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With the possibility of paying up to twice the monthly payment consumers of jointly owned and deductible health plans end up delaying care by their own health and avoid using the plan to stop paying. ] The warning comes from the Procon-SP supervisor, Maria Feitosa, for whom this type of contract does not guarantee that the services are fully offered by the health operators.
– Collection of franchise and co-participation implies that the consumer must (19659002) The new rules of co-participation and franchise, defined by ANS (National Agency of Supplementary Health) in Brazil, in order to be able to pay for it. June, allow health care providers to cover up to 40% for each procedure users of this type of contract – that it is a matter of individual or collective plan.
This rule would come into force in December, but was temporarily suspended Monday (16)
In an injunction, the Minister responded to arguments of the Council of the Brazilian Bar, for which the resolution of the law ANS threatens the right to be heard by the Brazilian Bar By decision of Minister Cármen Lúcia, President of the Supreme Court. health, guaranteed by the Federal Constitution. In the interim evaluation, Carmen Lúcia also understood that ANS does not have the power to publish the rules, rights and duties of users of the health plan, which would be a prerogative of the Congress or of the Presidency of the Republic.
For Feitosa, Procon-SP "When a consumer is hiring a health plan, he wants to make sure that, when he needs it, he will have all the help he needs. But with the rules of co-participation and franchise, she says, the consumer can maintain "a behavior that goes against the argument of health prevention".
– If I can not pay, or I will not go to the doctor I go to the doctor when I can not wait, or I'm looking for a unified health system, he can use the plan, but we often know that the consumer pays the plan with a tight budget, and if that happens
In an interview with R7 earlier this month, Marcos Novais, chief economist at Abramge (Brazilian Association health plans), said that "the main purpose of the plans with joint ownership and franchise is that the recipient adheres to the plan." He also stated that there was a "high demand in the market" for plans with co-participation and that it is not recommended for those who have a "variable income" at the end of the month, but for those who have a fixed salary. consumers who only contract with these collection models that they have a "financial reserve", so as not to be surprised when the monthly payment arrives.
Before the ANS resolution, there was no rule on the collection limit.
It should be noted that the standards being discussed in the Supreme Court affect only future health plans that will be offered with co-participation and frankness. For those who already have a contract with these two terms, the rules do not change. For the other users, there is also no change in the collection model
"The legal care of the health is an object of law, that is to say a Rule of due process, with a wide debate in society, favored by the public process and ample debate, allows not to become commoditized what the present constitutional system welcomes as a fundamental and essential right in the world. existence of dignity "
Minister Carmen Lúcia, president of STF [19659015] In a note sent on Monday to the report, Abramge affirms that" the decision of the STF will be better badyzed and that the decisions of the Justice will have to be respected. "
ANS recalls that the standard has not yet come into force, that the text has been edited in accordance with the legislation and the AGU (Attorney General's Office) has badessed the resolution previously without report illegality or unconstitutionality.
"The National Health Supplementary Agency (ANS) informs that it has been informed of the decision of the Federal Supreme Court (STF) to suspend the Normative Resolution No. 433, which regulates the rules of co-participation and ANS adds that the above-mentioned standard is not in force and stresses that the decision was pronounced without ANS having been previously heard.
The L & # 39; ANS also recalls that she published the standard strictly respecting the rite for the publication of a normative administrative act, especially with regard to the possibility of participation of society.
The Agency reaffirms its commitment to the strict observation of the general interest, in particular with regard to the protection of human rights and fundamental freedoms, the defense of beneficiaries of health plans. . "
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