Branches of the CASS
Social security is made up of two different branches or strands of protection: * General branch covers reimbursement, temporary disability, maternity, paternity, risk during pregnancy, disability, capital death benefits and orphan's pensions. * Retirement branch covers the situation of loss of income due to cessation of work or economic activity derived from age and is made up of the retirement pension and temporary and lifetime widow's pensions.Social Security contributions
Salaried workers' contributions
The Andorran law establishes that for salaried employees the CASS must collect the 22% of their gross monthly salary. The amount collected is divided between worker and employer: * Workers must allocate 6.5% of gross monthly salary to the coffers of the CASS 3% to the general branch and 3.5% in the retirement branch * The company must contribute 15.5% salary (7% for the general branch and 8.5% for retirement) The company is responsible for paying monthly amounts directly to the CASS, so some companies decide to assume a higher percentage of contributions in order to partially release their workers.Self-employed worker contributions
Self-employed workers also have to contribute to the CASS. There is a minimum contribution base for a self-employed person within the average Andorran salary of all workers affiliated with social security in the past year as established by law. And then, over that minimum contribution base is applied the rate of 22%. Usually this minimum contribution is about €450 monthly (Average salary is used to be around €2000–€21000 per month).Of this total amount 10% is for the general branch and 12% for retirement.Health expenses reimbursed
In Andorra, healthcare works by co-payment: the social security administration (the CASS) covers a part of the total expenses. The costs, in addition, in most cases are borne first by the user, and then the CASS reimburses the subsidized amount by transfer or other similar method. The medical expenses covered by CASS are basically divided according to the medical service and the amount subsidized: * Those patients who go to outpatients or health centers, to inquiries or visit specialists, CASS covers at least the 75% of the cost. * In case of hospitalization CASS covers 90% of expenses, also allowing payment of only the percentage not covered by CASS. * Expenses caused by occupational accidents or occupational diseases and births are 100% covered. * Finally, if your health expenses in Andorra are with services not affiliated with Andorran social security, reimbursements can be up to 33% of the total. CASS finances 100% of the treatment costs of people who demonstrate that they cannot cope with the debt, such as people without resources or in a situation of social exclusion. There are also agreements withReferral Doctor
In September 2018 the service moved to a referral system, where patients must register with a general practitioner who would decide whether to refer them to a specialist. Those who follow this integrated route are encouraged by a higher rate of reimbursement and the purpose is to improve access, efficiency and coordination of medical care. The user registered in the CASS currently must choose a doctor or pediatrician as referring doctor. This offers more personalized but general health care, and monitors the users' health status over time. It is the primary diagnosis, that autorises visits to specialists and guides the health system and coordinates with the different health professionals who treat the patient. In addition, it is not necessary to pay the total cost in consultations with the Referring Doctor.References
{{reflist Medical and health organisations based in Andorra