CNSS increases ambulatory medication coverage of family health insurance by 50%

Santo Domingo.- National Social Security Board (CNSS), approved this Thursday increasing outpatient drug coverage passing from RD 8,000.00 to 12,000.00 RDper annum, for the benefit of members Family health insurance (PZP) of the contribution regime, what does it contribute to? reduce expenses pocket of population.

At the regular meeting of the governing body of the Dominican Social Security System (SDSS) Resolution No. 581-03which also includes 70 new procedures, taking into account that these health services represent the greatest demand for care requested by members.

The CNSS gives the instruction Directorate General of Information and Defense Associates (DIDA) and the Superintendency of Health and Occupational Risks (Sisalril) to make the population aware of the new benefits and asks pro-consumers to remain vigilant, prevent drug prices from rising and this translates into spending that impacts the population associated with Family Health Insurance (SFS).

With the consensus of the sectors that make up the CNSS, solutions include biopsies and new approacheswhich will reduce surgical complications, prolong hospital stay and guarantee a greater accuracy in concluding with a diagnosis.

This resolution included the modification and organization of the list of coverages described in the basic health plan. streamlining the availability of healthcare servicesto avoid denial of coverage, slow response, and unreasonable charges to the associate population.

The resolution provides for the reorganization of vaccine coverage accordingly Expanded immunization program, which must be granted and 100% coverage guaranteed, no deductibles. Health Risk Managers (HRMs) must pay to branches of the Contribution Scheme, expenses spent on new benefits included.

─îNSS approved the increase of the monthly family health insurance (SPZ) of the contribution regime (RC) from RD 128.08 charged to the public health care account, from RD 1,555. 14 to RD 1,683.22effective coverage November 2023. It does not affect members’ pockets.

In the case of additional dependents, the increase will be reflected in the payment notices Social security cashier of January 2024, for coverage from February 2024.

The resolution was approved after receiving the submitted proposals Superintendence for Health and Occupational Risks (Sisalril) before National Social Security Board (CNSS), with new benefits to be incorporated into PBS/PDSS benefits catalog.

This resolution directs Sisalril to conduct an appropriate study to include these coverages in the subsidized scheme for those Pensioners and pension plans, and submit a report to the CNSS.

It is recalled that from 2020 until today, the CNSS has issued a number of resolutions which improved and expanded the catalog of health services. Medical coverage was included in cases of kidney transplantation, breast reconstruction due to cancer, preventive prophylactic mastectomy and the development of measures to reduce maternal and newborn mortality.

It was also approved reduce by 50% participation in Family Health Insurance (PSP) of the Contribution Scheme in the services of hospitalization, caesarean sections, operations, kidney transplants and other financially demanding diseases.

Expanded coverage of high-cost drugs related to breast cancer treatment RD 1,000,000.00 to 2,090,000.00 RD. Coverage of hospitalizations, medical fees and consultations during hospitalization, diagnostic examinations, hospitalization, as well as the use of rooms and equipment, among other health services, has increased.

It increased a 40% medical fees related to procedures aa fifty % during hospitalization consultations aa 7% for examination and diagnostic test fees. Also a fifteen % for use of rooms, equipment and use of rooms in clinics and hospitals.

Leave a Reply

Your email address will not be published. Required fields are marked *