Peru Info
Joined: 23 Nov 2006
Posts: 17
Home Country: peru
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 Posted: Thu Nov 30, 2006 5:57 am Post subject: HEALTHCARE IN PERU / PERU HOSPITAL GUIDE |
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HEALTHCARE IN PERU
OVERVIEW
The social security health system is the responsibility of both the Ministry of Health, which provides basic healthcare for the poor who do not make contributions, and ESSALUD, which provides services to those who make contributions as an employee or self employed and to their families. The major change under the modernisation is that private healthcare providers now compete with the state provider, although the non-life companies have written medical assistance business for a number of years.
In order to compete with the State specialist healthcare providers the EPS were formed. Insurance companies may not themselves be EPS, although they may own them, and EPS may belong to either private or public institutions other than ESSALUD.
Employers have the choice of staying with the ESSALUD or covering their employees with an EPS. The employees who have the right to vote and a majority of 50% of the workforce influence the decision plus one is sufficient for the decision to be taken. If the employer takes no action an election may be demanded if at least 20% of the workforce request it.
Managed Healthcare
In view of the inadequacies of the state healthcare system in Peru, the shortage of facilities and funds, and the lack of any medical attention in remote parts of the country, it is as much as the Ministry of Health and ESSALUD can do to cope with the situation, without having to consider managed healthcare, particularly following El Nino in 1998. Some efforts at preventive medicine are being made, particularly among children, but it is considered unlikely that any formal managed healthcare will be seen for some years.
Private Healthcare
In view of the inadequacies of the former state-run health service, private medical insurance has been an important element in the insurance market, with premiums of USD 79.6 mn in 1999, representing 16.7% of overall market income.
The following figures relate to the healthcare insurances written by the non-life companies. At the end of December 1999 the EPS had written USD 13.96 mn from 166,822 insured, against claims of USD 10.79 mn, representing a loss ratio of 77.25%.
Individual Private Medical Insurance
It is expected that demand will continue to grow. There is considerable competition but the nature of the cover given is not dissimilar from one insurer to another. Some companies offer national plans and international plans, although there now seem to be moves towards combining the two in one policy.
Most policies cover hospitalisation, out-patient treatment, medical and accident emergencies, maternity, home visits, repatriation or evacuation and burial costs, with different sums insured and conditions for cover in Peru and abroad.
Group Private Medical Schemes
There continues to be a high incidence of group policies. Under the most recent legislation it is obligatory for employers to cover all their employees for healthcare either with the state-run ESSALUD or with an EPS. In many cases additional group medical cover with a non-life insurer has been given as an employee benefit, with employees usually paying part of the premiums. Cover is similar to that given under individual policies; cover for the employee's family may or may not be given, depending on the agreement between the employer and employees.
Rating
There appears to be no standard method of quoting rates or deductibles and the various age groups for rating purposes differ considerably from one company to another. The market is very competitive and rates are said to vary between 2% and 9% of sums insured.
Major Insurers
All composite and non-life insurers write healthcare cover. In 1999 the leader was Pacifico Peruano Suiza with a 46% market share. Other important writers are Rimac Internacional (20%), Generali Peru (11%) and Positiva (6%).
As at 30 June 2000 the three EPS in operation were Rimac Internacional, owned by the insurance company of the same name; Novasalud Peru, owned by Backus and Johnston and Wiese Aetna Life; Pacifico Salud, owned by the Pacifico Peruano-Suiza.
These EPS have three types of insured:
1. employed, for whom health cover is obligatory,
2. optional, and
3. insured for WCA.
Reinsurance
If they reinsure at all some companies place cover on a quota share basis whilst others effect stop loss reinsurance on the annual account.
Distribution Channels
Around 90% of medical insurance is sold by brokers.
Long Term Care Insurance
This cover does not currently exist in the market.
DIRECTORY OF HOSPITALS & CLINICS
British American Hospital (Clinica Anglo-Americana)
Avenida Alfredo Salazar, 3rd Block,
San Isidro,
Lima,
Peru
Tel: + 51 1 221 3656
Fax: + 51 1 442 8274
Clinica Arequipa
Av Bolognesi esq Puenta Grau,
Arequipa,
Peru
Tel: + 51 54 253 416
Clinica El Golf
Sistemas de Administracion Hospitalaria,
Av. Aurelio Miro Quesada 1030,
San Isidro,
Lima,
Peru
Tel: + 51 1 264-33-00
Fax: + 51 1 264-30-87
Clinica Maison de Sante
Jr. Miguel Aljovin 208-222,
Lima,
Peru
Tel: + 51 1 619 6000
Fax: + 51 1 619 6001
Clinica Pardo
Av De la Cultura 710,
Cuzco,
Peru
Tel: + 51 84 240 387
Clinica Ricardo Palma
Avenida Javier Prado Este 1066,
San Isidro,
Lima,
Peru
Tel: + 51 1 224 2224
Fax: + 51 1 224 8027
Clinica San Felipe
Av. Gregorio Escobedo N 650,
Jesus Maria,
Lima,
Peru
Tel: + 51 1 463 0909
Fax: + 51 1 463 8671
Clinica San Pablo (Surco)
Av El Polo 789,
El Dervy de Monterrico,
Lima,
Peru
Tel: + 51 1 610 3333
Corporacion Nacional de Angioplasta
Sede Central Av. Miraflores,
Miraflores,
Lima,
Peru
Tel: + 51 1 225 3153
Fax: + 51 1 225 1892
Hospital Cuzco
Antiguo aeropuerto s/n,
Cuzco,
Peru
Tel: + 51 84 234 724
Instituto Oncologico de Lima
Calle 22 No. 202 san Borja,
Lima 41,
Peru
Tel: + 51 1 476 0823
Fax: + 51 1 225 7084
Instituto de Salud del Nino
Children's Hospital of Lima,
Avenida Brasil 600,
Brena,
Lima 5,
Peru
Tel: + 51 1 424 1996
Fax: + 51 1 425 1840 |
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