How is the GES activated in Fonasa?

Article by: Alejandro Bull | Last update: April 10, 2022
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In case of vital emergency, the admission to AUGE or GES of a Fonasa contributor or beneficiary will be through a SAPU or the Emergency Service of a public hospital. Then, if you are a contributor or beneficiary of an Isapre, the doctor must fill out the GES Patient Information Certificate Form.

How to activate GES in Fonasa?

How do I access? To access the AUGE/GES services, you must be registered in the Office or Cesfam closest to your home. To receive AUGE/GES care, it is the Doctor’s Office who must indicate if you have any of the 85 benefits and register it in the system.

When is the GES activated?

The Law grants the right of access to the GES to any beneficiary of Fonasa or an Isapre who meets the following requirements: Presents a disease that is included among the 80 health problems or GES pathologies.

How is the GES activated?

To activate AUGE-GES it is necessary that:

Members of an ISAPRE must submit the form and the exams (when applicable) at a branch of their ISAPRE to activate the benefits, in which case they will be referred to a provider in agreement.

How to obtain GES certificate?

How and where do I apply? Online: Entering via the Internet at www.supersalud.gob.cl, the GES Patient Certificate Form is available. The result is the GES Patient Information Certificate Form.

40 related questions found

How can I get the Fonasa certificate online?

Once on the Fonasa website, enter your provisional RUT and date of birth, select the type of certificate “affiliation” or “quotes” and click “obtain certificate”. As a result of the procedure, you can immediately download the certificate.

What is the GES notification?

GES” or the exceptionally authorized alternative document for the health problems “Acute Respiratory Infection (ARI) under ambulatory management in children under 5 years of age” and “Ambulatory Dental Emergency, for people who have had a confirmed diagnosis of any of the the health problems contained…

How to activate GES in Isapre?

You can do it through your Virtual Branch (GES-CAEC menu) in branches, in our GES Centers or by calling 600 600 3600.

How do I know if I am GES?

– Instructions Online process

Click on “go to the online procedure”. Once on the Fonasa website, click on “ClaveÚnica”. … Fill in your RUN and password, and click on “continue”. Click on “My Auge” and consult the status of compliance with Fonasa’s AUGE-GES opportunity guarantee.

Who can access the AUGE Plan?

The Law grants the right of access to the GES to any beneficiary of Fonasa or an Isapre who meets the following requirements: Presents a disease that is included among the 80 health problems or GES pathologies.

Who notifies a GES patient?

All the private providers subject to inspection respond that they notify their patients when there is suspicion or diagnostic confirmation of a GES health problem.

What happens if the GES guarantee is not fulfilled?

If a Provider of the GES Network does not comply with the term indicated for the Opportunity Guarantee of a GES health problem that has been diagnosed, the patient or a third party representing him must claim Fonasa or Isapre, as appropriate, within 30 (thirty) days after the expiration of the corresponding term.

Who pays the GES in the Isapres?

In the case of Fonasa users, the AUGE/GES benefits are financed with the 7% legal contribution and by the public insurance itself and, therefore, the beneficiary only pays the corresponding extra copayment.

How does the GES work in vital emergencies?

In case of vital emergency, the admission to AUGE or GES of a Fonasa contributor or beneficiary will be through a SAPU or the Emergency Service of a public hospital. Then, if you are a contributor or beneficiary of an Isapre, the doctor must fill out the GES Patient Information Certificate Form.

How to obtain a Fonasa certificate with RUT?

How to download the certificates?

Enter social security number. Enter date of birth. Select the Type of Certificate you want to download. Select where it says “I am not a robot.” Click on the Get certificate button.

How to know in which Fonasa I am with the RUT?

How to know if you are in FONASA or Isapre? Simply enter the official FONASA website by clicking here and consult the existing certificates using your RUT. In this way, it will be verified whether or not your Certificate of Affiliation to the public health system in Chile exists.

How do I know if I am in Fonasa without a Unique Key?

– Telephone contact instructions

Call the Fonasa Call Center: 600 360 3000. Explain the reason for your call: to request a membership certificate. As a result of the process, the certificate will be sent to your email.

Who pays the Isapre?

It is the employer who must deduct from the worker’s gross salary: 10%, for the social security contribution.

Who pays my Isapre?

The Labor Law establishes that the National Health Fund is in charge of making the corresponding payments. When an employee is on medical rest, it is an obligation to make the corresponding health contributions.

How to request a change of GES provider?

Yes, a patient or their representative can directly request their Insurer (Fonasa or Isapre), the designation of a new provider of the AUGE or GES Network, however, the Insurer is not obliged to agree to their request.

What is the GES opportunity guarantee?

The Opportunity Guarantee is the right for health care to be delivered within a maximum period defined for each problem. The Financial Protection guarantee says that care for Auge-Ges health problems will have a maximum value to be paid, according to your Fonasa or isapre forecast.

What is a second lender?

To do this, it designates a second provider, which allows the Fonasa insured to access the required benefit in another assistance establishment (public or private), after presenting the claim at a branch or through the Fonasa call center.

How is Isapre paid?

If as a fee worker you have contracted a plan with an ISAPRE, your contribution will be paid by the General Treasury of the Republic in said institution. However, if the value of your plan is greater than your 7% contribution for health, you must pay the difference directly to the ISAPRE.

What happens if the Isapre is not paid?

The Isapre can terminate the contract

If this is maintained for more than six months, it is necessary to take into consideration that judicial collection actions could be initiated against the debtor, even being exposed to being sued in court.

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