Saturday , May 21 2022

How to Save on Health Day Plans


With the uncertainty of the public health system, people – who can afford to spend a little money each month – have no alternative to health care other than getting a medical contract. Contributions range from R $ 103 (Amil), R $ 134 (Golden Cross), R $ 161 (thus), R $ 173 (Bradesco) and R $ 208 (SulAmérica), according to a study done by DAY, It is important to note that these values ​​refer to collective membership or corporate plans.

There are so many advertisements and offers on the internet and on the streets that the consumer is ultimately dizzy and does not know which one to choose. To give this naughty little hand, we made a "catch" on health plans so the reader would know what he was renting and broke the prices with traditional operators: Bradesco, Assim, Amil, Golden Cross and SulAmérica.

What are the types of plans a user can rent? Nowadays, there are individual or family plans that can be shared or deducted; membership groups – created by cooperatives -; and the corporate teams that are the hiring companies. Although consumer protection agencies recommend that individual health insurance be rented, collective and corporate insurance are generally more affordable.

Economist Andre Louise de Sousa, 52, so to speak. According to a study, the health insurance of parents, Alamir and Arlette, seniors, pays 28% less to pay the agreement. "I currently administer my elderly parents' health insurance. My father is 76 years old and my mother is 73. By negligence, they did not make the migration, avoiding the exemption from age adjustment, so it was very expensive to maintain. "But three years ago I changed the plan from individual to group. This transition made a lot of difference in my pocket. I paid $ 5,000 for both of them before. Today I paid $ 3600 R," says Andre Louise.

The Bradesco Saúde Rio plan focuses on small and medium-sized enterprises (SMEs) and it is possible to conclude a $ 173.11 Bradesco plan with 20% participation.

According to Bradesco Saúde, the plan offers a hospital referral network in partnership with the D & Or Group and restores consultations and procedures throughout the national territory, including in the event of an emergency and emergency.

Joint participation and franchising

In any type of plan available, it is possible to conclude a joint venture or franchise agreement. In general, monthly fees are even cheaper, but you should carefully evaluate the contract because it can be cheap.

In the case of a joint participation plan, the operator charges the client a portion of the amount spent on each procedure. There is currently no fee, but companies often charge about 30% of the proceeds.

ANS policy states that the operator may charge a maximum of 40% for a procedure. The total amount that can be billed per month cannot be higher than the monthly fee. Also, the maximum limit a customer can pay each year is the value of the 12 monthly payments.

Plan values
At Bradesco Saúde Rio in a modality with 20% co-participation in the ward, the beneficiary can find plans starting at $ 313.08, from 29 to 33 years. From 39 to 43, this value reaches $ 367.62, and from 49 to 53 years, to $ 526.46. This plan is exclusive to the people of Rio de Janeiro and 12 other municipalities in the metropolitan region, with Belford Roxo, Duke de Caxias, Guapimirim, Yaperi, Maghe, Mosque, Nypolis, Niteroi, Nova Iguazu, Keimados, Sao Gonzalo and Sao João. Merity.

Amil offers $ 103.20 in Rio de Janeiro Health Plans, an Amil Fácil product price, for small to medium-sized businesses with 30 to 99 lives, up to 18 years, with regional coverage and no co-participation.
For those in the 24- to 28-year-old age group, the value of the plan is $ 161.25, $ 39-43, $ 204.88, and for 59 or more, the value is $ 616.24.

In hospital mode for Essential 100 companies, the plan for people ages 0 to 18 reaches $ 134.46; from 39 to 43 for R $ 241,18 and from 49 to 53, R $ 490,29.

In Asim Saud, it is possible to find values ​​ranging from R $ 161.34 (0 to 18), in the classic mode, to R $ 422.62, from 39 to 43 years. With the Ideal 330, the main track starts at $ 202, 96 (0 to 18) and goes to $ 808.50 (54 to 58). In Superior and Exclusive ranges from 0 to 18 are R $ 243.53 and R $ 324.71 respectively. Those 54 to 58 are $ 970.19 and $ 1,293.59.

The exact plan, laser modality, from the operator leaves R8 208.09 for those 0 to 18 years, R $ 322.54 from 24 to 28 years. For those who are 39 to 43 it goes to $ 444.37 and from 49 to 53, $ 622.57.

See the terms of the agreements

The main advantage of an individual plan is that this type of contract is regulated by ANS. This means that it is the agency that sets the upper limit for the monthly adjustment. For those with contracts from May 2019 to April 2020, for example, the maximum adjustment will be 7.3%.

Another benefit of this plan is that healthcare providers cannot breach an individual plan contract, even if the plan harms the company: the commitment is vague. The downside is the pockets: they are more expensive than collective plans.

Collective plans are generally cheaper than individual plans, which has attracted the attention of consumers and made them the most agreed on the market – out of 47.3 million plans in the country, 38 million are collective. Its main advantage is the lower price.

In the case of such plans, the negotiation is carried out by an association or union, for example, through an intermediary company that manages the benefit. Therefore, who negotiates the plan is the administrator directly with the healthcare provider. This year, the adjustments applied range from 15% to 19%.

In corporate teams, hiring is done by the hiring company, not by the plan user. The advantage is that depending on the size of the company, the trading margin is higher and good discounts or smaller adjustments are possible.

As with adhesion plans, the advantages and disadvantages are the same: starting prices are lower, but there are no restrictions on adjustments.

Collective and adhesion plans adjusted 20%

The increase in corporate and membership plans reaches 20%, nearly tripling the correction announced last year on July 23 at the National Agency for Supplemental Health (ANS) for individual plans, from 7.35% – below 10% fixed in 2018.

Collective plans represent 80% of the Brazilian supplementary healthcare market of 47.18 million beneficiaries and do not have ANS-regulated adjustment as individual. The annual increase follows free trade.

Qualicorp's customers, which manages the plans for 2.4 million beneficiaries of major carriers such as Amil and Bradesco, received 19.98% correction slips this month. The index is well above the IPCA, the country's official inflation, which closed 2018 at 3.75%.

From 2012 to 2018, the accumulation of adjustments by operators in collective plans reached 111.72%, while those accumulated under individual plans reached 77.29%.

"Until there is greater scrutiny or other enforcement mechanisms by ANS, abuse of collective plan increases will continue," says Rafael Robo, a lawyer specializing in health law at the office of Wilda Silva.

According to him, the path found by many healthcare users is to question the adjustments. With the withdrawal of individual plans from the market, collective plans jumped from 7.5 million beneficiaries in 2000 to 31.6 million in May this year.

Noting, ANS states that it regulates both individual / family and collective plans, including the annual adjustment. Noting, Qualicorp informs that the responsibility for determining and applying the annual correction rests solely with the operators. "As a compensation plan manager, the company strives to negotiate minor consumer adjustments."

Collaboration with intern Larisa Esposito

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