Fonasa stands for Fondo Nacional de Salud, meaning "National Health Fund." It is Chile's public health insurance system that provides healthcare coverage to workers, pensioners, and their dependents. Approximately 80% of the Chilean population is covered through Fonasa.
Coverage Categories
Fonasa beneficiaries are classified into four groups (A through D) based on income. Group A includes uninsured individuals with no income who receive free care. Groups B, C, and D are contributing workers who pay increasing copays but can access both public hospitals and preferred private providers through the Modalidad Libre Elección (free choice modality).
Services Covered
Fonasa covers a wide range of medical services including primary care, specialist consultations, hospitalization, surgery, maternity care, and prescription medications. The GES (Garantías Explícitas en Salud) program guarantees timely access and financial protection for 85 specific health conditions.
EOR Relevance
When an employee in Chile chooses Fonasa over an Isapre, the EOR processes the mandatory 7% payroll deduction and remits it to Fonasa. The EOR ensures proper enrollment and handles any changes in the employee's health coverage selection.