Saturday , July 24 2021

Health plans will have a discount of 8.19%. The lawyer explains the changes



Individual health plans or family medically regulated hospitals will become cheaper for the first time in history. Approximately 8 million users will benefit from the measure, and the percentage of collected ANS to be used is -8.19% of the monthly subscription. The reason for the reduction is due to the coronavirus pandemic, as people went to doctor’s appointments that were not necessary, which in turn reduced the cost of the plans.

The reduction was announced on July 12, when the National Agency for Complementary Health (ANS) announced that this adjustment would affect those whose contracts have been signed since May.

But what can this reduction really mean in the pockets of those who have an individual health plan, so exclude entrepreneurial ones? Suppose. Maria Fernanda, who lives in the Bacacheri neighborhood of Curitiba, for example, joined a health plan for her family in August 2019. When it reaches its eighth month of the year, it will have an 8.19% reduction in billets.

If he pays R $ 300, the discount will be R $ 24.57, which means the monthly subscription will be R $ 275.43. The savings will amount to R $ 1,368 per year, as only next year will the ANS College Committee set the maximum percentage for adjusting the agreements.

If the anniversaries of the contract are May, June or July, the benefit is included in the following monthly payments. For those who have an agreement signed in the first four months of the year, the discount will not be valid until 2022.

Melissa Kanda, a lawyer specializing in medical and health law, points out that the reduction only applies to contracts with individuals, so if the health plan is work-related, the discount does not apply. “They are negotiating between the company and the operator to adjust the collective plan. Last year, the plans had no cost as people with a pandemic were more at home. We had closed clinics, banned elective surgeries, and many avoided routine checkups. On the other hand, others who fear the disease have ended up with new plans, ”the lawyer said.

Rate in the ticket

When viewing the payment slip, the consumer may have noticed a charge that will last for 12 months. In August 2021, the ANS suspended the use of adjustments due to the economic crisis and pandemic, and in January it was determined that health plans could adjust the values ​​in 2020 in diluted form within 12 months. “These amounts started to be charged retrospectively. The person continues to pay this fee regardless of the 8.19% discount. These are two independent things, ”Melissa emphasized.

Did something go wrong? Demand!

If the consumer has questions or even a complaint, the first step is to contact the ombudsman under a contractual health plan. If the case is not completely resolved, go to the ANS website. “Write down a complaint that ANS will be able to find an operator. They are on top and really fine, ”the lawyer advised.


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