The Board of Directors of the Costa Rican Social Security Fund (CCSS) agreed, this Wednesday March 11, in an extraordinary session, to modify the regulations that govern the granting of licenses and disabilities for active insured (salaried and independent workers), so that may grant this benefit to asymptomatic contacts, but who have a sanitary order for home isolation indicated by the Ministry of Health, in relation to COVID-19.
Dr. Román Macaya Hayes, executive president of the CCSS, explained that this decision seeks to protect these people in a more comprehensive way, since until before this change an active insured with a health order, but without symptoms, could not be a beneficiary of a disability allowance. The hierarch said that the institution made this determination so that people who should be isolated in their homes, even if they do not have symptoms of the disease, do not see limited financial resources that allow them to meet their basic needs. Similarly, he said that the CCSS has the responsibility to mitigate the possibility of contagion.
“From the point of view of public health, it is clear that the comprehensive protection of individuals and communities requires preventing the transmissibility of this virus, which quickly spreads from person to person. We must establish the necessary mechanisms to guarantee this comprehensive health protection. Said protection cannot be considered complete, as the people who must maintain a state of isolation, to protect others, are limited in access to economic resources to meet their primary needs, ”said the executive president.
For his part, Dr. Mario Felipe Ruiz Cubillo, medical manager of the CCSS, explained that although, by definition, active policyholders who are asymptomatic contacts are not sick people, from the point of view of comprehensive health care, the Which is the Institution responsible, if they present different situations of a psychosocial nature that can negatively affect their health status and that this decision will protect them, as well as the people around them, while they complete their period of isolation by instruction of the sanitary order.
The manager said that the change occurs in the Health Insurance Regulations of the CCSS with the addition of article 10 bis, to include disability due to a health alert due to Coronavirus “COVID-19”, as an exceptional and temporary rule, in the following terms:
“Article 10 bis. – “Disability due to health alert due to coronavirus” COVID-19 “:
a. It is included within the concept of disability indicated in this article, those cases that are in an investigative or probable condition, that the insured may suffer from the disease “COVID-19” for the granting of disability, by the team treating health, the following special provisions must be followed:
a.1. It is an exceptional and temporary disability, the maximum term of which will be established in the health order.
a.2. It will be based on the home isolation health alert issued by the competent authority of the Ministry of Health.
b. For the purposes of granting the disability, the health order may be presented by the insured, relatives, interested person or by officials of the Ministry of Health, so that the disability is expedited by the Treating Doctor of the Fund in an expedited manner.
c. Payment of this disability is subject to the requirements and conditions established in the Health Regulations.
For the cases already declared, its application will be retroactive from the issuance of the sanitary order. This measure will be carried out for a reasonable period of time as the health emergency in the country persists.
Article 2 of the Regulations for the Granting of Disabilities and Licenses to Health Insurance Beneficiaries was also amended to read as follows:
Article 2. Definitions.
“… In no case will an incapacity be granted to a healthy person, even if it is to care for a sick patient, except in cases in which the validity of article 10 bis of the Health Insurance Regulations is maintained.”
The modifications approved by the Board of Directors of the CCSS are temporary and exceptional, so the institution can make the adjustments it considers when required.
These changes will govern as of their publication in the official Gaceta newspaper.
Additionally, the Board of Directors agreed, in the midst of addressing the situation presented in the face of the threat of the COVID 19 virus, to extend a thank you to all the officials of the CCSS for all their collaboration, commitment and mysticism shown at all times.