When an obra social (union or employer health insurance fund) or a private health insurer (prepaga) refuses a medication, a treatment or a surgery, the wait can be distressing. But that refusal is not the final word: you can challenge it in court through a health amparo, a fast-track action designed for urgent situations.
Together with the amparo, you can request an interim court order: a temporary order from the judge requiring the coverage to be provided while the case is ongoing. That way, your treatment is not put on hold.
Our team reviews your case, gathers the medical documents and files the claim with the urgency your health requires. We stay with you throughout the process.
“Health can't wait.”
When can you make a claim?
- Your obra social (union or employer health insurance fund) or private health insurer (prepaga) refuses a medication, treatment or surgery your doctor prescribed.
- They offer to cover only part of what you need.
- They are delaying an authorization and your health can't wait.
- You need a disability-related service and it is refused or only partly provided.
What can you claim?
- High-cost medication, or medication not on the approved list.
- Therapies and treatments.
- Disability coverage, with a Disability Certificate (CUD).
- Complex surgery and hospital stays.
- Prostheses, orthoses, hearing aids, infusion pumps and medical supplies.
- Home-based or residential care.
- Nursing homes and assisted living.
- Assisted fertility treatment.
- Treatment for eating disorders.
- Treatment for cancer, HIV, autism and diabetes, among others.
- Therapeutic support workers, transport, classroom support teachers and day centers.
Membership and continuity of coverage
An amparo can also help when the problem is not a specific treatment, but the coverage itself:
- Being refused membership because of a pre-existing condition.
- Unreasonable increases in your monthly fee.
- Refusal to keep your coverage when you retire.
- A change of plan without your consent.
How we support you
Personal advice
We listen to your situation and review your doctor's prescription and the response from your health fund or insurer.
Filing the amparo
We prepare and file the court action with all the supporting documents.
Urgent measures
When the situation calls for it, we request an interim court order so your coverage doesn't have to wait.
Ongoing support
We follow the case through to the end and explain every development to you.
Useful documents
- Your ID (DNI) and health fund or insurer membership card.
- Your treating doctor's prescription or order, with the diagnosis.
- Medical records or test results supporting the request.
- The written refusal, or proof of your request: emails, letters or screenshots.
- Your Disability Certificate (CUD), if you have one.
Don’t worry if you don’t have everything: we will go through it together at the consultation.
Frequently asked questions
What is a health amparo?
It is a fast-track court action to protect the right to health when an obra social, a private health insurer or PAMI (the national health program for retirees) refuses or delays coverage. It is designed for situations where waiting could cause harm.
What is an interim court order?
It is a temporary order from the judge, requested together with the amparo, so that the coverage is provided while the case is decided. That way, your treatment is not put on hold.
Do I need a written refusal to make a claim?
Not always. Often the refusal is given verbally, or no answer ever comes. In that case, we gather other proof of your request, such as emails, letters or screenshots.
Can I make a claim if I have private health insurance rather than an obra social?
Yes. Private health insurers must also provide the coverage they are required to, and they can be sued with a health amparo.
Does it work against PAMI too?
Yes. PAMI must also provide the services it is required to and, if it does not, you can bring an amparo.
Related topics
- Nursing home coverage, PAMI and assisted living100% coverage of nursing home care when there is a medical order and a need for permanent care.
- Professional malpracticeClaims for negligence by doctors, dentists, lawyers, architects and other professionals.
- Legal capacity proceedingsRestriction of legal capacity and support systems, handled with respect and care.
General information only. It is not a substitute for advice on your specific case.