Special supplementary plan

What is the Special Supplemental Plan?

It is a modality of individual or collective contracting that gives you comparative advantages of access to a differential care network with greater coverage and benefits that expand the services of the Mandatory POS Health Plan.

  • Extensive experience in providing excellent quality health services.
  • Easy access and simplicity in administrative procedures.
  • Innovative technology, with proven cost-effective evidence that ensures the care process, generating the perceived value in sharpening additional plans.
  • Non-payment of bonuses and partial coverage of the moderating fee.
  • Coverage of the copayment that the beneficiary must pay for non-pre-existing events.
  • Discounts for periodicity in payments.
  • Various forms and channels of payment.
  • Access to the services of your Plan, only presenting your identification document.
  • For your affiliation you will receive the membership card that accredits you as a member and will allow you to access healthy benefits.

* Extensive experience in providing excellent quality health services.
 

  • Access to specialties without referral: general practitioner, internist, family doctor and pediatrician.
  • Direct access to: Promotion and Prevention Programs, Oral Health, Gynecology, Obstetrics, Psychology, Optometry, Urology and Orthopedics.
  • Other subspecialties with remission in the first evaluation.
  • Complementary medicine after referral from the personal doctor (one consultation and one control).
  • Wide differential network of professionals strategically located in different sectors of the city.
  • Telephone assignment of medical appointments (general and specialized medicine according to direct access).
  • Coverage for the family group, according to individual bonding.
  • Newborn coverage for the first 30 days and their inclusion in the Special Complementary Plan, maintaining the seniority of the mother enrolled in the Plan.
  • Telephone medical guidance 24 hours 4853530 option 4 appointments, then option 2 supplementary plan and then option 3, or direct line 6531313, from the beginning of the contract for priority appointments, emergency care, recommendations at home and home doctor when the state of the patient warrants it, after evaluation and authorization of the professional of the 24-hour emergency orientation line. In addition, ground ambulance within the urban perimeter, if the patient's pathology requires transfer, with prior authorization from the EPS
  • Individual room in case of hospitalization and surgery in the network of contracted institutions with differential care.
  • EPS Comfenalco Valle has developed its own health infrastructure and a service provision network that makes it possible to provide care with efficiency and opportunity, through its own IPS and IPS registered for our members of the Special Complementary Plan.
  • We have an agreement with recognized private and public IPS such as hospitals and accredited clinics in the city (individual room), a representative number of attached specialist doctors, as well as different locations and points for drug delivery.

Through this means, as a user of the individual supplementary plan, you sign an authorization for the corresponding value of the supplementary plan fees to be debited from your bank account on a monthly basis.

If you are interested in using this service, we invite you to fill out the following form (View format) and send it by email to: renew my complementary plan@epscomfenalcovalle.com.co In this way, the change in the payment method of your contract will be legalized. Please note that to perform automatic debit, the account must meet the following requirements:

1. The account must be in the name of the contract holder.
2. It should not be a shared account or a pension account.
3. The dates for the debit according to your choice are: 5, 10, 15, 20 or 25 of each month.

They are the channels through which the different forms of payment can be collected.

The defined means of collection are: individual through checkbooks for payment in cash, in banks, check, credit or debit card and electronic and business transfers, the above except for checkbook.

The banking entities authorized to collect the additional plan are:

  • Colpatria: It is an agreement through which Comfenalco Valle receives its collection at the Colpatria offices. Savings account 308700054-7.
  • AVVillas: It is an agreement through which Av.Villas receives its collection. Savings account 165-00411-0.
  • Transfers and consignments: They are bank transactions for the payment of the complementary plan, received by transfers and consignments in the bank account of the COLPATRIA agreement (allows business and individual payments).
  • Agrarian Bank: It is an agreement through which Comfenalco Valle receives its collection (individual and business payment), at Banco Agrario's offices throughout the national territory. Savings account 4-6903-302298-9.
  • Baloto Points: (Individual payment) This means of payment can be accessed by the user with billing (Check Book No.), approaching any ballot point throughout the national territory and indicate the agreement 951508.

At the beginning of the term of the contract

  • Personalized medical guidance for cases of hospitalization, surgery, diagnostic support and therapeutic complementation.
  • 24-hour emergency telephone medical guidance.
  • Outpatient consultation (general and specialized).
  • Professional care at home, when the EPS medical service justifies it due to the member's health status.
  • Means of diagnostic support and therapeutic complementation.
  • Individual psychotherapy treatment.
  • Prenatal checkups.

From the 5th month in collective affiliation and from the 7th month in individual affiliation

  • Treatment of terminal illnesses through home care and / or intermediate care facilities.
  • Means of support and diagnosis and therapeutic complementation (III and IV level).

From the 6th month in collective affiliation and from the 8th month in individual affiliation

  • Treatment of diseases that require surgical management of group 8 and above according to the manual of activities, interventions and procedures of the POS.
  • Psychiatric hospitalization.
  • Treatment for an inpatient in the Intensive Care Unit with stays of less than five (5) days.

From the 8th month in collective affiliation and from the 10th month in individual affiliation

  • Delivery and cesarean delivery care.

From the 11th month for collective membership and from the 13th month for individual membership

  • Cancer chemotherapy and radiation therapy treatment.
  • Artificial kidney and peritoneal dialysis on an outpatient basis for the treatment of reversible kidney failure.
  • Surgical treatment for the patient with major trauma.
  • Treatments for patients admitted to the Intensive and / or Intermediate Care Unit with stays longer than five (5) days.
  • Surgical treatment for diseases of the heart and central nervous system.
  • Joint replacements.
  • Treatment of the great burn.

Comfenalco Valle Entidad Promotora de Salud, will not assume the cost of medical and complementary services provided to an affiliate, even if they are provided by registered IPS, in the following cases:

  • Treatment for malformations and / or congenital anomalies and their consequences (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Pre-existing illnesses or malformations (covered by the Mandatory Health Plan, in accordance with current regulations).
  • Surgery and aesthetic or cosmetic treatments, as well as complications, procedures, interventions and medications derived from these, also plastic surgery to treat pre-existing conditions, with the exception of reconstructive surgery practiced for the treatment of an injury originated after the affiliation to the Special Complementary Plan.
  • Executive medical check-ups or similar.
  • Illnesses, accidents or treatments caused by the effect of alcohol or drugs -without medical prescription (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Injuries caused by states of dementia, under conditions of mental derangement or by suicide attempt (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Treatment for the Human Immunodeficiency Virus "HIV", or the Acquired Immunodeficiency Syndrome "AIDS", as well as the sequelae, recurrences and diseases caused by them (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Illnesses or accidents caused by catastrophes, such as: earthquakes, wars, strikes, kidnapping or disturbance of public order (Covered by the Mandatory Health Plan, in accordance with the regulations in force for these events).
  • Treatment or cures of rest or sleep and hospital treatment for chronic nervous or mental illnesses. Psychoanalysis is also excluded (Covered by the Mandatory Health Plan, in accordance with current regulations for these events).
  • Accidents and occupational diseases.
  • Injuries from the practice of sports or highly dangerous activities, including: competitive motor racing, boxing, hunting, bullfighting, wrestling, paragliding, parachuting and others considered highly dangerous, (covered by the Mandatory Plan of Health, in accordance with current regulations).
  • Supply of elements such as: pacemakers, valves, rings, vascular devices, trusses, crutches, wheelchairs, orthopedic devices or equipment, prostheses of any kind, hearing aids, artificial sphincters, cardioverter, resynchronizer, allografts, CPAP, BPAP, mattresses, hospital beds, organs for transplants, elastic stockings, corsets or girdles, orthopedic insoles and shoes, colostomy bags, personal hygiene items, diapers, cosmetic items (It is covered by the Mandatory Health Plan in accordance with current regulations ).
  • Supply of medications for outpatient treatment (Covered by the Mandatory Health Plan, in accordance with current regulations for these events).
  • Dental treatments, orthodontics, rehabilitation, implantology, prosthetics, periodontology and dental procedures with aesthetic purposes (Covered by the Mandatory Health Plan, in accordance with current regulations for these events).
  • Study and treatment of fertility and artificial insemination.
  • Injuries caused in military service or by military practices (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Corrective treatments or procedures for conditions caused by visual refractive errors, implantation of intrastromal rings, supply of spectacles, contact lenses or spectacle lenses and frames in material other than glass or plastic with filters, colors or special films, as well as correction by means of medical or surgical treatment of astigmatism, myopia or hyperopia (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Genetic studies to determine paternity, innate metabolic diseases, diseases of genetic origin and / or with a hereditary component.
  • Irreversible comatose states (Covered by the Mandatory Health Plan, in accordance with current regulations).
  • Surgical treatments or interventions ordered by doctors not affiliated with the EPS Comfenalco Valle service network, except in emergency cases.
  • Treatment for non-reversible chronic renal failure (Covered by the Mandatory Health Plan, in accordance with current regulations) and organ transplantation (Covered by the Mandatory Health Plan, in accordance with current regulations). Accordion content

We inform that the emails: authorizaplancomplementariaespecial@epscomfenalcovalle.com.co and authorizapacvalle@epscomfenalcovalle.com.co, are not available since last September 14.

All medical services must be authorized through our Authorizations application. Enter here and request your services: www.comfenalcoeps.com

ACT. 2020

I want to join

Address: Carrera 8 # 6 - 38
Call the phone: 4853530 option 3
Write to email: affiliationsepscv@epscomfenalcovalle.com.co

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