What benefits do those insured in EsSalud have in 2024?

Social Health Insurance, also known as EsSalud, is a key institution in the Peruvian health system; since it has more than 12 million members. This contributory insurance, which is attached to the Ministry of Labor and Employment Promotion, offers various prevention, promotion, recovery, rehabilitation and other social benefits.

In addition, it not only guarantees medical care for its insured, but also has four financial subsidies intended for situations such as temporary disability, funeral, maternity or breastfeeding. Next, review all the benefits and plans that EsSalud offers to ensure better protection and assistance to the affiliated population.

What are the benefits that EsSalud offers its policyholders?

EsSalud policyholders enjoy a wide range of benefits that cover everything from medical care to financial support in times of need. In total, there are five types of coverage that we list below:

EsSalud Coverage Regular Insurance (+SEGURO)

This Social Health Security plan is provided to active workers who work under a dependency relationship or as members of worker cooperatives, pensioners, as well as independent workers who are incorporated by mandate of a special law. Below, learn about the coverage provided by this insurance:

• Health prevention and promotion benefits: health education, risk assessment and control, and immunizations
• Health recovery benefits: outpatient medical care, hospitalization, medicines, medical supplies and rehabilitation services
• Maternity benefits: health care for the pregnant mother and childbirth care
• Welfare benefits and social promotion: outreach activities, social help and rehabilitation for work.

Optional Insurance Coverage (+HEALTH)

Potestativa Insurance is EsSalud insurance and is aimed at anyone residing in the country, especially independent workers and their dependents, as well as university students, interns and other entrepreneurs. Likewise, it covers the treatment and recovery of an illness or accident that is within the contracted plan. Your coverage consists of the following:

• Outpatient and hospital medical care
• Medical and accidental emergencies
• Rehabilitation services
• Maternity care
• Medications and medical supplies contained in institutional requests
• Home assistance program and EsSalud online.

Complementary risk work insurance (+PROTECTION)

This insurance provides coverage to workers who, as a result of the high-risk work they perform, suffer an accident or an occupational disease. These are:

• Promotional preventive assistance and advice on occupational health to the employing entity and the insured
• Medical, pharmacological, hospital and surgical care until the insured person’s complete recovery or declaration of total or partial permanent disability or death
• Rehabilitation and labor readaptation of the disabled insured under this insurance
• Coverage of prosthetic and orthopedic devices necessary for the insured.

EsSalud Agrarian Insurance

Provides health, economic and social benefits to independent agricultural workers who carry out cultivation or breeding activities on their own behalf or on behalf of third parties. This plan offers the following coverage:

• Prevention and promotion benefits: health education, risk assessment and control
• Benefits for health recovery: outpatient medical care, hospitalization, medicines, medical supplies, prostheses and rehabilitation services
• Welfare and social promotion benefits: outreach activities, social assistance and rehabilitation for work
• Financial benefits for temporary disability, maternity, breastfeeding and expenses for funeral services.

EsSalud Accident Insurance (+VIDA)

This insurance provides compensation in the event of death or total or partial permanent disability as a result of an accident. These are the coverages:

• Coverage of up to S/75,000 in case of death
• Special benefits for mourning and burial
• Designation of beneficiaries to receive compensation. These include spouse, children, parents, siblings and legal heirs.

EsSalud 2024: what financial subsidies does EsSalud offer?

1. Temporary disability allowance: this benefit supports regularly active, agricultural and special regime insured persons to compensate for loss of income due to inability to work caused by health problems
2. Maternity allowance: insured mothers receive financial support during the maternity leave period
3. Breastfeeding allowance: EsSalud grants this financial support of S/820 to the mother of the newborn baby of an insured person. In situations of multiple births, a subsidy is granted for each baby born alive.
4. Funeral benefit: Social Health Security grants an amount of money to those who have covered the expenses of funeral services after the death of a regular and regular insured person. This amount reaches a maximum of S/ 2,070 and is granted to the direct beneficiary of the deceased.

What is EsSalud?

EsSalud, or Social Health Insurance, is a decentralized state entity in charge of providing health coverage to formal workers and their beneficiaries in Peru. With a network of hospitals and clinics throughout the country, EsSalud offers medical, preventive and rehabilitation services; In this way, it ensures access to quality medical care for its policyholders.