Chile Healthcare: FONASA or ISAPRE?

by Brett Andrews

About Chile Healthcare

The Chilean healthcare system generally meets a high standard of service, reporting wide coverage and long life-expectancy. Universal health care is largely financed by government funding and payroll taxes, with families contributing 5-7% of their income to their chosen option. Expats usually prefer private or global insurance for their medical needs.

Chile’s public and private healthcare systems serve complementary roles for tax-paying residents. Fondo Nacional de Salud (FONASA) administers the public side, focusing on preventative care and treatment. Private insurers called Instituciones de Salud Previsional (ISAPREs) focus on specialized medical needs as well as primary care. Either choice collects a 7% payroll deduction, though ISAPREs may levy additional premiums. Anyone working in Chile is automatically subscribed to health insurance.

Service in the public system is often slow and overcrowded, especially in more rural areas. Most doctors do speak English. Bring cash and your RUT/RUN card when seeking health care in the public sector; facilities may expect payment upfront if insurance doesn’t cover it.

Private health insurance replaces the public option in Chile. Private coverage, either from an ISAPRE or global insurer, pays for private clinics and hospitals that offer faster service, more individualized care and up-to-date technology. Chilean physicians all have high educational credentials and should speak English.

Pharmacies can be found throughout Chile, most often in city centers or attached to hospitals. Expats find that many prescription-only drugs in the US are available over the counter in Chile. Pharmacies are usually open late, with some offering 24-hour access. Most pharmacists speak English here.

Finding a Physician

Finding your new general physician (GP) in Chile healthcare is fairly direct. Start by using Salud Responde, Chile’s public health care website. You can search for healthcare providers based on your needs and location. You can also make appointments through the site. Otherwise, visit your local centro de salud (healthcare center) to register with a new GP.

Residents using FONASA should pay little to no fee for seeing a GP. ISAPREs may differ in coverage and cost; consult your policy for those details. Note: most Chilean doctors specialize in a particular aspect of medicine, instead of general practice. For best results, have your medical records translated to Spanish before you schedule your first appointment.

Public Healthcare in Chile

Public healthcare (FONASA) is available to legal Chilean residents and workers for a 7% salary deduction. Expats, including self-employed, qualify under the same stipulations, provided they pay taxes and have legal residency.

Expats can register for Chile’s universal healthcare by getting a RUT/RUN card before scheduling their first GP appointment. Consult your local Registro Civil or centro de salud to complete the process. If you need a temporary RUN card, contact your healthcare provider.

Chile’s public health coverage is strongest around larger cities like Santiago or Valparaíso. Healthcare gets slower around rural areas, though Chile is working to overcome this. FONASA specializes in primary medical care and preventative medicine, but this public scheme may refer patients to the private sector for more complex medical needs.

Private Healthcare

Most expats in Chile carry private insurance, either with an ISAPRE or a global insurer like Cigna Global. Those insured under an ISAPRE contribute 7% of their salary, though additional fees may apply.

Private health insurance comes with the usual perks these plans have in countries with universal healthcare: private clinics and hospitals, shorter wait times, and offset out-of-pocket costs. When shopping for a private plan, confirm that pre-existing conditions are covered in a new policy. ISAPREs cover different plans; do your research to confirm that your chosen provider fits your needs.

Chile offers exceptional private medical care, leading expats to prefer private options over the public FONASA plan. While health insurance isn’t required to enter Chile, we highly recommend having coverage in place at all times.

Out-of-pocket Options

With dramatically lower health costs compared to the US, paying out of pocket for medical treatment is certainly an option in Chile. Dental care, for instance, is usually paid out of pocket. Expats paying out of pocket may use both the public and private health systems, though the bill may be due before service. Walk-in clinics may provide a cost-effective solution for out-of-pocket care in minor situations. We strongly recommend carrying travel insurance during scouting trips and private health coverage during your time in Chile.

Healthcare Checklist

• Schedule final appointments with your primary care physician and any specialists you see.
• Research your medications for availability in Chile and find alternatives where needed.
• Stock up on prescription refills until you can get to the pharmacy in Chile. It’s a dance because you’ll save money by filling your prescriptions in country, but it may take time for you to learn your way around.
• Print out and keep photographic records of all prescriptions. Bring meds in original packaging with a letter from your doctor detailing your condition, the drug, and its generic name.
• Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work. Get them translated to Spanish for easier service.
• Ask your providers for referrals abroad. You never know!
• People often find physicians by visiting Salud Responde or the local centro de salud. Also, ask locals for recommendations.
• For public healthcare, visit your local Registro Civil office to get your RUT/RUN card. Employment by a Chilean company makes for easy access to FONASA.
• For private healthcare, apply for private insurance directly or through work. Research the ISAPREs carefully to select the one that fits your needs. Global insurance is also an option.
• See your family doctor and get prescriptions and referrals.