What conditions are covered by GES and how does the benefit work?

Explicit Health Guarantees (GES) they care about provide coverage for various diseases through National Health Fund (Fonas) and social security institutions (ISAPRE).

What diseases does GES cover?

Are 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.

All diseases covered by GES:

  • 1. Chronic kidney disease stages 4 and 5.
  • 2. Operable congenital heart disease in persons under 15 years of age.
  • 3. Cervical cancer in people aged 15 years and older.
  • 4. Cancer pain relief and palliative care
  • 5. Acute myocardial infarction.
  • 6. Type 1 diabetes.
  • 7. Diabetes mellitus type 2.
  • 8. Breast cancer in people aged 15 and over
  • 9. Spinal dysraphia
  • 10. Surgical treatment of scoliosis in persons under 25 years of age.
  • 11. Surgical treatment of cataract.
  • 12. Total hip arthroplasty in persons aged 65 years and older with osteoarthritis of the hip joint with severe functional limitation.
  • 13. Cleft lip and palate.
  • 14. Cancer in people under 15 years of age.
  • 15. Schizophrenia.
  • 16. Testicular cancer in people aged 15 years and older.
  • 17. Lymphomas in people 15 years and older
  • 18. HIV/AIDS, acquired immunodeficiency syndrome.
  • 19. Acute respiratory infection (anger) for outpatient treatment of persons under 5 years of age.
  • 20. Community-acquired pneumonia in outpatient treatment in persons 65 years of age and older.
  • 21. Primary or essential arterial hypertension in persons aged 15 years and older.
  • 22. Non-refractory epilepsy in persons from 1 year to 15 years of age.
  • 23. Comprehensive oral treatment for 6-year-old boys and girls.
  • 24. Prevention of preterm birth
  • 25. Violations of impulse generation and conduction in persons aged 15 years and older who need pacemakers.
  • 26. Prophylactic cholecystectomy for gallbladder cancer in persons aged 35 to 49 years.
  • 27. Stomach cancer
  • 28. Prostate cancer in people 15 years and older.
  • 29. Anomalies of refraction in people over 65 years of age.
  • 30. Strabismus in people under 9 years old.
  • 31. Diabetic retinopathy
  • 32. Non-traumatic rhegmatogenous retinal detachment.
  • 33. Hemophilia
  • 34. Depression in people 15 years of age and older.
  • 35. Treatment of benign prostatic hyperplasia in symptomatic individuals.
  • 36. Technical assistance to people over 65 years of age.
  • 37. Ischemic stroke in persons 15 years of age and older.
  • 38. Outpatient treatment of chronic obstructive pulmonary disease.
  • 39. Bronchial asthma of moderate and severe degree in persons under 15 years of age.
  • 40. Respiratory distress syndrome in a newborn.
  • 41. Drug treatment of persons aged 55 years and older with mild to moderate osteoarthritis of the hip and / or knee joint.
  • 42. Subarachnoid hemorrhage against the background of a ruptured brain aneurysm.
  • 43. Primary tumors of the central nervous system in persons aged 15 years and older.
  • 44. Surgical treatment of hernia of the nucleus pulposus of the lumbar.
  • 45. Leukemia in people 15 years and older.
  • 46. ‚Äč‚ÄčOutpatient dental emergency
  • 47. Comprehensive oral health for 60 year olds.
  • 48. Severe multiple trauma.
  • 49. Traumatic brain injury of moderate and severe degree.
  • 50. Serious eye injury.
  • 51. Cystic fibrosis
  • 52. Rheumatoid arthritis.
  • 53. Harmful use or dependence on alcohol and drugs at low to moderate risk in persons under 20 years of age.
  • 54. Pain relief in childbirth.
  • 55. Big burn
  • 56. Bilateral hearing loss in people aged 65 years and older who need to use a hearing aid.
  • 57. Retinopathy of prematurity.
  • 58. Bronchopulmonary dysplasia of prematurity.
  • 59. Bilateral sensorineural hearing loss in preterm infants.
  • 60. Non-refractory epilepsy in persons aged 15 years and older.
  • 61. Bronchial asthma in persons aged 15 years and older.
  • 62. Parkinson’s disease
  • 63. Juvenile idiopathic arthritis.
  • 64. Secondary prevention of terminal chronic kidney disease.
  • 65. Dislocation dysplasia of the hip joints.
  • 66. Comprehensive health of the oral cavity of a pregnant woman.
  • 67. Relapsing-remitting multiple sclerosis.
  • 68. Chronic hepatitis caused by hepatitis B virus.
  • 69. Chronic hepatitis caused by hepatitis C virus.
  • 70. Colorectal cancer in people 15 years of age and older.
  • 71. Epithelial ovarian cancer.
  • 72. Bladder cancer in people aged 15 and over.
  • 73. Osteosarcoma in people 15 years and older.
  • 74. Surgical treatment of chronic aortic valve lesions in persons aged 15 years and older.
  • 75. Bipolar disorder in people 15 years and older.
  • 76. Hypothyroidism in persons aged 15 years and older.
  • 77. Moderate, severe and profound hearing loss in persons under 4 years of age.
  • 78. Systemic lupus erythematosus
  • 79. Surgical treatment of chronic lesions of the mitral and tricuspid valves in persons aged 15 years and older.
  • 80. Helicobacter pylori eradication therapy.
  • 81. Lung cancer in people 15 years and older.
  • 82. Thyroid cancer in people 15 years and older.
  • 83. Kidney cancer in people 15 years and older.
  • 84. Multiple myeloma in people 15 years and older.
  • 85. Alzheimer’s disease and other dementias.
  • 86. Comprehensive care for acute sexual violence
  • 87. Sars cov-2 rehabilitation

You can find information on each of the diseases HERE.

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