EsSalud is a public entity in Peru in charge of providing health insurance to the country’s working population and their families, to guarantee access to health prevention, promotion, recovery and rehabilitation services. It operates through a network of medical establishments nationwide, offering coverage in various medical specialties and treatments, financed by contributions from employers and workers. insured.
The financing of the institution comes, for the most part, from contributions made by both employers and workers. EsSalud manages an extensive network of health care infrastructure, which includes hospitals, medical centers and health posts spread throughout the country. Beyond offering medical services, the Social Health Insurance provides financial subsidies in situations of temporary disability, during maternity, breastfeeding and for funeral services. Below are all the details of these financial supports.
Maternity allowance
Aimed at insured women who are in work, it aims to compensate for the absence of income during the period of childbirth and the initial care of the newborn. To qualify for this subsidy, the insured must have made contributions during a period of three continuous months or four discontinuous months within the six months prior to the beginning of enjoying the subsidy.
It is essential to maintain the employment relationship both at the beginning and throughout the period of receiving the subsidy and to have been in employment during the month in which conception occurred. Those insured under the special regime, as well as independent artisanal fishermen and fish processors, must have paid the contribution corresponding to the month of conception before proceeding with the subsidy application.
In situations where the employer has reported some or all of the days that correspond to the maternity benefit period as days of work, EsSalud will proceed to partial payment of the subsidy for the days that have been correctly declared and will issue a resolution that partially recognizes the subsidized days, detailing those days not recognized because they were reported as work days. This resolution leaves open the possibility of filing administrative appeals.
Funeral benefit
The funeral benefit EsSalud It consists of a financial amount granted to the person who certifies having incurred the expenses of the funeral service due to the death of a regular, active or pensioner insured, with a limit of S/2,070. This benefit is assigned to the closest relative of the deceased, following an established order of precedence that includes the spouse or cohabitant, children, parents, older siblings or even a third party.
To be a beneficiary of this benefit, the deceased regular insured must have contributed for three consecutive months or four non-consecutive months in the period of six months prior to his death. In the case of workers, it is necessary that they have maintained their employment relationship until the moment of their death.
Regarding pensioners, it is necessary that they have maintained their pensioner status at the time of death. It should be noted that this benefit is not extended to those insured who have died while being affiliated with the Complementary Risk Work Insurance (SCTR).
Temporary disability allowance
Temporary disability allowance EsSalud It is granted to regularly active insured persons, as well as to those belonging to the agricultural sectors and special regimes. This bonus is intended to offer financial compensation for loss of income while the worker is experiencing health problems.
To be eligible to receive this benefit, the regular insured needs to have made contributions for three consecutive months or four non-consecutive months in the six-month period prior to the onset of disability. Fishing workers governed by Law No. 28320 must have at least two contributions, consecutive or not, in the six months prior to the start of the disability.
It is a requirement that the worker maintain their employment relationship at the beginning and during the duration of the subsidy. In accident situations, it is enough to be affiliated at the time of the event. In cases where the employer has reported some or all of the days of the period covered by the temporary disability benefit as days worked, EsSalud will make a partial payment for the days duly declared and will issue a resolution that partially recognizes the days subject to subsidy. This resolution will detail the days not recognized because they have been reported as work days, and will open the possibility of filing administrative appeals.
Breastfeeding allowance
The breastfeeding subsidy consists of financial aid of S/820 granted by EsSalud to the mother of a newborn infant. This financial support is designed to contribute to the care of the minor. In cases of multiple births, a subsidy is allocated for each baby born alive.
To be eligible for this benefit, it is necessary that the insured have made contributions for a period of three consecutive months or four non-consecutive months within the six months prior to birth. Likewise, it is essential that the employment relationship be maintained at the time of birth.
In addition, it is a requirement that the newborn be registered as a beneficiary of the insurance holder. In the event that the child’s mother is not the owner of the insurance, she must be registered as a beneficiary in EsSalud.
Source: Larepublica
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