Clipping of news on Brazilian Culture, Law and Citizenship
02/19/2014
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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Portability is the ability to exchange health plan within the same operator or different ones. Depending on the time of hiring of the plan , consumers need to use different procedures for making changes to the contract. The recipient must also meet certain prerequisites , which vary according to the type of portability . Check out the tips of Protest - Consumers Association to change plans without headaches .
1 - Normal Portability
Occurs when the consumer decides , on its own, which will change the health plan , with this new plan from the same carrier or another, considering the same segmentation .
2 - Special Portability
This kind of portability can occur in three distinct situations : Registration canceled by the operator ANS , for dependent who lost its link with the plan or ex - employee dismissed without just cause or retired .
3 - Requirements to normal portability
So that consumers can switch health plans, it must meet six requirements simultaneously :
1. Owning individual / family plan purchased after 1/1/1999 or adapted to Law 9.656/98 ;
2 . Being with payment to date with current health plan ;
3 . Being in the source plane for at least two years , or at least three years , assuming the recipient has fulfilled Temporary Partial Coverage ( CPT ) ;
4 . The plan target must be compatible with the current plan , according to the criteria in the Guide ANS ;
5 . The price range of the target plan must be equal to or lower than the current plan ;
6 . The plan of destination must be active, not just power your registry in "active marketing with suspended " or " canceled " status .
Stay tuned because in family health plan contracts , just one part of the plan , or even the whole family group , you can opt for exchange.
4 - Requirements to make special portability
As the special portability occurs in exceptional situations , the rules to make mobility are somewhat different . They are:
1. In case of an administrative proceeding or cancellation of registration of operator , in case of death of the plan holder or loss payee, or condition in the case of health plan after termination and / or retirement ;
2 . Keep up with the monthly health plan origin;
3 . Select a plan to target compatible with your current plan ;
4 . Choose a plan with target price range of the target equal to or lower than that in the plan that fits the source plane;
5 . Not be considered as the target plane with suspended marketing plans .
5 - Former Plans
In the case of the old plans , hired prior to 1/1/1999 , the consumer can perform in most cases only the migration or contractual adjustment .
Check out the types of contractual changes :
Migration : Is the conclusion of a new contract with the same provider. Lack of compliance may not be required again , as long as the new plan is compatible with the pre-migration ( eg hospital plan for hospital plan) plan.
Adaptation : Occurs when there is a change from the old contract , with the objective of increasing the minimum mandatory coverage of ANS , keeping those that were already contained in the same type of contract and segmentation , and provided they do not contradict the current legislation on health plans . Furthermore , there can be no new count of deficiencies.
However, in some cases of the former planes and also for new contracts , it is possible to realize the portability.
Source : The Globe - Online
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This article was translated by an automatic translation system, and was therefore not reviewed by people.