What are the benefits for EsSalud policyholders in 2024?

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

In addition, it not only guarantees medical care for its insured, but also has four economic subsidies for situations such as temporary disability, burial, maternity or breastfeeding. Below, review all the benefits and plans offered by EsSalud to ensure better protection and assistance to the affiliated population.

What are the benefits that EsSalud offers to 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, which we list below:

EsSalud Seguro Regular (+SEGURO) Coverage.

This Social Health Insurance plan is provided to active workers who work as employees or as members of workers' cooperatives, pensioners, as well as self-employed workers who are incorporated by mandate of a special law. Below, you will learn about the coverage provided by this insurance:

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

Optional Insurance Coverage (+Health)

The Potential Insurance is an EsSalud insurance aimed at all persons residing in the country, especially independent workers and their dependents, as well as university students, trainees and other entrepreneurs. It also covers the treatment and recovery of an illness or accident that is within the contracted plan. Its coverage consists of the following:

1. Outpatient and inpatient medical care
2. Medical and accidental emergencies
3. Rehabilitation services
4. Maternity care
5. Medicines and medical supplies contained in institutional requests.
6. Home assistance program and EsSalud online.

Complementary insurance for risky jobs (+PROTECTION)

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

• Assistance and promotional preventive advice on occupational health to the employer and the insured.
• Medical, pharmacological, hospital and surgical care until full recovery of the insured 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 farming or breeding activities on their own account or on behalf of third parties. This plan offers the following coverage:

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

EsSalud Accident Insurance (+VIDA)

This insurance provides compensation in case 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 bereavement and burial
• Designation of beneficiaries to receive the indemnity. These include spouse, children, parents, siblings and legal heirs.

EsSalud 2024: What financial subsidies does EsSalud offer?

• Subsidy for temporary disability: this benefit supports the regular insured in activity, agrarian and special regimes to compensate the loss of income due to the inability to work caused by health problems.
• Maternity allowance: insured mothers receive financial support during maternity leave.
• Breastfeeding allowance: EsSalud grants this economic support of S/820 to the mother of the newborn child of an insured member. In situations of multiple births, an allowance is granted for each live birth.
• Burial allowance: The Social Security Health Insurance grants an amount of money to those who have defrayed the expenses of funeral services after the death of a regular and titular 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 Seguro Social de Salud, 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, thus ensuring access to quality medical care for its policyholders.

Where do I go for care? Check HERE with your ID card

• Enter the EsSalud website: https://dondemeatiendo.essalud.gob.pe/#/consulta
• Enter the type of document and number, the verification digit of the DNI, as well as your date of birth. Click on 'search'.
• Finally, you will see results such as which hospital you should go to in order to claim your insurance, coverage period and more.