¿La Prepaga te dejo sin cobertura cuando mas la necesitas? ¿Tenes un problema de salud y la Prepaga se niega a darte cubertura? Encontra la Alternativa Legal para exigir que te vuelvan a afiliar y te cubran el tratamiento que necesitas.
La respuesta a la pregunta es no: las Empresas de Medicina Prepaga no pueden desafiliar a quienes se han asociado a ella.
¿Y la Obra Social? Menos aun. Es obligación de la Obra Social cubrir cualquier enfermedad que atraviesen sus afiliados, sin poder ejercer la opción de seleccionar a quien se pueda afiliar a ella.
Si bien la actividad que asumen las Empresas de Medicina Prepaga presenta rasgos mercantiles, no debe soslayarse que tienen un compromiso social con sus usuarios y que debe ser pilar de la relación que los vincula la preservación de la salud de sus afiliados.
Cuando se evalúa la posibilidad de desafiliar a quien se asoció a una Empresa de Medicina Prepaga se encuentra comprometido el derecho a la salud y a la integridad física de las personas, ambos reconocidos por Pactos Internacionales de Derechos Humanos que gozan de Jerarquía Constitucional (es decir, el rango legal más alto en la pirámide normativa local).
¿Y si quien se asoció lo hizo sin declarar una enfermedad preexistente? La respuesta sigue siendo no. Los derechos en cuestión seguirían siendo los mismos y aún con mayor motivo: la falta de cobertura pondría en serio peligro el estado de salud de la persona.
No obstante, si hay un falseamiento de datos en la solicitud de ingreso, la Empresa de Medina Prepaga puede valorizar la cuota del afiliado de acuerdo a la dolencia denunciada.
¿Qué hago si me desafiliaron y necesito un tratamiento de modo urgente? Contacte a su abogado de confianza. Es viable iniciar una Acción de Amparo solicitando judicialmente la reafiliación a la Empresa de Medicina Prepaga, así como la restitución de los servicios médicos y la cobertura asistencial en idénticas condiciones en las que se encontraba con anterioridad a la anulación del contrato.
Si tenés una consulta por este tema podés escribirnos a [email protected] o completar el siguiente Formulario de Contacto que será respondido por un profesional a la brevedad.
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