February 1, 2023
Health plan: How to change health insurance without meeting the grace period - Economy

Health plan: How to change health insurance without meeting the grace period – Economy

a Portability of health plans It may be an alternative for families to be able to reduce their monthly costs, especially with a readjustment rate of 150%, according to Procon-SP.

Replacing one plan with another is a right of the citizens who begin to use the benefit.

to make plan portabilityHowever, it is necessary to be aware of the requirements, rules and possibilities specified in the legislation, especially those of the ANS (National Agency for Complementary Health).

To forward a change request, it is necessary to pay attention to these five main points:

• The plan must have been contracted from 1999 or adapted to the Health Plan Act (Act No. 9656 of 1998);
• must be active, i.e. not deactivated;
• Payment must also be up to date;
• Have at least two years of contract with a health plan prior to the first transfer. If you cover temporary partial coverage for a pre-existing injury, the requirement is three years from the original plan; And
• If the user wants to implement a new portability, the required period is at least one year. However, if the health insurance you immigrated to has new coverage, the minimum time increases to two years.

How to make portability?

Below, check the documents and deadlines and make a file Portability of health plans:

documents

The plans require a set of documents to forward portability, such as proof of the last three monthly fees or a statement from the normal mode operator and a proposal for a signed adhesion.

Another required document is the compliance report of Origin and destination plans, issued by ANS and operators. If the plan is group, the person will be required to provide evidence that they qualify for inclusion.

The deadlines

The operator has up to ten days to analyze the portability request. If the answer is not provided within this period, the transfer procedure will be considered valid.

The beneficiary has up to five days to request the cancellation of the previous plan. If the individual does not do so, he will be subject to the satisfaction of needs.

change of plans

Portability is performed at the operator or responsible for the destination safety plan. The person must contact the company and request a plan change, as well as canceling the old plan with the previous operator.

Vulnerability can be implemented – the possibility for an individual to make the change without having to fulfill the period during which he pays for the service but cannot use it.

If you wish to make portability for a plan with new coverage that was not provided in the previous plan, you will be subject to grace periods.

According to the ANS Deficiency Transfer Handbook – Check out the document hereGrace periods are 24 hours for emergencies or emergencies, six months for hospital, outpatient and dental coverage and 300 days for deliveries.

Where can I find information about operators?

ANS created file Health Insurance Guide This allows consultation on alternatives to changing medical insurance. The system collects information about plans and portability without any shortage.

Interested parties need to create a record in Gov.br to access the system. Lists the person’s active and inactive plans.

case or The plan is not listed, it is possible to do the transfer with its information (such as the contract number, for example).

The person must complete a form and provide the required information:

• Type of plan (individual, group).
• Scope (national, municipal or groups of municipalities);
• Attend co-pay (Pay for Actions).
• The scheme of the destination, state and city in which its headquarters is located.
• Genre (with registration number). And
• The minimum and maximum monthly fees that a person can pay.

The form allows the user to compare other plans with the original plan.

The system also provides information about each agreement to facilitate decision-making on portability.

Another tip is to reach for primer portability From the ANS, which explains the whole process on health plans, such as coverage types, scope, concepts, prices, requirements, deadlines, and requirements for specific sectors (eg children).

The company’s exit from the market

in the case of a A company that is no longer operating in the market by a court decision or liquidation, ANS opens a 60-day period, extendable for the same period, so that people who have a plan with this operator can make their own portability for grace periods.

In this case, the minimum time requirements in the original plan or price ranges do not apply.

But rules such as grace period for new coverage, not in the previous plan, apply.

The health plan denies bariatric surgery, and the user loses 41 kg without surgery