July 25, 2024

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How do you make portability to another health plan?

How do you make portability to another health plan?

Prevent Senior is being investigated by a healthcare provider CPI to Covidand the National Agency for Complementary Health (ANS) responsible for regulating the sector, Appointing a technical director to follow up on the work From the company. The manager assesses whether there are risks and quality problems for patients. Customers interested in the service can implement the possibility of transferring to other health plans. The company was consulted by UOL to comment on the customer’s eventual departure, but did not respond until this text was published. See the procedure below.

As with cell phone plans, it is possible to change the company responsible for the health plan without losing the grace period that was previously fulfilled. The possibility of transferring a health plan can be requested every two years. It is important to remember that this exchange is not necessarily related to whistleblowing, as in the case of Prevent Senior.

The only requirement is that you have a contract that was signed after 1999 or that was amended to the Health Insurance Act (in 1998). Contracts concluded before this period do not have this right.

According to Francisco Gomez Jr., health law specialist and partner at OGF Advogados, there is a list of requirements to consider, such as:

  • You have a valid contract
  • Being updated with payments
  • You have met the minimum stay in the plan, which is two years if this is your first plan change, or three years if you meet temporary partial coverage, i.e. if you have already requested transferability before

After requesting portability, the new operator has 10 days to analyze the offer. If the operator does not respond, the proposal is automatically considered accepted. From now on, the user has five days to cancel the previous plan, says Gomez Jr.

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Portability is simple, rights must be preserved

The procedure is simple, says Alexander Rico, an attorney who specializes in consumer law, but he remembers that the user still had to pay a proportional amount until the day he canceled the old plan, and he would also pay what he started using from the accepted proposal. The user pays the proportional amounts for the two accounts (closed and new).

Gomes Júnior, who is also president of the Association for the Defense of Personal Data and Consumers (ADDP), says he doesn’t think users who want to leave Prevent Senior would face major difficulties, even with the ANS’s intervention.

“The agency must be very careful in its intervention, so as not to harm the services for users. As far as we know, the operator has a strong financial position. In other words, even if it suffers some penalties, it is able to bear these costs. For users., it is recommended to follow the progress of ANS investigations without panic, since the rights of users must be preserved,” he says.

ANS has values ​​for health plans

a ANS has a portal where the value of health plans can be consulted For your city, which serves your area. It is necessary to have a record in the gov.br system (also used for other services), and then follow the steps to filter plans.

See portability questions:

How to make portability?

It is necessary to enter ANS Guide to Health Plans. In addition to consulting prices, it is also possible to generate a compatibility report, which has a validity period of five days after release.

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This is one of the documents required for portability and has a comparison of rates and services for the current plan and the new plan.

The user must also provide a document proving the minimum length of stay in the current plan. Among the documents are contracts and payment receipts, for example, which also show that there are no late fees.

From there, the user contacts the new operator and says he wants portability. The company has 10 days to review the application. If you do not respond within this period, the portability will be considered expired, and the user has another five days to cancel the old plan. No explanation required for the reason for portability.

Do I have to face the deficiency again?

There will be no need to meet new waiting periods or required temporary partial coverage if it was already covered by your previous health plan.

If the destination plan includes coverage not provided for in the current plan, the user may fulfill a grace period only for such services. In this case, the grace period is limited to 300 days for deliveries and 180 days for other coverage.

Is it necessary to pay any additional value upon completion of the transfer?

Operators cannot charge for portability.

Where do I find prices for health plans that serve my city?

You must access ANS Guide to Health Plans. For access, it is necessary to have a login and password in the gov.br system, which is also used for other access, such as a virtual business card and the FGTS application, for example.

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Once logged in, you can choose the details: city, coverage and price list.

I have a Prevent Senior programme. Does anything change in portability?

No, the process is the same for any health plan, even for Prevent Senior.