Health insurance and healthcare in Argentina

We have been with Hospital Italiano since the beginning, however it is impossible to get regular checks because there are no spots available.

I have a skin issue on my hands at the moment, and the first available date is on May 24, 2024. My dermatologist is no longer with HI, and she is also no longer attending at the private skin clinic that is near my house. I don't mind spending for a private consult if it means not waiting for 6 months, but at the same time I think it is pointless to have private healthcare if it means seeking care privately every single time.

Are your insurances the same?

Quote from Rice

serafina , what does HI charge for their insurance, and what if anything is not covered? (Other than prompt help when you need it)

We have just paid 86k pesos for November for the both of us. We are in our 40s.

The older you are, the higher the fee. An acquaintance of mine is over 70 and she pays 200k/month for herself alone!

We have the basic coverage but the access to appointments is the same, regardless.

It includes a few basic services, I can’t remember the details. I seem to recall that the GP is maybe unlimited or has a high number of visits per year (30?), 4 visits with the gynecologist, 2 with the ophthalmologist, and so on. Dermatology is not included.

We have also hospitalization and urgent care included.

Other specialties are co-paid and we can also access them also privately. This means that if I want to see a specialist, I can ask my GP to authorize it and I will have access to the co-pay price. Otherwise I will pay the full price. And I have up to 40% off meds, but this applies only to meds prescribed by doctors that work for Hospital Italiano and purchased from adhering pharmacies.

For example, if I want to see a psychologist, but my GP doesn’t think I need one, I will pay the full price. Otherwise he will authorize a “derivation to psychology services” and I will get co-pay prices.

I have a “derivation” for dermatology and I pay about 7k pesos per visit with dermatologist. Then any hands-on service, like day hospital surgery or tests, are paid.

The point is that there are not enough appointments those services!

The reason is that my insurance is also open to patients that are not insured by Hospital Italiano, so the demand is incredibly high and the service sucks as a result. I was never able to get proper dermatology care because of you need to see the same professional every 1-2 months, there are no appointments (the booking calendar is only open for a few months out, so you can’t book today appointments for the next 12 months).

Some specialties are in demand, like dermatology, others not so much, like vaccination services (you can find one even on the same day!).

My husband has a lot of moles and he needs to have them mapped every year to track how they change and see if any should be removed preventatively. It takes him 6 months to get a mapping appointment and then about 4-5 months to get an appointment with his dermatologist to read the result and evaluated which ones should be removed. Then it is about 3-4 months for a mole removal surgery. An all year affair! He is very pissed and keeps complaining with the hospital, but this how it is…

Just to provide more examples… I get a yearly check up with a gynecologist, he does a pap-smear and the results are sent to the lab and they upload a report. Now, you have to read the results and you need another appointment with a gynecologist who will tell you if everything is good or if you need to run more tests. My gynecologist stopped working with hospital italiano, he was great because I could just send him a text through the hospital messaging system and he told me if it was all good or not. Since he left, I have been looking for another gynecologist as good (or just available) as him. I didn’t find one because the first available one doesn’t use the messaging system because she said there are just too many inquiries from patients and she is not getting paid for the time spent to read the messages. She told me to just book an appointment with the first available gynecologist.

I went with another one and she said “all good, but since you are over 40 let’s do a mammography”. I did it (two days later, incredible!) but now I am back to square one because I need a gynecologist to read the results. So I just googled them because I think the results are normal and I don’t want to waste another 3 hours just to be told so (even if you have an appointment, they are always late and I have to sit in the waiting room for at least one hour).

My current skin issue is very minor, just a dry patch that seems to be spreading, and I now have it on the other hand, too. I have been self-treating it with ointments/cream I have at home (a cortisone ointment, that didn’t work, and another one with salicylic acid which also doesn’t work).

Quote from Rice

serafina , what a frustrating situation! It sounds as if the problems with Hospital Italiano are growing rather than being resolved.

Is there another hospital system that gives better care and better access to its medical providers? If so, what would be involved in switching? Would you have to pay more for joining in your 40’s instead of in your 30’s, as you did with HI?

I am not entirely sure, Rice . When we first arrived, we applied with several insurances, but a couple declined me for one health issue I had when I was 10 years old (I won't call it a precondition because it is not an ongoing issue and it doesn't put me at health risk more than anyone else, but stil...). I think it is illegal to discriminate based on preconditions, but obviously they won't tell outright the reason of rejection. They just provide a vague reply such as "unfortunately we cannot accept your application at this time". So, I simply omitted it to get Hospital Italiano's coverage and it worked. It was the sales advisor's suggestion, as she took pity on us after we told her that Hospital Aleman and Suizo had already rejected us.

Hospital Italiano is renowned for their staff and equipment, but I suppose the best players are left for the most pressing issues or better-connected insured patients. They also have their own Hospital here in Almagro. This is their biggest selling point, especially to us who live close. Some health insurances here are just brokerages and do not have their own facilities, so they resort on Hospital Italiano, Hospital Aleman etc.

We can get care also at other facilities that are part of their affiliated network, but sometimes they don't share the same medical opinion as their colleagues at Hospital Italiano.

When we were still in San Isidro, I had an abscess that needed to be drained because I couldn't sleep at night due to the pain it was causing me. We went to the HI facility in San Isidro (guardia), but it was a basic facility with no surgery tools nor sterile environment. The doctor on call directed me to the nearest affiliated hospital, also in San Isidro - Hospital San Lucas. We paid a co-pay fee to be attended at their ER at this other place since it was not a HI facility. However, when the other doctor saw me, she said she didn't think my abscess needed to be cut and refused to even touch me.

At that point, my husband walked back to the HI facility. Luckily, the same doctor who had seen me was still on call. She said to go to the ER of the HI Hospital in Almagro, and that she was calling them in advance to make sure I'd get my abscess drained as soon as possible. We didn't have a car back then, but my husband's grandfather drove us to Almagro and I was able to get my abscess cut.

We are keeping HI just in case anything big should happen, as it is the best hospital near to us and probably one of the best in the City. It is just that they make it so hard to actually access care for regular checkups.

I am also very happy with my GP, who is still the one I had in San Isidro and that I have never seen in years, but he uses the messaging system, and whenever I need something, he is just one text away.