SIS health insurance in Peru: who qualifies and what it covers

The core misunderstanding: thinking SIS is only for the poor

For years, Peru’s public health insurance (SIS) was almost synonymous with “insurance for the poor”: a state subsidy reserved for people registered as poor or extremely poor. That stopped being accurate in November 2019, when the government opened SIS to any Peru resident without another health insurance, regardless of how much they earn.

The 2019 shift: free SIS no longer depends on your income

Emergency Decree N.° 017-2019 states it plainly:

“Autorícese a la IAFAS – SIS a afiliar independientemente de la clasificación socioeconómica, a toda persona residente en el territorio nacional que no cuente con ningún seguro de salud, con la finalidad de garantizar la protección del derecho a la salud. Esta afiliación garantiza a los beneficiarios la cobertura gratuita del Plan Esencial de Aseguramiento en Salud – PEAS.” (“Authorize IAFAS-SIS to enroll, regardless of economic classification, any person residing in national territory who has no health insurance whatsoever, in order to guarantee protection of the right to health. This enrollment guarantees beneficiaries free coverage under the Essential Health Insurance Plan – PEAS.”)

That’s what’s now known as the SIS Para Todos plan: free, with no economic-classification screening, for anyone without other insurance. The same decree makes clear that what still depends on your income is access to additional coverage:

“El acceso a la cobertura de los planes complementarios, se encuentra sujeto a la aprobación de estos y sus criterios de elegibilidad basados en la vulnerabilidad económica.” (“Access to complementary-plan coverage remains subject to those plans’ approval and to eligibility criteria based on economic vulnerability.”)

What SIS guarantees you at minimum: the PEAS

Every insured person in Peru’s health system — whether through SIS, EsSalud, an EPS plan, or private insurance — is entitled to a minimum floor of coverage called the Plan Esencial de Aseguramiento en Salud (PEAS). The Consolidated Text of Law N.° 29344 defines it this way:

“El Plan Esencial de Aseguramiento en Salud (PEAS) consiste en la lista priorizada de condiciones asegurables e intervenciones que como mínimo son financiadas a todos los asegurados por las instituciones administradoras de fondos de aseguramiento en salud, sean estas públicas, privadas o mixtas, y contiene garantías explícitas de oportunidad y calidad para todos los beneficiarios.” (“The PEAS is the prioritized list of insurable conditions and interventions that, at minimum, are financed for all insured persons by health-fund administrators — public, private, or mixed — and it carries explicit guarantees of timeliness and quality for every beneficiary.”)

And it isn’t an optional list your insurer can trim: the same law says it’s mandatory and that any beneficiary can demand it:

“El Plan Esencial de Aseguramiento en Salud (PEAS) es ofertado de manera obligatoria por todas las instituciones administradoras de fondos de aseguramiento en salud. Cualquier beneficiario puede exigir su cumplimiento ante las instancias de regulación y supervisión respectivas.” (“The PEAS must be offered by all health-fund administrators as a mandatory matter. Any beneficiary can demand it be honored before the relevant regulatory and oversight bodies.”)

In practice, SIS covers well beyond that legal minimum: according to its own official page, it covers more than 12,000 diagnoses, including several types of cancer, plus medicines, procedures, surgeries, supplies, a burial benefit, and emergency transport.

SIS’s five plans, and which one applies to you

SIS isn’t a single plan — it’s five, each with different requirements.

SIS Gratuito — for people registered in the Sistema de Focalización de Hogares (Sisfoh) as poor or extremely poor, plus groups the rule adds directly: pregnant women, children under five, firefighters, among others.

SIS Para Todos — free for any resident without other health insurance, regardless of economic status or classification (CSE). The official page specifies that even people whose CSE has expired or who are classified as “No Pobre” (not poor) can access it. One catch: if you enroll in another insurer that also offers PEAS plus a complementary plan, your SIS Para Todos coverage is voided — the two don’t stack.

SIS Independiente — for anyone who prefers to pay a monthly contribution in exchange for coverage. It costs from S/ 39 a month for the policyholder alone, S/ 78 with one additional family member (dependent), S/ 94 with two, and S/ 115 with three or more.

SIS Emprendedor — built for people who work independently with no employees of their own (dressmakers, shopkeepers, hairdressers, plumbers, and similar trades). If you pay the Nuevo RUS (NRUS) simplified tax regime for three straight months in bracket 1 or 2 with SUNAT, you’re enrolled automatically at no cost; you can add your partner and minor children for free too, though that step must be done in person.

SIS Microempresas — lets a small-business owner enroll their own workers and the family members who depend on them.

The three regimes behind these plans

Legally, these five plans aren’t stand-alone categories — they sit under three financing regimes the law recognizes across Peru’s entire health system, not just SIS:

“El régimen subsidiado: Comprende a las personas que están afiliadas a las instituciones administradoras de fondos de aseguramiento en salud, por medio de un financiamiento público total. Dicho régimen está orientado principalmente a las poblaciones más vulnerables y de menores recursos económicos y se otorga a través del Seguro Integral de Salud. El régimen semicontributivo: Comprende a las personas que están afiliadas a las instituciones administradoras de fondos de aseguramiento en salud, por medio del financiamiento público parcial y aportes de los asegurados y empleadores, según corresponda.” (“The subsidized regime covers people affiliated to health-fund administrators through full public financing, aimed mainly at the most vulnerable and lowest-income populations, delivered through the Seguro Integral de Salud. The semi-contributory regime covers people affiliated through partial public financing plus contributions from the insured and, where applicable, their employers.”)

SIS Gratuito and SIS Para Todos are, in essence, the subsidized regime: the state pays 100%. SIS Independiente and SIS Emprendedor sit closer to the semi-contributory regime: there’s a contribution from the member (or, for Emprendedor, from the NRUS tax payment) combined with public financing. The third regime, contributory — based on a dependent worker’s payroll contribution — belongs mainly to EsSalud, not to SIS.

If your condition isn’t in the PEAS: FISSAL

The PEAS is a floor, not a ceiling — but some high-cost health conditions fall outside that base list. For those cases, the law sets up a separate fund:

“Las enfermedades de alto costo de atención que no están incluidas en el PEAS pueden ser financiadas para la población bajo el régimen subsidiado y semicontributivo con el Fondo Intangible Solidario de Salud (FISSAL). El listado de las enfermedades que serán aseguradas deberá ser definido previamente por el Ministerio de Salud.” (“High-cost diseases not included in the PEAS may be financed, for people under the subsidized and semi-contributory regimes, through the Fondo Intangible Solidario de Salud (FISSAL). The list of diseases to be covered must be defined in advance by the Ministry of Health.”)

In other words: if your diagnosis is high-cost and doesn’t appear in the PEAS, the next question isn’t “does SIS not cover this?” but “is it on FISSAL’s list?” — a list the Ministry of Health defines and updates separately, and one this page doesn’t detail.

Where you’ll be treated, and what SIS doesn’t cover

SIS pays for care, but it doesn’t deliver it directly: according to its own plans page, “SIS pays for your health care, and the health facility is responsible for actually treating you and dispensing your medicines.” That facility is always public — run by the Ministry of Health or a regional government — never EsSalud or a private clinic, aside from limited arrangements this page doesn’t cover. If you have EsSalud or an EPS plan, those are separate insurers with their own networks.

One thing worth watching if you choose SIS Para Todos: according to the official page current as of this article’s verification date, that specific plan’s complementary-plan coverage and burial benefit are announced as valid through December 31, 2026. If you’re reading this after that date, check SIS’s website to see whether that coverage was extended or changed.

How to protect yourself in practice

• Check your current enrollment before filing anything new — you may already be covered without knowing it.
• If you have no other insurance, request SIS Para Todos — it’s free and doesn’t depend on how much you earn.
• If you’re living in poverty, check or update your Sisfoh classification to access SIS Gratuito.
• If you want more coverage and can pay, compare SIS Independiente (from S/ 39 a month) with SIS Emprendedor (free if you pay the NRUS in bracket 1 or 2).
• Go only to public facilities run by the Ministry of Health or your regional government — and if you’re denied something the PEAS guarantees, you can demand it before SUSALUD.