The Explicit Guarantees Universal Access Plan (AUGE), also known as the General Explicit Guaranteed Health Guarantee Regime (GES), guarantees coverage for 87 diseases through the National Health Fund (Fonasa) and Social Security Institutions (ISAPRE).
This program was formulated to protect people throughout the health care process, alleviating the associated economic burden.
Although this does not occur in all pathologies, AUGE-GES in some cases provides financial coverage from the moment the disease is suspected, and in some cases includes follow-up after treatment.
Where to check if the disease is included in the HPP
There are currently 87 pathologies covered by GES. These include, among other categories, chronic diseases, mental health disorders, oral health, certain cancers and serious accidents, lung disease, brain disease, and preventive care.
Here are some of the major diseases:
-Chronic terminal renal failure
– Operable congenital heart disease in children under 15 years of age.
-Cervical cancer in people aged 15 years and older.
– Pain management and palliative care for cancer.
– Acute myocardial infarction
– Type I diabetes mellitus
– Type II diabetes mellitus
-Breast cancer in people aged 15 years and older.
– Surgical treatment of scoliosis in children under 15 years of age
-Surgical treatment of cataracts
-Total hip arthroplasty in people aged 65 years and older with osteoarthritis of the hip joint with severe functional limitation.
– Cancer in children under 15 years of age.
-Schizophrenia
– Testicular cancer in people aged 15 years and older.
-Lymphomas in people aged 15 years and older
– Acquired immunodeficiency syndrome HIV/AIDS
– Acute respiratory infections (ARI) in small outpatient settings in children under 5 years of age.
Ambulatory community-acquired pneumonia in persons aged 65 years and older
-Primary or essential arterial hypertension in persons aged 15 years and older.
– Non-refractory epilepsy in people aged 1 to 15 years.
Complex treatment of the oral cavity for children aged 6 years.
-prematurity
Impulse generation and conduction disorders in individuals aged 15 years and older requiring a pacemaker
-Prophylactic cholecystectomy for gallbladder cancer in persons aged 35 to 49 years.
-Stomach cancer
-Prostate cancer in people aged 15 years and older
– Refractive errors in people aged 65 and older.
– Strabismus in children under 9 years of age.
– Diabetic retinopathy
– Non-traumatic rhegmatogenous retinal detachment.
-Hemophilia
-Depression in people aged 15 years and older.
-Technical assistance for people aged 65 and over
-Ischemic cerebrovascular attack in persons aged 15 years and older.
– Surgical treatment of benign prostatic hyperplasia in symptomatic people.
Orthopedic products (or technical devices) for people aged 65 and over.
-Ischemic stroke in persons aged 15 years and older
– Outpatient treatment of chronic obstructive pulmonary disease
– Bronchial and severe asthma in children under 15 years of age.
– Respiratory distress syndrome in the newborn.
-Medical treatment of people aged 55 years and older with mild or moderate osteoarthritis of the hip and/or knee.
– Subarachnoid hemorrhage due to ruptured brain aneurysm.
– Surgical treatment of primary tumors of the central nervous system in persons aged 15 years and older
– Surgical treatment of hernia of the nucleus pulposus of the lumbar
-Leukemia in people aged 15 years and older
-Outpatient dental care
– Comprehensive oral health of people aged 60 years.
– Severe polytrauma.
– Emergency care for craniocerebral trauma of moderate and severe severity.
– Severe eye injury.
– Cystic fibrosis
-Rheumatoid arthritis
Harmful use and dependence on alcohol and drugs in people under 20 years of age
– Childbirth pain relief
-Excellent burn
-Bilateral hearing loss in people aged 65 years and older who require the use of a hearing aid.
To find out if your case is insured under the General Explicit Medical Benefits (GES) regime, you can go to the Minsal website, which is specially prepared for this purpose.
On this site you will find a search engine for 87 pathologies. To use it, you need to enter a keyword to find out the coverage details. For example, in case of depression, at the time of writing, the screen will display the type of coverage you have within the scheme.