It is urgent to review the insurance family expenses

Pocket spending, improper payments, low coverage of drugs and the exclusion of certain diseases and procedures, remain the main causes of complaints do affiliates to the family health insurance (SFS) in the direction of information and defence of affiliate (DIDA), yesterday revealed its Director.

Nélsida Marmolejos said that these complaints, joined by low pensions granted under occupational risk insurance and related to the financing, of the reasons that make urgent that the country is appropriate to a technical revision of the Dominican system of Social Security (SDSS), to adapt it for the benefit of members.

He said that his greatest concern is the part of the health of the SDSS, because although there is greater benefit, there is also increased spending of pocket.

He also cited that continue improper charges, what has not been possible to stop and is discretionary payment makes the mé u000aI dico to affiliate, apart from the insurer.

To this addition, noted Marmolejos, most medicines are excluded from coverage, because there is always a component which is not in the Basic Plan of health, as well as exclusions of procedures and diseases that prevent the affiliate access to their rights, because there are diseases that should be covered, but are excluded by a name technician.

Said that means a huge expense for the family and a concern. "Such situations are a daily challenge for the system, here the majority of people who come to claim is improper charges, procedures that are not covering, and people are spending lot of money, then there is to do an urgent technical review of diseases and procedures that are covering to adapt to the reality of every day", pointed out.

Means that the system not can continue covering diseases that only u000athey exist in the old catalog.

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