CHART OF MODERATING QUOTAS AND COPAYMENTS FOR THE YEAR 2007 ACCORDING TO AGREEMENT 260 OF THE 2004 OF CNSSS
TYPE
SALARY RANGE 1
WIN FEWER THAN 2 SMLMV

(until $ 867.400)

SALARY RANGE 2 BETWEEN 2 Y 5 SMLMV
(from $ 867.400 until $ 2,168,500)

SALARY RANGE 3
MORE THAN 5 SMLMV

($ 2,168,500 and more)

MODERATING QUOTAS
(should be cancelled by the quoting and the beneficiaries)

Value in pesos and percentage
$ 1.700
(11.7% de 1 SMLDV)

$ 6.700
(46.1% de 1 SMLDV)

$ 17.600
(121.5% de 1 SMLDV)

CO-PAYS
(Should be cancelled only by the beneficiaries)


Percentage to apply
Maximum top for a same event
Maximum top of co-payments per calendar year.

11.5%
$ 124.500
(28,7% de 1 SMLMV)
$ 249.400
(57.5% de 1 SMLMV)

17.3%
$ 498.755
(115% de 1 SMLMV)
$ 997.510
(230% de 1 SMLMV)

23%
$ 997.510
(230% de 1 SMLMV)
$ 1.995.020
(460% de 1 SMLMV)
Services subjected to the collection of moderating quotas
(Article 6 agreement 260 of the CNSS)
Services subjected to the colllection of co-pays
(Artícle 7 Agreement 260 of the CNSSS)
1. External medical consult, odontology, paramedic and accepted alternative medicine.
2. External consultation by specialist doctor.
3. Medicine formula for ambulatory treatments
4. Examinations of diagnosis by clinical laboratory, ordered in ambulatory form and that do not require additional authorization by the treating doctors.
5. Diagnosis exams for imagenology, ordered in ambulatory form and that they don't require additional authorization by the treating doctor.
6. Attention in the service of urgencies only and exclusively when the use of these services does not obey, in opinion of a health profession, to problems that jeopardize the life.
Co-pays must be apply to all services contained in the Obligatory Health Plan, with the exception of:

1. Promotion and prevention services.
2. Control programs in infantile maternal attention.
3. Control programs in attention of the transmissible diseases.
4.Catastrophic or high cost diseases.
5. Urgencies initial attention.
6. The services enunciated in Article 6 of the Agreement 260 of the CNSSS.

Source: Agreement 260 of 2004 of the National Council of Social Security in Health. SMLMV (abrv. in Spanish) = Effective Monthly Legal Minimum Wage. SMLDV (abrv. in Spanish) = Effective Legal Minimum Wage per day.
SMLMV 2007= $ 433.700.

 
 
 
CHART OF CO-PAYMENTS FOR THE OR THE YEAR 2007 FOR SUBSIDIZED RÉGIME ACCORDING TO LAW 1122 OF 2007 AND I AGREE 260 OF THE 2004 OF CNSSS
LEVELS
VALUE OF THE ACCOUNT

CHARGE FOR SAME EVENT

TOP VALUE PER YEAR
CO-PAYS

Indigents and indian communities
Level 1 I according to Law 1122 of 2007
Level I I according to agreement 260 of 2004

$0
$0
10%

$0
$0
$216,850

$0
$0)
$433,700
Services non subject to the collection of Co-pays
(article 11 agreement 260 of the CNSSS)
Services subject to the collection of co-pays
1. Promotion and prevention services.
2. Control programs in infantile maternal attention, including attention of the childbirth.
3. Control programs in attention of the transmissible diseases.
4. Catastrophic or high cost diseases.
5. The initial attention in emergency room.
6. The attention of the child during the first year.

1. Services of Hospitalization and Surgeries.
2. Ambulatory Procedures

Source: Law 1122 of January, February 9 of 2007 and agreement 260 of 2004 of the National Council of Social Security in Health. SMLMV (abrv. in Spanish) = Effective Monthly Legal Minimum Wage. SMLDV (abrv. in Spanish) = Effective Legal Minimum Wage per day.
SMLMV para año 2007= $ 433.700.

 
 
 
 
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