Essalud is the Peru’s best-known Social Security, provides multiple services, including prevention, recovery, and rehabilitation services, among others. Do you want to request a medical appointment? Read on and find out how to do it.
What is Eshealth?
Essalud It covers services from the most common to complex diseases such as organ transplants, cancer, kidney failure, and emergencies of all kinds. It is aimed at all Peruvian citizens who meet certain requirements and established characteristics. It was previously known as Regular Insurance
It has 385 healthcare centers throughout Peru with modern facilities, high-tech equipment, highly-trained doctors and effective treatments to treat all kinds of diseases.
It seeks to constantly expand its coverage, promoting the registration, declaration and registration of workers to social security with the purpose that more and more Peruvians can enjoy these services.
The monthly contribution made by employers is equivalent to 9% of the salary of each of their workers, which means that does not imply any discount for workers but only for the employer.
Every worker cancheck if your employer is contributing adequately and if your data is well registered. To do this, you must go to the Social Assistance department of your company or enter the EsSalud website.
What are the services you promote?
- Regular Insurance (+ Insurance):It is aimed at all those workers who are part of a formal company, it benefits the worker and their families. It also has coverage for pensioners.
- Optional Insurance (+ Health):It offers services to independent workers or unemployed people capable of making their contributions independently.
- Supplementary Risk Work Insurance (+ Protection): It is intended for workers whose work involves risky activities, and that may lead to occupational accidents.
- Essalud Accident Insurance (+ Life): This insurance grants compensation to regular, agrarian and optional insured in case of death or disability caused by an accident.
- EsSalud Agricultural Insurance: It provides services to workers in the farming and/or breeding sector, the poultry sector, agro-industry and aquaculture. Excludes workers in the forestry sector.
How to get the medical appointment?
Essalud has an advanced appointment scheduling system, so each registered person is assigned a specific health center. It is therefore important to verify the pre-established health center before requesting the appointment. In the same way, it must be taken into account if any specialized care is required, since if so, it will be referred to a health establishment that has said specialty.
It is also important to take into account that each center has a fixed delay periodamong them:
- Medical centers and polyclinics: take between 1 day and 2 weeks.
- Hospitals: They take between 1 week and 2 months.
- High complexity national hospitals: They take between 1 week and 6 months.
Considerations to take into account
Some considerations that you should take into account when using EsSALUD
- Maternity care: Requires 10 continuous months of contribution.
- Cancer treatment: Requires 12 continuous months of contribution.
- Congenital diseases: for newborns or undiagnosed 24 continuous months of contribution.
- Treatment of HIV, AIDS: Requires 24 continuous months of contribution.
- Internal prostheses or stents: Osteoarticular prostheses, packs or cages require 24 continuous months of contribution.
Some illness that your optional health insurance does not cover are:
- Pre-existing diseases: those health conditions that have been diagnosed before taking out the insurance.
- Pprocedures or therapies that do not contribute to recovery or rehabilitation of the patient.
- orphan diseases.
- Terms derived from sports activities high-risk
- have a valid ID.
- own the active insurance. To do this you can check with your employer or perform an online verification.
- If you are unemployed, you can opt for a special unemployment coverage.
Steps to follow
- Know the assigned care center and the specialty you will go to.
- Complete the application form from EsSalud online dating.
- Choose the date and turnor in which you want to attend the appointment.
- To describe physical discomfort.
- Send the formula.
In a minimum of 72 hours they will be sending you an informative email that you must print and take with you on the day of your appointment.
a) Go to your established health center
- Go to your assigned establishment depending on DNI.
- Go to the admission module and explain what type of appointment you require.
- Present your ID to verify that you are active in the insurance and in the correct pre-established medical center.
- In case you have already scheduled your appointment previously, you only have to go to the established office.
b) Schedule your appointment
- The person in charge will schedule an appointment with the required health professional according to your needs. The delay time will vary according to the availability of the specialist.
- You will be given a document that specifies the date, time and the name of the doctor who will treat you. At the same time, they will take your data to be able to confirm your attendance at the appointment by means of your telephone number and your email. Important: Write down the date, time and name of the doctor who will treat you in case the notification mechanisms fail.
c) The day of your appointment
- Make sure you arrive at your appointment at least half an hour before the scheduled time.
- Go to the query module.
- Present the paper that was given to you the day you requested your appointment together with your ID to verify your data.
- You will be directed to the specialist you were scheduled to request your appointment.
- Wait your turn to be attended.
- Answer the questions asked by the specialist who has been assigned to you, since he or she will later examine you to give you a diagnosis if you present it.
- A prescription will be issued along with a medical test or procedure if necessary.
This mechanism can only be used in first level health establishments such as medical centers and polyclinics and in some second level such as hospitals (if you need a specialized medical center you must go to your medical center and schedule your appointment in person). In case of being in Lima 411-8000
a) Call EsSalud online
- Call EsSalud online, remember this call is not free as it applies the costs of a local call
- Identify the EsSalud telephone number depending on your department
- An operator will request your ID number and verify that your insurance is active
b) Schedule your appointment
- Indicate to the operator with which specialty you want to make your medical appointment, he will verify if your assigned health center has that specialty, if not, you will be scheduled for a general medicine appointment
- You will be told the date and time you were scheduled for the medical appointment you requested
- Write down this information and make sure you do not forget the date and time of your appointment.
C) Introduce yourself to your Appointment
- Make sure you arrive at your established medical center at least half an hour before the scheduled time
- Go to the external consultation module and present your ID
- The person in charge of the medical center will take care of verifying your identity
- You will be directed to the specialist you were scheduled to see
- Wait your turn to be attended
- Answer the questions posed by the specialist assigned to you and he or she will proceed to examine you
- A diagnosis will be made and, if necessary, a prescription, an exam or a medical procedure will be issued.
EsSalud provides multiple benefits for its policyholders, including:
- Lactation: The breastfeeding subsidy is an economic benefit provided directly by EsSalud and has the objective of contributing to the care of the newborn, the child of the insured worker. For this, the worker must have three consecutive months of contributions or four non-consecutive months in the six months prior to delivery. This procedure is carried out before EsSalud and has no cost.
- Sickness or temporary disability allowance: The first 20 days of disability must be paid by the company and from the 21st the social security assumes the payments up to 11 months and 10 days from the registration of the accident or illness. Bonus granted for disability costs and payments for the burial cost of the death of the insured, the amount granted is for a maximum of S. / 2010.00 soles. EsSalud grants CITT temporary disability certificates for the purposes that the insured considers.
- Maternity: The insured worker has the right to rest 45 days before the birth (prenatal) 45 days after (postnatal), these days are cumulative. Any woman who has a newborn should receive S./820.00 soles. The insured have a monetary amount to cover the expenses of the birth and needs of the newborn.
- SCTR: It is the complementary risk work insurance, it is granted by companies whose work involves high-risk work.
- latency: Benefit granted by EsSalud to workers who have lost their job and who have contributed a minimum of 5 months. 2 months of attention are granted for every 5 months of previous contribution.
- Outpatient care: Medical consultations of all specialties, for example. clinical exams, X-rays, cures, dental care, among others.
- Hospital Care: Attentions in which the insured must remain hospitalized in a health center by medical indication, also in the case of outpatient surgeries, emergencies, hospitalization, etc.
- Accidental or Medical Emergencies: Accidents that endanger the life of the insured or seriously risk their health.
- Medicines: medicines and medical supplies contained in the institutional requests.
- Home Assistance Program (PADOMI): It benefits the holder and their affiliated dependents, requires prior medical authorization from EsSalud.
We hope the information has served you. Regards!
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