Exchange of health plan without grace is worth
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Health Minister Jose Gomes Temporão together with the chairman of the National Health Agency (NSA), Fausto Pereira dos Santos, set the rules on the portability of health plans, which come into effect from this Wednesday. The rules were approved on January 15, but the operators had a period of 90 days to prepare strategies and to adapt to new rules that will allow consumers to take the needs already met in his plan to another provider.
Can use the portability of some 7.5 million users of health plans, individual and family hired in 1999 or adapted to the Law 9656/98. To aid the user you want to change operator using the portability of needs, the NSA has developed and is launching the Guide to Health Plans, an electronic system that allows the linking of data for consultation and comparison of more than five thousand individual health plans and family members registered.
Portability will increase competition among plans
José Gomes Temporão The Minister emphasized that the portability of needs was an important decision for the approximation of both the public and private:
- Go forward in the quality of health supplement, which is already in its third edition and give more security to the system as a whole, including advancing the issue of reimbursement of expenses to the Unified Health System
The president of the NSA, the portability will increase competition between plans, because the carriers will improve the quality of care and the composition of networks accredited to retain users. Pereira dos Santos explained that the creation of the Guide to Health Plans aims to reduce the asymmetry of information, creating a set of rules that serve for all:
- We will incorporate the guide information that operators send, so that the user can have all the necessary data to compare the plans. In this first moment is not possible to compare networks accredited, but the few we have all the information.
To change the plan, the user must be at least two years in terms of origin, or three years in cases of temporary partial coverage (CPT), when you discover that you have a preexisting disease when it is in a plan. Moreover, the consumer must be up with their monthly therefore the Normative Resolution 186, must be submitted the last three pay slips. The health plan has chosen to be compatible with the price of the home, the range of prices could be equal to or below the plane of origin. And the plan must be chosen with the record in active state, ie can not be registered in the "active marketing with suspended" or canceled.
Pereira dos Santos said that portability will also to collective plans until next year. He added that operators can not be chosen to receive the users willing to migrate if they meet all requirements of the new rules:
- If the person complies with the rules, there can be no obstacle. There is no age limit for the exchange. If there is failure, the operator may be fined at R $ 50 thousand for each problem. Consumers should report the abuse by 0800 701 9656.
While recognizing as a victory for consumers, consumer protection bodies suggest reservations concerning, especially, the restrictive character of the new rules. According to the lawyer Maíra Idec Feltrin, the portability of health plans is a step forward, but needs to be improved:
- We estimate that only 15% of contracts will be included. Therefore, our main criticism is related to the small scope defined by the NSA. We hope that soon the plans to include collective as well as the old contracts. Furthermore, we believe that the rules may cause confusion for consumers. People must be very careful and read every detail carefully to achieve benefit.
Entities criticize restrictions and advise much attention
The coordinating institution of the Brazilian Association of Consumer Protection (protest), Maria Inês Dolci, agrees with the issues raised by the expert Idec. Maria Inês says that in the portability of health plans is an old fight, but says that the way is being made in the benefit becomes challenging for the consumer:
- There are many restrictions. It is important that people stay alert to the needs for two years to change operator, and three in the case of temporary partial coverage. First, you need to know if the person meets the requirements imposed by the NSA.
Then, before any change, the consumer must take all the doubts about the plan you want to hire.
According to both experts, it is important to check each contract information. According Maíra Feltrin, consumers can prevent a number of ways before choosing the plan:
- You should check if the company is registered with the NSA and has a procedure or technical direction of tax against it. It is important to ask for references to other users and if the truth of all that is offered. The consumer should ask everything in writing and also store advertising flyers for example - aa lawyer says, explaining that the health plans occupy first place in the ranking of claims of Idec years.
For Maria Ines, is essential to compare the plans and not be lead only by prices or promotions:
- Consumers should check the best in their needs. It must be very careful about the promises of brokers, which may not appear in contracts. Find general information on the economic condition of the company in the NSA is also important. And if there are, you can seek recourse to the NSA or bodies for consumer protection.
Source: O Globo Online
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Important:
The JurisWay site does not interfere in the work provided by doctrine, why only reflect the opinions, ideas and concepts of their authors.
