lakeside101

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Seguro Popular chart of coverage

lakeside101 replied to chapala45900's topic in Ajijic/Chapala/Guadalajara

Letter of Rights and Obligations “This program es public and not affiliated with any Political Party. Is Prohibited its use for different purposes than the ones established by the Program.” Mexican Federal Government Mexico 2010 Health Jalisco Health Department Welcome to Seguro Popular The State and Federal government congratulate you for your decision you took to register with the Seguro Popular, from now on your family and you will receive Medical attention that you deserve, in the Regional Hospital , near where you live. You will not have to pay a co-payment at the moment of receiving the care, while the terms of this policy do not expire. When you join the Seguro Popular , you will receive the Affiliation Policy in which your period of validity for this Policy is Stated, also your name, the beneficiaries , the Health Center in which you will receive care, and the fee you will pay. As a beneficiary of Seguro Popular , you have the right to receive Medical Consultations in a Health Center, or when the Doctor deems it so, you may see a Specialist , you may also receive Surgery and/or Hospitalization. At the same time you are entitled to medicaments, lab studies, included in the Catalog of Universal Services of Health ( CAUSES). Healthy Pregnancy, is a strategy that was created with the purpose of protecting the health of Women and their babies during the Pregnancy. The women Beneficiary have access, among other services to receive attention during the pregnancy, during labor, birthing, physiological puerperium, delivery by cesarean , and surgical puerperium. The affiliated ones to this policy could receive attention from the same day of affiliation, and once the baby is born, the family could continue enjoying Seguro Popular. If during the validity of this Policy, a child is born in your family unit, do notify the Office of Affiliation and Orientation, closer to your home immediately. The child has the rights of the benefits of the Medical Insurance called SMNG (Seguro Medico para Una Nueva Generacion) , by which the baby will receive the necessary care for the protection of his/her Health from birth. In the same way, and in necessary cases through the Fondo contra Gastos Catastroficos, you will be offered specialized treatment for specific illnesses, that may cause serious Financial distress. It's important that all the families belonging to Programa Oportunidades and that affiliated to Seguro Popular continue with their responsibilities, since they belong to both programs without losing their supports. Things you should know. To warranty the quality of the attention that you and your family deserve, it's important that you know and have the following in consideration. Affiliation Policy Once you register with Seguro Popular, verify that you are given a Affiliation Policy, and the Letter of Rights and obligations. It is your RIGHT. Remember that this Policy is an Official Document and should be kept in a safe place and good shape. It should not have any corrections or crossing outs. This document is Personal and non-transferable, and you should present it at the moment you use the medical services, you require. This policy indicates a period of coverage, the location for medical care. Access to Medical Services Universal Catalog of Medical Services (CAUSES ) They are all the Medical Services to which you and your family have the right to. And they are described here. Direct Benefits. It's indispensable that you read this letter carefully to know the benefits that Seguro Popular covers. The Family Contribution to join the Seguro Popular, depends on the paying capacity of you Family. You will not have to pay co-payments at the moment of receiving medical attention. The seguro popular, covers up to 275 medical services and warranties the supply of 315 associated medicaments to such services. If your family has Mexican kids born from December 1st of 2006, by the means of Seguro Medico para una Nueva Generacion (Medical Insurance for a New Generation), they will be covered by an additional 128 medical services to the one mentioned on CAUSES. If you follow the recommendations of your Doctor, and take the medicines recommended you will be able to keep or recover your Health. Furthermore, to prevent illnesses, you will be able to program preventive appointments and exams. Cooperate with us to maintain your Health! Continuity of Care To maintain the continuity of care, and the rights to the services and medical interventions covered by seguro popular, do NOT forget to: 1. Provided all the complete documentation at the Moment of Affiliation, if that is not the case, you should do so within 90 days of joining the program. 2. You should cover the fee that corresponds you to pay to join the program, in case the Socio-Economical Study has determined a fee for you. 3. To make proper use of your Policy of Affiliation. 4. To attend the Center of Affiliation and Operations to renew your Policy during the last month of coverage of your Policy. 5. To provide truthful information about your income level , employment status , ineligibility to IMSS , ISSTE, ISSFAM, SEDENA, MARINA, PEMEX, among others. Protect your Heath and that of your Family! Supporting Document _________________________ as beneficiary of Seguro Popular has rights and obligations. It's important that you know them and exercise them to make better use of the Medical Services that are offered from __________ until___________ Rights 1.To receive information about the procedures that govern the workings of the establishments to access and obtain medical services and attention. 2. To have egalitarian access to medical attention. 3. To receive dignified , respectful treatment and quality attention. 4. To be treated with Confidentiality. 5. To never receive any kind of discrimination to the integral services of health, the necessary medicines, and the materials required for the diagnosis, and treatment of the illnesses covered on the Net of medical Units of Seguro Popular. 6. To Count on a Clinical File. 7. To receive Medical attention in cases of urgency. 8. To receive sufficient, clear, opportune, and truthful information , as well as, the orientation necessary in respect to the medical attention to your health, about the risks and alternatives to the diagnostic , therapeutic, and surgical procedures indicated for you, or that apply to you. 9. To Count on a facility for a Second Opinion. 10. To decide freely on the attention you will receive. 11. To grant or not your valid and informed consent, and to refuse procedures or treatments you are not comfortable with. 12. To not pay for recuperation fees , specific to the services received. 13. To be able to present complaints in front of Regimenes Estatales de Proteccion Social en Salud, or in front of Servicios Estatales , for inadequate , or lack of services granted, as well as,lack of receiving information about procedures, limits , and forms I which your consults and complaints would be attended. 14. To be attended , when you are not pleased with the Medical Attention received. 15. To know the Annual Management Report of Seguro Popular. Obligations To provide truthfully the information necessary to document their acceptance to Seguro popular, and for the determination of the fee to pay as a Familiar fee. To cover promptly the familiar fees and regulatories in case they are assessed. Consult the procedures that rule the functioning of the establishments for access and services of medical attention. To give a respectful treatment to all the Medical Personnel , as well as other patients and their companions. To cooperate with the medical team, informing them truthfully and with veracity about your medical history, needs, and health problems. To use your ID as beneficiary, which is not transferable in any way. To make responsible use of the Health Services. To help take care of and maintain the health installations. To adopt behaviour that promotes health and prevention of Illnesses. To follow the recommendations , prescriptions ,treatments or general procedures that you have agrred to submit to. To ask the risks and alternatives of the therapeutics and surgical procedures that are indicated or applicable to you, as well as, Consult procedures, and complaints. To attend the Modulo de Afiliacion y orientation in case of needing to modify or ammend the data of your health policy, such as address , addtion or removal of a family member, change of social security membership, etc. DO NOT FORGET: To read the documents that you were given at the Modulo de Afiliacion y orientacion ( Policy, CAUSES and Letter of Rights and Obligations). To verify tha date of coverage of the Affiliation policy, Also check that all members of your family are considered and all personal data are correct. Inform yourself, where your Health Center is located. To review the Universal Catalog of Health Services, so you know the illnesses covered by Seguro Popular. To go to the Health Center assigned to you to open your Medical History. To take advvantage of your right to Medical Care responsibly and without abusing it. Be certain to know your obligations described on the letter of Rights and Obligations. To notify the Modulo de Afiliacion y Orientacion assigned to you, in case oy your family recibe medical services from IMSS, ISSSTE , SEDENA , MARINA , PEMEX , etc. Contribute with Us so we can offer you every day a Better Attention! List of Interventions. Public Health Newborn and Children less than 5 years old. BCG Vaccine Anti-Hepatitis B Vaccine Pentavalente Vaccine ( DpaT + VIP +Hib). Triple Viral Vaccine SRP. Rotavirus Vaccine. Influenza Vaccine. DPT Vaccine. Polio Vaccine ( Oral Trivalent , Type Sabin). Preventive Actions for Newborns. Preventive Actions for Minors under 5 years old. Boys and Girls from 5 to 9 years old. Preventive Actions for boys and girls from 5 to 9 years old. Early detection of eating disorders. Preventive actions foe adolescents from 10 to 19 years old. Anti-Hepatitis B Vaccine. Adults from 20 to 59 years old Double Viral SR Vaccine. Tetanic and Diphtheritic Toxoide ( Td ). Preventive Actions for women from 20 to 59 years. Preventive Actions for men from 20 to 59 years. Complete medical exam for women from 40 to 59 years old. Complete medical exam for men from 40 to 59 years old. Preventive and attention for Family and Sexual Abuse for Women. Adults Older than 60 years old and older. Neumococci Vaccine for Seniors. Influenza Vaccine for Seniors. Preventive Actions for seniors over 60 years old. General /Family and Specialty Medical Consult. General/Family Consult Diagnostic and Treatment of Iron-Deficiency Anemia and for Deficiency of Vitamin B12. Diagnostic and Treatment of Deficiency of Vitamin A. Diagnostic and Treatment of German Measles. Diagnostic and Treatment of Measles. Diagnostic and Treatment of Chickenpox. Diagnostic and Treatment of Acute Faringoamigdalitis. Diagnostic and Treatment of Whooping Cough. Diagnostic and Treatment of Non Suppurative Mid Otitis. Diagnostic and Treatment of the Common Cold. Diagnostic and Treatment of Conjunctivitis. Diagnostic and Treatment of Allergic Rhinitis. Diagnostic and Treatment of Classic Dengue. Diagnostic and Treatment of Ambulatory Acute Diarrhea. Diagnostic and Treatment of Paratyphoid fever and Salmonella. Diagnostic and Treatment of Typhoid Fever. Diagnostic and Treatment of Herpes Zoster. Diagnostic and Treatment of Candidiasis. Diagnostic and Treatment of Gonorrhea. Diagnostic and Treatment of infections by Chlamydia- includes Trachoma- Diagnostic and Treatment of Trichomoniasis. Diagnostic and Treatment of Syphilis. Diagnostic and Treatment of Cystitis. Diagnostic and Treatment of Acute Vaginitis. Diagnostic and Treatment of Acute Vulvitis. Diagnostic and Pharmacological Treatment of Intestinal Amoebiasis. Diagnostic and Pharmacological Treatment of Ankylostomiasis. Diagnostic and Pharmacological Treatment of Necatoriasis. Diagnostic and Pharmacological Treatment of Ascariasis. Diagnostic and Pharmacological Treatment of Enterobiasis. Diagnostic and Pharmacological Treatment of Echinococcosis. Diagnostic and Pharmacological Treatment of Schistosomiasis ( Bilharziosis). Diagnostic and Pharmacological Treatment of Strongyloidiasis. Diagnostic and Pharmacological Treatment of Filariasis. Diagnostic and Pharmacological Treatment of Giardiasis. Diagnostic and Pharmacological Treatment of Taeniasis. Diagnostic and Pharmacological Treatment of Ttichuriasis. Diagnostic and Pharmacological Treatment of Trichinosis. Diagnostic and Treatment of Scabies. Diagnostic and Treatment of Lice Infections and Phthiriasis. Diagnostic and Treatment of Superficial Mycosis. Diagnostic and Treatment of Onychomycosis. Diagnostic and Treatment of Infectious Cellulitis. Diagnostic and Treatment of Allergic Contact Dermatitis. Diagnostic and Treatment of Atopic Dermatitis. Diagnostic and Treatment of Contact Dermatitis by Irritants. Diagnostic and Treatment of Diaper Dermatitis. Diagnostic and Treatment of Exfoliative Dermatitis. Diagnostic and Treatment of Seborrheic Dermatitis. Diagnostic and Treatment of Common Warts. Diagnostic and Treatment of Acne. Diagnostic and Treatment of Hepatitis A. Diagnostic and Treatment of Acute Gastritis. Diagnostic and Treatment of Irritable Bowel Syndrome. Diagnostic and Pharmacological Treatment of Diabetes Mellitus 2. Diagnostic and Pharmacological Treatment of Arterial Hypertension. Diagnostic and Treatment of Osteoarthritis. Diagnostic and Treatment of Lumbago or Low Back Pain. Other Attentions of General Medicine. Temporary Methods of Family Planification : Hormonal Contraception (AH). Temporary Methods of Family Planification : Condoms. Temporary Methods of Family Planification : Intrauterine Device. Pre-Natal Attention during the Pregnancy. Specialty Consultations. Diagnostic and Treatment of Disorders of Attention Deficit Disorder and Hyperactivity. Diagnostic and Treatment of Widespread Disorders of Development ( Autism ). Diagnostic and Treatment of Dysmenorrhea. Attention of Climacteric and Menopause. Diagnostic and Treatment of Mastopathy Fibrocystic. Diagnostic and Treatment of Endometrial Hyperplasia. Diagnostic and Treatment of Chronic Vaginitis. Diagnostic and Treatment of Endometriosis. Diagnostic and Treatment of Urethritis and Urethal Syndrome. Diagnostic and Treatment of Scaly Intraepithelial lesions of low Grade. Diagnostic and Treatment of Scaly Intraepithelial lesions of high Grade. Diagnostic and Treatment of Malnutrition and Obesity of Children and Adolescents. Diagnostic and Treatment of Kwashiorkor. Diagnostic and Treatment of Marasmus. Diagnostic and Treatment of Sequels of Malnutrition. Diagnostic and Treatment of Acute Laryngotracheitis. Diagnostic and Treatment of Otitis Media Suppurative. Diagnostic and Treatment of Acute Sinusitis. Diagnostic and Treatment of Asthma in Adults. Diagnostic and Treatment of Asthma in Children. Diagnostic and Treatment of Tuberculosis (TAES). Diagnostic and Treatment of Pharmaco-Resistant Tuberculosis . Prevention , Diagnostic and Treatment of Psoriasis. Diagnostic and Treatment of Gastroesophageal Reflux Disease. Diagnostic and Treatment of Peptic Ulcers. Diagnostic and Treatment of Dyslipidemia. Diagnostic and Treatment of Hyperthyroidism. Diagnostic and Treatment of Congenital Hyperthyroidism and in Adults. Diagnostic and Pharmacological Treatment of Diabetes Mellitus 1. Diagnostic and Treatment of Chronic Cardiac Insufficiency. Diagnostic and Treatment of Osteoporosis. Diagnostic and Treatment of Gout. Diagnostic and Treatment of Rheumatoid Arthritis. Diagnostic and Treatment of Affective Spectrum ( Dysthymia , Depression, Emotional Bipolar Disorder. Diagnostic and Treatment of Disorders of Anxiety ( general Anxiety, Anxiety Crisis,, Panic Attacks, Serious Stress and Disorders of Adaptacion, Stress Disorders, Post-Traumatic Stress Disorders, etc.) Diagnostic and Treatment of Psychotic Disorders( Schizophrenia , Psycotic Delusional , Schizotypical Delusion.) Diagnostic and Pharmachological Treatment of Epilepsy. Diagnostic and Treatment of Parkinson's Diagnostic and Treatment of the Congenital Luxation of the Hip. Rehabilitation of Fractures. Rehabilitation of facial Paralisis. Selective Prevention and Indicated Addictions ( Counseling). Diagnostic and Treatment of Addictions. Dentistry Prevention of cavities and periodontal disease. Sealing of dental fissures. Ellimination of cavities, and restaurations of dental pieces with amalgam, resine , or dental cement. Ellimination of focuses of infection , abscesses ( including drasinage and pharmacotherapy). Extraction of dental pieces, including root fragments, erupted pieces ( does NOT include the 3rd Molar not erupted). Diagnostic and Treatment of Pulpitisand Pulpar Necrosis. Diagnostic and Treatment of Maxillary Abscess. Extraction of the 3rd Mollar. Urgency. Stabilization of urgencies for Hypertensive Crisis. Stabilization of urgencies of Diabetic Patient. Management of urgencies of the Hyperglucemic Non Cetosico Syndrome. Stabilization of urgencies for Chest Angina. Diagnostic and Treatment of Acute Poisoning by Phenothiazines. Diagnostic and Treatment of Acute Poisoning by Alkali. Diagnostic and Treatment of Acute Food Poisoning. Diagnostic and Treatment of Acute Poisoning by Salicylates. Diagnostic and Treatment of Acute Poisoning by Methanol. Diagnostic and Treatment of Acute Poisoning by Organophosphates. Diagnostic and Treatment of Acute Food Poisoning by Carbon Monoxide. Diagnostic and Treatment of Snake Bites. Diagnostic and Treatment of Scorpion Bites. Diagnostic and Treatment of Bee , Spider , and other Arthropod Bites. Management of Bites and Prevention of Rabies in Humans. Extration of Foreign Bodies. Management of Traumatic Lesions on soft Tissue ( Healing and Sutures ). Diagnostic and Treatment of Traumatic Brain Injury ( Glasgow 14-15 ). Management of Urgencies on First Degree Burns. Diagnostic and Treatment of Cervical Sprain. Diagnostic and Treatment of Shoulder Sprain. Diagnostic and Treatment of Elbow Sprain. Diagnostic and Treatment of Hand and Wrist Sprain. Diagnostic and Treatment of Knee Sprain. Diagnostic and Treatment of Ankle and Foot. Hospitalization Diagnostic and Treatment of Pyelonephritis. Diagnostic and Treatment of Bronchiolitis. Diagnostic and Treatment of Acute Bronchitis. Diagnostic and Treatment of Meningitis. Diagnostic and Treatment of Mastoiditis. Diagnostic and Treatment of Osteomyelitis. Diagnostic and Treatment of Children's Pneumonia. Diagnostic and Treatment of Senior's Pneumonia. Diagnostic and Treatment of Amoebic Liver Abscess. Diagnostic and Treatment of Pelvic Inflamatory Disease. Diagnostic and Treatment of Threat of Abortion. Diagnostic and Treatment of premature Childbirth. Attention of Childbirth and postnatal. Infection in the Pelvic Peritoneum. Postnatal Endometritis. Diagnostic and Treatment of Postnatal Septic Shock. Attention to the Newborn. Neonatal Jaundice. Diagnostic and Treatment of Preterm Birth without Complications. Diagnostic and Treatment of preterm Birth with Hypothermia. Diagnostic and Treatment of the Underweight Newborn. Diagnostic and Treatment of Pre-Eclampsia. Diagnostic and Treatment of Severe Pre- Eclampsia. Diagnostic and Treatment of Eclampsia. Postnatal Obstetrical Hemorrhage. Placental Abruption Hemorrhage. Infection of Obstetric Surgical Wound. Diagnostic and Treatment of Kidney and Urethral Stones. Diagnostic and Treatment of Inferior Urinary System stones. Diagnostic and Treatment of Hemorrheic Dengue. Diagnostic and Treatment of Moderate Traumatic Brain Injury ( Glasgow 9-13 ). Diagnostic and Treatment of Acute Pancreatitis. Hospital Management of a Convulsive Crisis. Hospital Management of Arterial Hypertension. Diagnostic and Treatment of Acute Cardiac Insufficiency (Pulmonary Edema). Chronic Obstructive Pulmonary Disease. Diagnostic and Treatment of Peripheral Neuropathy Secondary to Diabetes. Hospital Managementof Second Degree Burns. Diagnostic and Treatment of Digestive Hemorrage. Diagnostic and Treatment of HELLP Syndrome. Diagnostic and Treatment of Coroamnioitis. Diagnostic and Treatment of Obstetric Embolisms Diagnostic and Treatment of Gestational Diabetes. Diagnostic and Treatment of Functional Cardiopathy in Pregnant Women. Diagnostic and Treatment of Deep Thrombosis in Pregnant Women. General Surgery Exploratory Laparotomie. Appendectomy. Splenectomy. Surgical Treatment of Diverticulosis. Surgical Treatment of Ischemia and Mesenteric Ischemia. Surgical Treatment of Bowel Obstruction. Surgical Treatment of Gastro-Intestinal Perforations. Surgical Treatment of Volvulus Colonic. Surgical Treatment of Rectal Abscess. Surgical Treatment of Anal Fistule and Fissure. Hemmorrhoidectomy. Surgical Treatment of Hiatus Hernia. Surgical Treatment of Pyloric Stenosis. Feloral Hernioplastia. Inguinal Hernioplastia. Umbilical Hernioplastia. Ventral Hernioplastia. Open Cholecystectomy. Laparoscopic Cholecystectomy. Surgical Treatment of Genital Warts. Surgical Treatment of Breast Fibroadenoma. Surgical Treatment of Ovarian Cysts. Surgical Treatment of Torsion of the Annexes. Tubal Ligation( Permanent method of Family Planification ). Surgical Attention of Gestational Trophoblastic Disease. Surgical Treatment of Ectopic Pregnacy. Therapeutic Uterine Curettage due to an incomplete Abortion. Caesarean Section and Surgical Childbirth. Uterine Repair. Endometrial Ablation. Endometrial Laparoscopy. Myomectomy. Abdominal Hysterectomy. Vaginal Hysterectomy. Colpoperineoplasty. Vasectomy ( Permanent Method of Family Planning). Circumcision. Orchidopexy. Open Prostatectomy. Transurethral Resection of the Prostate. Excision of Lesion of Skin Cancer ( excluding Melanoma) Excision of Benign Tumor of Soft Tissue. Tonsillectomy with or without Adenoidectomy. Juvenile Pharyngeal Papilloma Excision. Palatoplasty . Repair of Cleft Lip . Surgery for Strabismus Muscle Shortening . Muscle lengthening Surgery for Strabismus . Surgical Treatment of Glaucoma . Excision of Pterygium . Surgical Treatment of Hydrocephalus . Placement and Removal of Various Catheters. Radical neck dissection . Thoracotomy, and chest drain pleurotomy . Surgical treatment of congenital dislocation of hip . Surgical treatment of clubfoot in children . Saphenectomy . Surgical reduction of dislocations . Surgical reduction of fractured clavicle . Surgical reduction of fracture of the humerus (includes osteosynthesis material) . Surgical reduction of fracture of the ulna and radius (includes osteosynthesis material) . Surgical reduction of fracture of hand . Surgical reduction of hip fracture (including hemiprótesis with acetabulum) . Surgical reduction of femur fractures (osteosynthesis material included) . Surgical reduction of fracture of tibia and fibula (includes osteosynthesis material) . Surgical reduction of fracture of ankle and foot. . Knee arthroplasty (includes arthroscopy) . Lower limb amputation secondary to diabetic foot . Treatment of synovial cyst.