Questionnaire Text

Questionnaire form view entire document:  text  image

6. Are you:
A member of an emergency medical service?

[] Yes
[] No

A member of a private or mutual health plan?

[] Yes
[] No

Affiliated with a social institution?

[] Yes
[] No

Questionnaire instructions view entire document:  text  image

Question 6: Are you [in a health program]?
You should complete "yes" or "no" for all of the categories included in this question.

The "medical emergency system" is the system for medical consultation at home that implies the attention starting with the long--distance request put into place to resolve health problems of patients in states of potential--risk on site or their transfer to the corresponding institutions. This is characterized by the voluntary inclusion of the beneficiary.

The "private or mutual health plan" is a health system characterized by the voluntary enrollment and the payment for service by the beneficiary in its totality. Emergency medical services are excluded.

On the other hand, the "social program" refers to the health coverage that is obtained by persons who work in a relationship of dependency and their family members, through a voluntary affiliation, or the legal coverage that retired or pensioned persons receive.

All health coverage that depends totally or partially on the discounts that by law are made to the workers is considered as affiliation of a social program. Therefore, whenever there is a discount made to the worker for social programs, it is considered that he/she is affiliated with a social program, independently of whether he/she also makes a voluntary payment to pay the social program or if the discount is derived from a private or mutual healthcare plan.

Lets look at some examples:
1. Hugo is an employee of the Ministry of Economy and his social program OSME has an agreement with a private healthcare provider. Hugo requested that his discounts for the social program be derived from this private healthcare plan. In this case, he should mark "Yes" only in the affiliated with a social program and "No" in the rest of the healthcare coverage options.

Are you?
Associated with a medical emergency service? Yes [ ] No [x]
Associated with a private or mutual healthcare plan? Yes [ ] No [x]
Affiliated with a social program? Yes [x] No [ ]

2. Marcela is self--employed and pays for a private healthcare plan (pre--paid medicine).She should mark "No" for associated with a medical emergency service, "Yes" for associated with a private or mutual healthcare plan and "No" in affiliated with a social program.

Are you?
Associated with a medical emergency service? Yes [ ] No [x]
Associated with a private or mutual healthcare plan? Yes [x] No [ ]
Affiliated with a social program? Yes [ ] No [x]

3. Doña Inés is retired and has PAMI health coverage. In addition, her daughter contracted "Medical Emergencies". In this case, you should mark "Yes" for associated with a medical emergency service, "No" for associated with a private or mutual healthcare plan and "Yes" in affiliated with a social program.

Are you?
Associated with a medical emergency service? Yes [x] No [ ]
Associated with a private or mutual healthcare plan? Yes [ ] No [x]
Affiliated with a social program? Yes [x] No [ ]