ANS agrees 15.5% increase in individual health plans: Understanding how adjustment works | Economie

When will my plan be returned?

The amendment will apply to plans that have anniversaries from May 2022 to April 2023And the

Will all plans be modified?

The amendment is valid for medical hospital plans that have been contracted as of January 1999 or that have been adapted to new legislation (Law No. 9656/98).

What goes into the adjustment account?

The annual adjustment is calculated based on changes in expenditures with services to beneficiaries, the intensity of use of plans by customers and inflation measured by the consumer price index (IPCA).

Individual plans versus group plans

Individual health plans are in the minority in the market and supply is decreasing. In March of this year, there were 49.1 million beneficiaries of health care plans in the country, compared to 47.6 million in February 2021. The number of individual plan customers is about 8 million, or 16.3% of the total.

In collective plans, readjustments are already taking place, because they do not depend on permission from ANS. In 2021, the average adjustment was 5.55% for contracts with 30 lives or more, and 9.84% for contracts with a lifespan of up to 29 people, according to a survey. ANS With data up to May last year.

Group plans are usually sold at a lower monthly fee. However, Idec cautions that moving from an individual plan to a group plan may not be beneficial over the years.

“A group plan has less protection than an individual plan: one is the ceiling that results in fewer modifications, and the other is protection against unpaid cancellation. In the individual plan, the operator can only cancel in case of fraud or non-payment,” highlights the institute coordinator.

The ANS He maintains a directory on his website, where consumers can search all health plans sold in the state.

The ANS The following channels are provided for complaints about violations and service difficulties:

• communicate ANS: 0800701 9656
• call us: www.gov.br/ans
• Hearing impaired service center: 0800 021 2105