The National Health Fund (Fonasa) has implemented a new update to its membership classification, a process that reassigns users to tiers A, B, C, and D based on their registered income and social security contributions.
This periodic adjustment uses declared income and monthly contributions to determine each person's group. The change requires members to review their specific status to avoid any confusion regarding medical care.
Tier A remains designated for low-income individuals and those receiving family subsidies. This group benefits from 'Copago Cero' (Zero Copayment) within the public healthcare network, though they do not have access to purchasing vouchers through the 'Free Choice Modality.'
Meanwhile, Tier B includes those with a monthly taxable income of $539,000 or less. Like the previous group, they receive free care through the Institutional Care Modality and can use vouchers at participating private clinics.
Differences between higher tiers
Tier C includes members with incomes between $539,001 and $786,940. However, if a beneficiary has three or more dependents, the institution automatically reclassifies them into Tier B.
Finally, Tier D includes individuals earning more than $786,940. In these cases, having three or more dependents allows for a downward move to Tier C.
In practice, the operational difference between Tiers B, C, and D is minimal. This is because, as of 2022, a government mandate eliminated copayments for groups C and D, bringing their public network benefits in line with Tier B.
Members can verify their current status by visiting the institution's web portal, specifically the 'Mi Fonasa' section. Additionally, questions regarding the new classification can be addressed through the call center at 600 360 3000.