantucker

Registered
6 April 2019

6 September 2019
......So far this year, the prepaid received authorization to increase their fees five times : 5% in February, 7.5% in March, 5.5% in July, 6% in August and 6% in September.
That insurance is a disgrace, and the article you cite is a sponsored commercial. Be careful.
Gracias, Gracielle and Nikad.

A a lawyer gave me the following:

Ley 26.682 de Medicina Prepaga
Artículo 12- Personas mayores de 65 años. En el caso de las personas mayores de sesenta y cinco años, la Autoridad de Aplicación debe definir los porcentajes de aumento de costos según riesgo para los distintos rangos etarios.

A los usuarios mayores a sesenta y cinco años que tengan una antigüedad mayor a diez años en uno de los sujetos comprendidos en el artículo 1 de la presente ley, no se les puede aplicar el aumento en razón de su edad.

This seems to indicate that they can increase the rates at 65. I am going to go to the Superintendencia de Salud because they did the increase at 64, not 65. I guess I have to make an official reclamo at Accord Salud first before going to the Superintendencia, right? We went and talked with them but did not make the reclamo.
 

nikad

Registered
Gracias, Gracielle and Nikad.

A a lawyer gave me the following:

Ley 26.682 de Medicina Prepaga
Artículo 12- Personas mayores de 65 años. En el caso de las personas mayores de sesenta y cinco años, la Autoridad de Aplicación debe definir los porcentajes de aumento de costos según riesgo para los distintos rangos etarios.

A los usuarios mayores a sesenta y cinco años que tengan una antigüedad mayor a diez años en uno de los sujetos comprendidos en el artículo 1 de la presente ley, no se les puede aplicar el aumento en razón de su edad.

This seems to indicate that they can increase the rates at 65. I am going to go to the Superintendencia de Salud because they did the increase at 64, not 65. I guess I have to make an official reclamo at Accord Salud first before going to the Superintendencia, right? We went and talked with them but did not make the reclamo.
No, because usually they refuse to take your complaint or give you anything in written.

Do try to get a copy of your original contract with them though.

You simply go to Superintendencia and talk about your situation take the invoices from before the illegal increase and after. If they take your formal complaint, keep paying as usual and wait for them to notify the insurance, etc. The whole ordeal took about 12 months for us, I followed up from home and online. Once I got a ruling in our favor, they sent it to me in written and the insurance had to reimburse and make all the adjustments to the billing, etc.
 

London2Baires

Registered
7 August 2019
Thanks for that. I'll look into your critique.

Who is urgente24.com? I've never heard of them and can't find any details on their owners/funding/bias etc. Not saying I don't trust them, necessarily.

The miobrasocial site ranks based on the evaluations of a large number of service users. Osdepyme , according to them, is very well rated in terms of service recieved and price. I read through 40+ comments from service users and they mostly seemed positive. Sure that's not scientific obviously, but it's an indicator.

They do seem to have a fair amount of complaints relating to not paying out their doctors on time, that seems an accurate critique, though Its also a known issue even with the big boys like osde, so not sure how unique/widescale the problem is and whether it should worry a potential client rather than a 'prestador de servicios'


Will keep researching,

Cheers!
 

London2Baires

Registered
No, because usually they refuse to take your complaint or give you anything in written. You simply go to Superintendencia and talk about your situation take the invoices from before the illegal increase and after. If they take your formal complaint, keep paying as usual and wait for them to notify the insurance, etc. The whole ordeal took about 12 months for us, I followed up from home and online. Once I got a ruling in our favor, they sent it to me in written and the insurance had to reimburse and make all the adjustments to the billing, etc.
I'm curious, did they return the peso amount corrected for inflation? I assume not and that in 12 months you took a big hit in real terms?
 

nikad

Registered
I'm curious, did they return the peso amount corrected for inflation? I assume not and that in 12 months you took a big hit in real terms?
They do not correct for inflation. It was in 2017 so the hit was lighter. In the end it was not just about the money but more about not letting them impose an illegal increase on us. For every one complaint I am sure they have hundreds that simply pay and that is how they make quite a bit of extra $$$.
 

Stantucker

Registered
No, because usually they refuse to take your complaint or give you anything in written.

Do try to get a copy of your original contract with them though.

You simply go to Superintendencia and talk about your situation take the invoices from before the illegal increase and after. If they take your formal complaint, keep paying as usual and wait for them to notify the insurance, etc. The whole ordeal took about 12 months for us, I followed up from home and online. Once I got a ruling in our favor, they sent it to me in written and the insurance had to reimburse and make all the adjustments to the billing, etc.
Thanks. I asked about going to lodge a formal complaint with our insurer first, because when Edesur increased our rate by 400 dollars (because apparently they hadn't been reading our meter for years???, Just estimating), the regulatory agency told us they would take our complaint only after we had already lodged one with Edesur. Not only did we get a credit for the increase, but then the boludos gave us another one when it was officially resolved, something I still don't understand. It does pay to fight back.
 

gracielle

Member
Thanks for that. I'll look into your critique.

Who is urgente24.com? I've never heard of them and can't find any details on their owners/funding/bias etc. Not saying I don't trust them, necessarily.

The miobrasocial site ranks based on the evaluations of a large number of service users. Osdepyme , according to them, is very well rated in terms of service recieved and price. I read through 40+ comments from service users and they mostly seemed positive. Sure that's not scientific obviously, but it's an indicator.

They do seem to have a fair amount of complaints relating to not paying out their doctors on time, that seems an accurate critique, though Its also a known issue even with the big boys like osde, so not sure how unique/widescale the problem is and whether it should worry a potential client rather than a 'prestador de servicios'


Will keep researching,

Cheers!
You may consider adding this article to your research of Osdepyme.

12 May 2019
Before the serious denunciations of embezzlement of funds, they raided the facilities of the corporate social work that has José Bereciartúa as auditor, assigned to the position by the President.....
.... Among these complaints, he is accused of hiring press and dissemination services on behalf of OSDEPYM, Patricia Alba Souto, treasurer of Plan D-Regional Business Chamber of the Northern Zone and wife of the auditor Bereciartúa and the purchase directly and without intervention of the usual administrative areas of air tickets and tourist services to “Somos Mundo.com” of the Central de Turismo SA, a company of which Berreciartúa is part and also the president is Pedro Ignacio Bereciartúa.
Source: codigobaires
 

London2Baires

Registered
You may consider adding this article to your research of Osdepyme.

12 May 2019
Before the serious denunciations of embezzlement of funds, they raided the facilities of the corporate social work that has José Bereciartúa as auditor, assigned to the position by the President.....
.... Among these complaints, he is accused of hiring press and dissemination services on behalf of OSDEPYM, Patricia Alba Souto, treasurer of Plan D-Regional Business Chamber of the Northern Zone and wife of the auditor Bereciartúa and the purchase directly and without intervention of the usual administrative areas of air tickets and tourist services to “Somos Mundo.com” of the Central de Turismo SA, a company of which Berreciartúa is part and also the president is Pedro Ignacio Bereciartúa.
Source: codigobaires
Reads like a telenovela, very interesting, thanks for sharing!
 
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