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Under criticism, the portability of health plans are regulated - Part I

This article was translated by an automatic translation system, and was therefore not reviewed by people.

 


Since September 2007, the psychologist Deborah Braga Gasparello feel hostage to your health plan. It was then, when he discovered he had a cancer of the uterus, she went to make periodic checks to verify their health. Few of them, however, were covered by your plan, even met all the grace periods - the period counted from the contract during which the user is unable to use certain services. To change the plan, even within the same operator, the psychologist would have to meet new grace period - which, for it would be risks. "I'm stuck because I can not do the tests that have to do and if I change the plan, I will have to comply with grace, at the risk of cancer returning in another place and I do not have any assistance."
From April, Deborah has more freedom to change operator - and ultimately achieve full coverage of their needs. It is this month will come into force to regulate the needs of portability of health plans, published in the Official Gazette last Thursday. The measure allows the user to change operator without having to plan or meet new needs.

The benefit applies only to individual plans or family hired in 1999 or appropriate to law 9656/1998. The regulation also establishes certain conditions for the user to use the portability: it must be up with the tuition to be at least two years service in the home or three years if you have preexisting diseases, and may change the plan only in the month following the anniversary of the contract, and only for compatible types of plans - ie providing the same kind of coverage, with the same price range and geographic spread.

The regulation was seen as a breakthrough for consumers, since it will give greater freedom of choice and, according to the body that monitors the health plans, the National Agency for Supplementary Health (ANS), will stimulate competition in the sector. "It is a guarantee of better service quality, as companies, facing the possibility of losing customers, to improve their services, and competition tends to agitate," says the lawyer and expert in consumer law Cristiano Schmitt.

Acceptance of needs met by other operators was already a relatively common practice in the market, but it depends on company to company. "There are several operators who buy shortages, but only when the consumer interest to them - ie when he is young and healthy. Nobody buys lack of seniors. There is a difference between practice and regulation of the market, "said the lawyer and advisor to represent the Brazilian Institute of Consumer Defense (Idec), Daniela Trettel.

Critical

It is the constraints of portability, however, that the delay problem of the new regulation, according to the authorities of consumer protection. "There is a difference between a wave and a marola. The portability is sure to cause some unrest in the market, but is nothing near what we expected, "the lawyer believes the Idec.

She notes that the Regulation, be restricted only to individual contracts and after 1999, only reaches about 6 million users, a total population of 40 million beneficiaries of health plans - are 15% of customers in the country. "For the market, does not change much, because 80% of contracts are collective." Daniela also criticized the restriction on the change to only one month in the year, and the need to change plans only between the same price range. "The NSA has a rule very shy. It seems it is only to meet the requirement by the Ministry of Health in the Growth Acceleration Program (CAP). "

For the lawyer of Idec, the NSA is an agency ineffective in protecting consumers. "It is a captured agency. The actions are directed to a part of the relationship of consumption only, and forget the side of the right to health, people who are hiring them. What prevails is a question of economic and financial balance. "But the lawyer Cristiano Schmitt has another view:" Sometimes, the NSA takes some attitudes that seem to be directed to the companies, but the rate of economic contracts is also relevant " says.



Source: Gazeta do Povo

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This article was translated by an automatic translation system, and was therefore not reviewed by people.

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