Coverage guide

Health insurance coverage for pain treatment: OSDE, Swiss Medical, Galeno and more

General guidance on private health insurance and obra social (Argentine union-based insurance) coverage for the interventional procedures we perform most often.

Coverage by procedure

This table summarizes each health plan's typical coverage for the procedures we perform. If your plan isn't listed, send us a WhatsApp message.

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Health plan / Obra social Consultation Facet Block Radiofrequency Epidural Injection PRP (Regenerative Med.) Botulinum Toxin Joint Injection
OSDE ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
Swiss Medical ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
Galeno ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
Medifé ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
Omint ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
Medicus ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
OSDEPYM ✓ ⚠ ⚠ ⚠ ✗ ⚠ ✓
IOMA ⚠ ⚠ ⚠ ⚠ ✗ ⚠ ⚠
Self-pay ✓ ✓ ✓ ✓ ✓ ✓ ✓
✓Covered, no paperwork. Performed with the standard medical order.
⚠Requires prior authorization from your health plan. Our office handles it.
✗Usually not covered. Check with your plan or pay out of pocket.
Important note. This information is a general guide reflecting typical practice. Coverage can vary between plans within the same insurer (e.g. OSDE 210 vs OSDE 410). Before your procedure, our office handles the authorization with your health plan. If you have questions before your visit, send us a WhatsApp message.

How authorization works with each insurer

Pain medicine with OSDE

Specialist consultations are covered by OSDE plans. Procedures (facet block and radiofrequency ablation, epidural injection) require prior authorization: our office prepares the medical order and the clinical justification for submission. PRP is usually not covered and is done on a self-pay basis.

Pain medicine with Swiss Medical

Swiss Medical covers the specialist consultation; interventional procedures require prior authorization with a well-documented medical order. We prepare the paperwork and walk you through your plan's authorization process.

Pain medicine with Galeno

With Galeno, the consultation is covered and procedures require prior authorization. Joint injections often have direct coverage depending on the plan.

Pain medicine with Medifé or Omint

The process is similar: the consultation is covered, and prior authorization is required for nerve blocks and radiofrequency ablation (including knee radiofrequency ablation). Bring your membership card and your imaging; the authorization request goes out from our office with the full clinical justification.

A different health plan or obra social?

If your coverage isn't in the table, write to us anyway: many obras sociales (Argentine health funds) cover the specialist consultation and will evaluate procedure authorization with a well-documented medical order. You can also be seen on a self-pay basis.

Where we see patients

We accept these plans at both of our locations: Hepta, in San Isidro (Av. Fondo de la Legua 577, Zona Norte) and CIAREC, in Villa Urquiza (Av. Monroe 4770, CABA). We also offer virtual first visits. Phone: (011) 5895-3260.

Questions about your coverage?

Tell us which health plan you have and which procedure you've been prescribed. We'll confirm coverage before booking your appointment.

Check my coverage

We see patients through AAARBA · self-pay · virtual consultations.

Frequently asked questions

Do I need prior authorization for a facet block with OSDE?
Yes. Under most OSDE plans, facet blocks and other interventional procedures require prior authorization from the insurer. Our office handles that authorization for you, submitting the medical order, the imaging reports and the corresponding procedure code. You don't have to do any paperwork on your own.
Do health plans cover regenerative medicine (PRP)?
In general, Argentine private health plans do not cover PRP (platelet-rich plasma) or other regenerative medicine treatments, because they are not yet included in the PMO (Programa Médico Obligatorio, Argentina's mandatory coverage program). Some premium plans or specific riders may cover them partially. If you decide to have a regenerative treatment, it is most often done on a self-pay basis. We let you know the cost before the procedure.
How is authorization for radiofrequency ablation handled?
Once radiofrequency ablation has been indicated after your consultation — and usually after a prior diagnostic block — our office sends your health plan the clinical summary, the procedure codes and the studies supporting the procedure. Authorization usually takes 5 to 15 business days. As soon as the insurer responds, we schedule the procedure date with you.
What if my health plan isn't in the table?
Through AAARBA we work with most private health plans and obras sociales in the country, including many that don't appear in the summary table. Send us a WhatsApp message with the exact name of your plan and tier, and we'll confirm coverage before scheduling your consultation.
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