Health plans: They have an age that allows for a cumulative increase of 6 million clients; understand – Health

About 6 million customers Health insurance They are in the age group that Brazilian law allows to increase the monthly fee by age, in addition to the annual readjustment of value. The estimate comes from a research team led by Associate Professor Lígia Bahia Federal University of Rio de Janeiro (UFRJ). In total, the country has 41.9 million beneficiaries of health insurance. Not everyone, however, will experience this cumulative increase: part of the business plan contracts, for example, do not anticipate this type of price increase.

Calculation based on data National Agency for Complementary Health (ANS) He is a native Brazilian Institute of Geography and Statistics (IBGE), takes into account all types of plans: individual, corporate, collective by membership, among others. Last week, the ANS allowed a 15.5% readjustment limit on individual or family contracts, which account for one-fifth of the sector.

The agency only defines the value of individual or family readjustment plans. And there are no limits to readjustment in corporate collective plans or collective membership plans. The value of the increase in these cases is negotiated between companies and healthcare providers.

Companies in the sector also plan to relocate from one of the 10 pre-established age groups to the next. This increase in age can also be made at the age of 59; from then on, only annual adjustments are allowed. The rule also states that the last period (59 years or older) cannot be readjusted six times longer than the first (0 to 18 years).

According to Mario Scheffer, Professor of the Faculty of Medicine University of Sao Paulo (USP), the redistribution of values ​​for each age group is done with “relative flexibility”, which allows operators to decide for themselves which groups receive greater or lesser readjustment. “Usually, the highest values ​​are for higher intervals,” says the author of the blog Política & Saúde. Stay.

According to a blog post, adjustments to individual health plans can be more than 40%, depending on the age group of clients and the average value of health insurance. “The plans do not take care of the elderly on their shoulders,” said Ligia. “People pay for the plan for life, and when they turn 59 and over, they can’t afford the costs,” Scheffer added.

THE Brazilian Association of Health Plans (hug) states that most collective bargaining agreements do not provide for a readjustment by this parameter. And for Marcos Louvais, the organization’s executive, the 15.5% increase comes after a “negative” correction in the previous period, and the real value would be 6% in two years. “In the Brazilian economic landscape, we would say that the plan has one of the smallest readjustments in history. When we discount the claims, the remaining 14% is barely enough to pay taxes,” he argued.

Asked about the possibility of an increase of more than 40% National Federation of Complementary Health (FenaSaúde) states that readjustment is essential to recompose cost variation. And he says data on last year’s group plans show that rates well above average are “the exception, not the rule”. According to the entity, readjustments for these modalities accounted for 9.84% for 29 life-long plans; and 5.55% for those with 30 or more lives.

FenaSaúd also highlighted a 24% increase in spending in 2021. But the previous year saw a record decline in pandemic procedures.

The ANS says that “rapidly evolving factors” such as increased life expectancy are “urgent issues”. In this scenario, he says, the restructuring due to the change in the age group, provided for in the sector law, is justified. “The formation of age groups aims to spread the risk to a larger mass of users by offering a more balanced price to all beneficiaries.”

The minister and Bolsonaro criticize the rise

As announced by the ANS, the Minister of Health, Marcelo Queiroga, stated on social media. He believes that changes are needed in the sector, “such as greater transparency, greater efficiency and increased competition”. He added that “the increase in monthly fees paid by Brazilians who take out health insurance does not necessarily have to do with the quality of the service provided.”

already president Jair Bolsonarothe re-election candidate said in an interview this week TV network, not a “fair” upload. “Increase the health plan by 15%? I had to say a bad word here and I won’t,” he said.

Leave a Comment